This purpose of this dissertation was to examine the attitudes of retirees toward mental illness treatment. Secondary data from the Survey Research Center at the University of North Texas was utilized for this study. The focus was on the influence that gender, income, education, race/ethnicity, personal experience, fear, goodwill, and social control might have had on retirees' attitudes toward mental illness treatment. An n = 225 was selected out of the existing data to serve as the sample population. Binary logistic regression was utilized to analyze the data. Results indicated that the obtained significant findings were consistent with existing literature.

The purpose of this exploratory study was to examine resident, family member and staff perceptions of electronic monitoring and their effect on resident rights. The sample consisted of 53 nursing home residents, 104 staff and 25 family members, in the Dallas Fort Worth metroplex, from a nursing facility in which residents utilize video cameras in their rooms (Nursing Facility 1), two nursing facilities that have video cameras in their common rooms areas (Nursing Facility 2 and 3) and a nursing facility that does not utilize video cameras (Nursing Facility 4). The interview questions and self-administered surveys were in regard to the participant's perceptions of electronic monitoring, perceived risks and benefits of video cameras, awareness of resident rights and consciousness of potential risks to resident rights. Data were analyzed using a mixed methods approach using both ATLAS t.i and SAS. Study findings revealed that residents, family members and staff are aware of the potential benefits of electronic monitoring in nursing facilities. While respondents are hesitant to have electronic monitoring in resident rooms, they are interested in utilizing electronic monitoring in common areas. While residents and staff believe that electronic monitoring compromises resident rights, family members believe resident rights are protected. Different …

The purpose of this study is two-fold: (1) to examine the correlation between frequency of sexual activity and general happiness among older Americans and (2) to examine the correlation between frequency of sexual activity and marital happiness among older married Americans. This study employed quantitative data drawn from the 2004-2008 General Social Surveys. Two samples were used. The first sample included all respondents 65 years of age and older with valid responses for the dependent, independent, and control variables. The second sample was a subset of the first and included only the married respondents. Both bivariate cross-tabulations and binary logistic regression analyses were conducted. As expected, the data support a positive association between sexual activity and general happiness in both the total elder sample and the married elder sample (p < 0.05). Also, as expected, the data support a positive association between frequency of sexual activity and marital happiness in the married elder sample (p < 0.05). Even with the introduction of control variables, frequency of sexual activity was found to be a significant predictor of both general and marital happiness (p < 0.05). This study suggests that sexual activity does indeed contribute the happiness and well-being of older Americans.

This study examined if domestic violence shelters in Texas are responding to the needs of older female victims of intimate partner violence. Data for this study was collected through online questionnaire surveys of 45% of Texas domestic violence shelters. Findings of this study indicated that less than 10% of Texas shelters are providing specialized programming for older victims of IPV. In Texas, the demographic growth of older adults has remained comparable to increased national trends. The state of Texas will face several policy implications and social issues related to an older population that is rapidly growing. This includes, the importance of addressing certain members of an aging population who continue to fall victim to domestic violence. Furthermore, an unchanged resource of safety for victims of IPV is domestic violence shelters. Therefore, this study challenges current domestic violence shelter policies to address this issue of a rapidly growing segment of the Texas population. This study found less than 10% of shelters in Texas, who participated in this study, were providing specialized programming and outreach for older victims. Important practical implications for domestic violence shelter programming in Texas is provided.

The United States of America is a country composed of various ethnicities. This country is considered to be a multi-cultural society. There are various cultural traditions values, norms and superstitious practices within each ethnic group. Attitudes toward end of life care are complex and vary differently across each ethnic group. This study explored factors that explained African Americans' disproportionate use of hospice. Access to hospice care was address, experience with hospice was explored, and recommendations were provided. This study conducted non-experimental research. The design of this exploratory study was quantitative in nature. A survey approach was utilized to collect data that was statistically analyzed. The important concept was African American disproportionate use of hospice. The variable willingness to use was employed to try to explain African Americans' disproportionate use of hospice. The independent variables African Americans who mistrust formal healthcare providers and knowledge about hospice services were operationalized using multiple indicators. The independent variable experience with hospice services did not use a scale. The research findings supported all three study hypotheses. This research results recommend that an important focus of the future be to counsel persons on the availability of hospice as an option for end-of-life care. Well-structured programs of …

The purpose of this dissertation was to understand how genetics, socioeconomic status (SES), and lifestyle factors influence the development of age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy in an adult population in Dallas County. Two hundred fifty-three older adults participated in this study as the sample. Crosstabulation and binary logistic regression were utilized to analyze the data. Results indicated a disparity among participants' test scores, visual health status, and perceptions of their visual impairment and highlighted the fact that many seniors are not educated about age-related retinal disorders. Furthermore, variables reaching statistical significance were consistent with the literature included race/ethnicity, age, having a family history of both AMD and diabetes, frequency of eye exams, and level of education. The results not consistent with the literature as affecting visual health included health insurance, access to health care, body weight, and smoking status. Recommendations for future study included applied research focusing on determining risk factors, raising awareness, educating, and providing early detection of these diseases among low to middle income Caucasian, African American, and Hispanic older adults.

This study assessed falls efficacy and confidence-related changes among participants attending the a Matters of Balance/Volunteer Lay Leader (AMOB/VLL) falls prevention program for older adults, based on their residential location. Data were examined from 431 older Texans enrolled in AMOB/VLL during a two-year period, and assessed at baseline and post-intervention. Results indicate that participants significantly increased falls efficacy, reduced activity interference due to their health, and decreased the number of days limited from usual activity. Regression models show that participants, despite entering the program with lower reported health status, reported greater rates of positive change for falls efficacy and health interference compared with their baseline pre-intervention counterparts. Overall program attendance and attendance at major sessions showed the greatest influence. Findings contribute to the understanding of cognitive restructuring and strengthening variations with falls prevention program outcomes.

Promoting physical activity in older adults is an important part of healthy aging. With an increasing older foreign-born population in the United States, there is limited information on physical activity participation in this group and even less for those experiencing difficulties in physical functioning and chronic illnesses. The primary objective of the study was to determine how physical factors, psychological issues, chronic illnesses, pain symptoms, perceived health status, and number of years living in the U.S. influence physical activity participation in older foreign-born respondents. The secondary objective was to identify the difference of predictors of physical activity participation between older foreign-born and older native-born respondents. The study is based on data collected from the National Health Interview Survey (NHIS) conducted from 2002 to 2009 for adults aged 50 or older. Ordinal logistic regression analysis was used to predict and explain the physical activity participation in older foreign-born respondents. Factors associated with more physical activity participation included a higher level of education, more time living in the U.S., more positively perceived health status, and having at least one chronic illnesses, or pain symptoms. Having more difficulties in physical functioning caused older foreign-born respondents to participate less in physical activity. This study …

Access to healthcare is needed and wanted by people of all ages and especially by those of the older population. The number of people in the 65 years of age and older population is rapidly growing with their needs expected to have a significant impact on the existing healthcare system and healthcare providers. The impact will be critical given the severe shortage of healthcare providers, especially of nurses and the rate of services being more often provided in non-hospital settings. The objectives of the study were to discover the plans of graduating nursing students as they choose their first place of employment, if they have future plans to pursue a nursing advance practice degree, and if they are very happy with their decision to become a nurse. Data for the study were obtained from a questionnaire presented to senior graduating nursing students. The findings were: (a) Most students prefer a hospital setting. (b) Younger students are three times as likely to seek out the hospital, and 1/3 of the students seek out the hospital setting because they were encouraged to become a nurse. (c) About 70% of the students want to work with their friends while 1/3 will seek the …

HIV/AIDS can affect individuals of any age. Efforts to educate those considered to be most at-risk, based on the age at which the most individuals are infected, are ongoing and public. Less work and mainstream education outreach, however, is being directed at an older population, who can be more likely to contract HIV, is more susceptible to the effects of HIV, and more likely to develop AIDS, than younger persons. Guided by the Health Belief Model theory, research was conducted to determine what, if any, relationship existed between age of an individual and the possibility that an HIV test will be sought. Factors of gender, education, ethnicity and marital status were included in analyses. the research indicated that as age increased, likelihood for getting an HIV test decreased. Overall, most individuals had not been tested for HIV. the implications of an aged and aging population with HIV include a need for coordinated service delivery, increased education and outreach.

The transition from hospital to home or alternate care setting is a time of vulnerability for all patients and particularly for our elders. If not handled appropriately there is a risk to our elders for readmission to the hospital environment that may decrease their overall quality of life and further compromise their health status. in addition to the individual risks associated with patient readmissions, there are societal impacts that reach far beyond our current generation of elders 65 and older. This impact may have dire implications for the future fiscal health of the next generation. a review of the current and past literature shows that there are a limited number of resources available for hospitals to use in order to comply with the new Value Based Purchasing initiatives that are being implemented by CMS regarding the reduction in readmission rates. the problem of hospital readmissions is confounded by the many processes that are available for study, from pre-hospitalization conditions and care through hospitalization, discharge, and finally to post discharge processes. While most research and literature reviews have focused on individual disease causes, there is a need to provide hospitals with a resource that outlines the available options and interventions that …

This research study examines the decreased agitation level utilizing nonpharmacological therapeutic interventions in dementia patients, age 65 and older. The study examined the following question: Will a therapeutic art program diminish agitated behaviors in persons diagnosed with dementia, aged 65 and older? In this quasi-experimental research design, the sample consisted of 19 participants in 3 groups, selected using these criteria: must be receiving services from a long term care facility, be diagnosed with dementia, display agitated behaviors, and be age 65 and older. This research measures the reduction of agitated behaviors in demented patients with the use of a therapeutic art program. The therapeutic art group pretest, midtest and posttest means were separated into Factor 1: aggressive behavior, Factor 2: physically nonaggressive behaviors, and Factor 3: verbally aggressive behavior. A multivariate analysis of covariance (ANCOVA) was conducted on the data for Factor 1, Factor 2, and Factor 3. The ANCOVA was not statistically significant for Factor 1. The ANCOVA indicated statistically significant findings when using a one tailed test for Factor 2 and Factor 3. The ANCOVA indicated statistically significant findings using a two tailed test for overall agitation. These findings inform professionals about the efficacy of therapeutic art programs …

The dissertation examined family caregivers’ perceptions of wandering behavior after their loved one has been diagnosed with ADRD (Alzheimer’s disease and related dementias). Semi-structured in-depth face-to-face interviews of a convenience sample of 22 caregivers in the Dallas metropolitan area were conducted. Responses were analyzed using a grounded theory approach. The use of qualitative methods facilitated the study of how caregivers of a loved one with ADRD understood and explained in their own voice the wandering behavior associated with the disease and how their views of the behavior informed the caregiving process. In particular, this research examined why some caregivers tend to recognize wandering behavior as significant early on while the ADRD patient is still living in the home (and community) and modifications can be made to keep him or her there despite the behavior, and why some caregivers do not. Findings indicated that caregivers were concerned about the general safety of their loved one. Precautions were taken within the home for conditions related to frailty, but were much less likely to be taken to address wandering behavior and its negative consequences. Three groups of caregivers emerged: (a) those who primarily reacted to their loved one’s problem behaviors including wandering, and …

This study was exploratory in nature, with the purpose of examining the relationships between working Baby Boomers’ knowledge of retirement health benefits and health costs and actions they have taken to prepare for retirement. An online survey was completed by 209 Baby Boomers who are employed by three city governments in the Dallas-Fort Worth Metroplex. The research showed that health benefits knowledge does not predict retirement preparation but that Baby Boomers who demonstrate higher levels of knowledge-seeking behavior are more likely to undertake retirement preparation, specifically by purchasing an annuity. Among public sector working Baby Boomers, retirement preparation activities are found to be minimal. Age was found to predict knowledge-seeking behavior, in that older vs. younger Baby Boomers are more likely to engage in knowledge-seeking behavior related to retirement preparation. Current knowledge about health benefits does not predict retirement preparation.

The purpose of this exploratory study was to operationalize the responses from a sample of the community dwelling older population from Denton County, Texas on disaster preparedness education given by Denton County Health Department (DCHD) personnel. The goals and objectives were drawn from the Texas Public Health and Medical Emergency Management 5-Year Strategic Plan 2012-2016. It was hypothesized that after the disaster preparedness education was received, then comprehension, retention, and application of the information would increase and the goals set forth by the DCHD would be reached. Thirteen sites were used to educate the 224 participants between August 2011 and April 2012. The data were received using a pre-test survey before the training, a post-test immediately after the training, and a follow-up survey call approximately 30 days later. Using Cronbach's alpha, logistic regression and regression analysis through SAS, the data revealed that all DCHD goals were met by this training method and outcome which include the sample population increasing comprehension, retention, and action on the information learned.

The focus of this research study is glycemic control in the presence of multiple morbidities and polypharmacy in homebound individuals with Type 2 diabetes aged 65 years and older. The research method is a quantitative retrospective cohort study of discharged patients of a nonprofit community-based home health agency from January 1, 2010, to December 31, 2011, using OASIS data. Glycemic control is assessed using the hA1C laboratory test following the recommendation of the American Diabetes Association. The study documents a moderate significant association between glycemic control, polypharmacy and comorbid conditions, indicating that homebound individuals with Type 2 diabetes aged 65 years and older are less likely to have optimal glycemic control in the presence of multiple morbidities and polypharmacy. There continues to be a need for scientific research in this population cohort; and the dose-response association between antidiabetic therapy interventions designed to lower blood glucose levels in the presence of chronic disease and polypharmacy.

The purpose of this study was to identify factors that predict quality of life (QOL) for aging adults and to examine and compare Baby Boomers', Older Adults' and Younger Adults' responses to the 2010 National Health Interview Survey/QOL Functioning and Disability. Significant findings included several significant values based on the multivariate regression to estimate a model to predict QOL. In particular, being male, four ethnicities other than white, being older than Boomer, age in 10 years, the Functional Difficulty Index, the Functional Limitation Index scores, chronic heart disease, asthma, and arthritis all had significant p values. Adults with chronic heart disease, asthma, or arthritis scored lower on the QOL index, but cancer, stroke, or diabetes were not associated with the QOL index. Two hypotheses had strong support. Lower scores on both the Functional Difficulty Index and the Functional Limitation Index yielded lower QOL scores. Further research recommendations include establishing reliability and validity of the QOL index; running additional regressions for demographics (ethnicity, marital status, etc.) to predict possible combinations of variables predicting QOL or barriers to QOL; and investigating the viability of incorporating the QOL index into an electronic medical record (EMR) dashboard parameter to serve as a screening mechanism …

Although institutional care has started to be outmoded in the developed countries with development of different models of care, it still has a considerable place in the developing countries such as Turkey. This is because, changes in the demographic structure, extended family, and urban development of Turkey has brought about several aging problems leading older adults to end up in institutions. Loneliness was one of the significant reasons given in the Social Inquiry Survey of Applicants of Darulaceze Old-Age Institution and the basis for a micro level analysis in this study. Therefore, the main objective of the study was to determine the predictors of loneliness, including age, the state of living alone, functional independence, education, and gender. Analysis of the results indicated that these predictors have significant effects on the loneliness predominantly defined by social factors rather than medical factors. In addition, the meso and macro level analyses were employed to control the micro level analysis and see a general picture of institutional care. Thus, an academic example of diagnosing the main reasons behind the institutional care was presented to understand the context of aging in Turkey.

The purpose of this study was to examine perceptions of Texas Adult Protective Services (APS) case managers (CM) in regard to their relationships with the law enforcement community and area courts. The sample consisted of 138 Texas APS CMs. The survey measured respondents' perceived strengths and weaknesses of their relationships with both the law enforcement community and with area courts. Items also included respondents' interest in receiving additional training and their perceptions of level of job-readiness of newly hired APS CMs. Data were analyzed quantitatively using SAS. Findings of the survey revealed high ratings of perceived teamwork on the part of the CM are associated with high relationship ratings with both area courts and law enforcement. Findings also revealed that high ratings of perceived autonomy on the part of the CM are associated with lower relationship ratings with law enforcement personnel but not with area courts.

This secondary research study uses data from two convenience samples of homeless persons in Central Arkansas collected during 2004 and 2011 Point in Time Counts. The prevalence of predictors of homelessness are compared across years, and also compared by age (<50 and > 50) controlling for year of survey. The number of older adults increased significantly between 2004 and 2011 surveys, and reporting serious mental illness and veteran status significantly decreased from 2004 to 2011. Age differences were noted in 2004 with older adults more likely to report serious mental illness in comparison to younger adults. Older adults were also more likely to report veteran status in comparison to younger adults during both the 2004 and 2011 surveys. The predictors of homelessness -- including serious health problems, substance abuse, race, age, and developmental disabilities-- remained fairly consistent from 2004 to 2011 and across "age groups". In addition to Point in Time data, qualitative surveys and interviews of providers were performed for their observations of the older homeless population. Providers indicated their belief that the older homeless population is increasing. Providers suggested possible challenges and reasons for the increase among older adults who are homeless. In central Arkansas, service providers feel …

The purpose of this study was to investigate patient use and presentation of Internet health information and its effect on patient-health professional relationship from a sample of residents at active adult communities in Texas. Five sites were used to recruit the 260 participants between November 2012 and January 2013. The data were received using a self-administered survey. Using Cronbach’s alpha, logistic regression and regression analysis through SAS, the data revealed that older respondents are less likely to discuss web-based information with health professionals. In addition, logistic regression analysis indicated that four of the variables, IHI Sharing, educational status (bachelor degree), marital status (married), and perceived health status (excellent and very good health) predicted varied of the 20 indicators making up the patient-health professional relationship scale. Further studies are needed to enhance this research.

This study examined how Korean co-ethnic churches serve as connections between Korean seniors and the agencies that offer social and health care services. The study developed from a pilot outreach program funded by the North Central Texas Council of Governments’ Area Agency on Aging (NCTAAA) to inform Korean seniors about Medicare-related programs between February and May of 2011. The results of the pilot program suggested that the Korean-American church can be an effective place for program outreach. The dissertation project, working in partnership with the NCTAAA and 2-1-1 services, further explored the use of Korean churches as a vehicle to connect Korean seniors to Extra Help (EH) and Medicare Saving Programs (MSP) and 2-1-1 services, a toll-free number for information about non-emergency health and social services. Fifty-three pastors were contacted to participate in a telephone survey and a face-to-face, in-depth semi-structured interview. Thirty telephone surveys and 11 face-to-face interviews were conducted. Five of the 30 pastors agreed to host program outreach presentations for the EH, MSP, and 2-1-1 services in their churches. Host churches tended to be more likely highly structured, regularly scheduled programs (e.g., Senior College) for seniors already in place. A total of 405 Korean seniors participated in …

The primary purpose of this study was to examine the correlation between depression and the personal characteristics of Asians who are 50 years or older. The secondary objective was to determine whether Asians 50 years or older living in the United States are more likely to be depressed than other ethnicities. The information for this study was secured from the National Health Interview Survey, spanning the years 2001 to 2010. In this study, I utilized the SAS-Callable SUDAAN statistical system. Multivariate regression was used to predict and determine significant correlations. The results indicated that Asians 50 and older living in the U.S. and who experience functional limitations, poor vision, hypertension, poor health, not married, and unemployed in previous year were in general more prone to depression. Furthermore, the study indicated that Asian elderly living the U.S. showed lower rates of depression than all non- Asian ethnicities. However when controlled for personal characteristics only Whites and Hispanics had higher depression incidences than Asian elderly. Recommendations for future studies include: conducting more micro and macro studies of Asian elders, such as in-depth case studies for each ethnicity, longitudinal studies of various Asian subgroups, and studies of Asian elderly with hypertension who have …

The intent of this qualitative, grounded theory study was to understand why the Nigerian (Igbo) adult immigrants in the United States provide long distance international caregiving to their elderly parents left behind in Nigeria, the challenges they encounter, and their views on long-term service care. This study was grounded in semi-structured interviews of 20 Igbo adult immigrants residing in the Dallas/Fort Worth Metropolis. Analysis of the literature demonstrates a lack of existent topic on long distance international caregiving to elderly parents left behind in Nigeria. Findings show that reasons for Igbo adult children immigrants providing care to their elderly parents left behind stem from filial obligation, immigrant’s position in the family, perceived vulnerability of parents, and lack of government support. Also because of cultural expectations, the participants felt obligated to reciprocate to the care their elderly parents gave to them when they were growing up. While providing long distance international care, the participants encountered some challenges like adjusting to their new country, distance, financial constraints, being available for family procreation, issues with means of communication, and legal papers and parental adjustment to life in the U.S. This study also revealed that the participants would support the Nigerian government and private …