Age-Related Microaggressions: Their Frequency, Emotional Impact, and Relationship to Negative Affect.

Age-related microaggressions are forms of ageist discrimination that occur in day-to-day interactions. This study aimed to validate the findings of a previous study, to identify common age-related microaggressions, and determine how affect influences emotional reactions to microaggressions. Using an online survey, participants (n = 200) were asked about their experience with age-related microaggressions, their affect, and their physical health. Participants were familiar with these microaggressions 53% of the time and had negative reactions to 43% of these microaggressions. The frequency of negative reactions to microaggressions was significantly correlated with scores of negative affect (r = .34, P < .001) and with ratings of perceived physical health (r = -.32, P = .002). The results of the study provide further insight into the topography of, and how older adults experience microaggressions. This information should be used as an educational tool to reduce the prevalence of ageism.

Age-Related Microaggressions: A Descriptive Study.

BACKGROUND AND OBJECTIVES: The aim of this study was to expand the literature on ageism by exploring the phenomenon of age-related microaggressions. RESEARCH DESIGN AND METHODS: Fifty-one participants completed an online survey asking a series of questions about their experiences with microaggressions related to their age. Responses were summarized using a thematic analysis. RESULTS: Participants reported frequently experiencing age-related microaggressions, particularly microinsults. Microaggressions occurred in a variety of settings, often by individuals unfamiliar to the older adult. Although most participants reported having negative emotional reactions to microaggression and believing these acts are intentional, in most cases, perpetrators are not confronted. DISCUSSION AND IMPLICATIONS: Our hope is this descriptive study will serve as a foundational framework for conducting future exploration on age-related microaggressions and their effects on older adults and society at large.

Effect of Neck Botulinum Neurotoxin Injection on Proprioception and Somatosensory-Motor Cortical Processing in Cervical Dystonia.

Background. Cervical dystonia (CD) is a neurological movement disorder characterized by involuntary contractions of the cervical musculature and is known to be associated with proprioceptive dysfunction in dystonic/nondystonic limbs. Objectives. We examined how neck botulinum neurotoxin (BoNT) injection affects wrist proprioception and the corresponding sensorimotor cortical activity in CD. Method. Wrist position sense acuity of the dominant (right) hand was evaluated in 15 CD and 15 control participants. Acuity measures were a psychophysical position sense discrimination threshold (DT; based on passive joint displacement) and joint position matching error (based on active movement). Cortical activity during the motor preparation period of the active joint position matching was examined using electroencephalography. Results. In their symptomatic state, patients demonstrated a significantly higher wrist proprioceptive DT, indicating an abnormal passive wrist position sense. Yet BoNT injections had no significant effect on this threshold. During active joint position matching, errors were significantly larger in patients, but this difference vanished after the administration of BoNT. Motor preparation of active wrist position matching was associated with a significantly higher rise of ß-band (13-30 Hz) power over contralateral somatosensory-motor cortical areas in patients. This excessive cortical activity significantly declined post-BoNT. Conclusion. Wrist proprioceptive perception during passive/active movements is abnormal in CD. An excessive rise of premotor/motor cortical ß-oscillations during motor planning is associated with this proprioceptive dysfunction. Neck BoNT injections normalized the cortical processing of proprioceptive information from nonsymptomatic limbs, indicating that local injections may affect the central mechanisms of proprioceptive function in CD.

The Use of Stimulus Preference Assessments for Persons with Neurocognitive Disorder: A Literature Review.

Objectives: Stimulus preference assessments are a systematic, observation-based approach for identifying preferences among individuals with impaired communication skills. The purpose of this paper is to provide a review of the existing empirical literature that has utilized these methods with persons who have neurocognitive disorder (NCD).Methods: Studies were identified by searching online databases using a variety of search terms. Articles were included in the review if they were peer-reviewed, in English, were empirical in nature, and conducted a stimulus preference assessment with older adults diagnosed with NCD.Results: Eleven articles met the search criteria. Results revealed that data from stimulus preference assessments could increase activity engagement, increase requests for preferred items, identify reinforcers, and reduce behavioral and psychological symptoms.Conclusions: A small body of empirical literature suggests that data derived from stimulus preference assessments can be used to improve the lives of persons with NCD and their caregivers. Additional research is needed, however, to determine how effectively these procedures can be implemented into everyday practice in long-term care facilities.Clinical Implications: Stimulus preference assessments may provide a clinically useful means for efficiently identifying preferences in persons with severe NCD who cannot verbalize their needs.

Effects of Brief Acceptance and Cognitive Reappraisal Interventions on Experiential Avoidance in Socially Anxious Individuals: A Preliminary Investigation.

The current study compared the effects of 15-min acceptance-based and cognitive reappraisal-based interventions on experiential avoidance (EA) in socially anxious college students who participated in an experimental public speaking task. Participants were randomly assigned to receive one of the two interventions designed to aid in preparation for a 5-min laboratory-based public speaking task. Results indicated that participants receiving the acceptance-based intervention reported significantly lower levels of EA at the post-public speaking task measurement time, indicating that this brief acceptance-based intervention yielded the proposed mechanism of action in the sample used for this study. These findings highlight the importance of process-based accounts of cognitive-behavioral psychotherapy and shed light on the importance of developing interventions for alleviating social anxiety.

Developing the Family Involvement Questionnaire-Long-Term Care: A Measure of Familial Involvement in the Lives of Residents at Long-Term Care Facilities.

INTRODUCTION: Existing measures designed to assess family involvement in the lives of older adults residing in long-term care facilities are basic, using visitation frequency as the prominent gauge of involvement in a situation specific fashion. The purpose of this study was to design and validate a measure of family involvement that could be used to gauge more aspects of family involvement than visitation alone and be useful in a variety of settings for both researchers and long-term care facility administrators. METHODS: Long-term facility staff were asked to assist in creating a 40-item questionnaire that used 4-point Likert scales to measure various aspects of family involvement. The finalized Family Involvement Questionnaire-Long-Term Care (FIQ-LTC) was distributed to the family members of older adults residing in long-term care facilities around the country. RESULTS: A total of 410 participants responded. Researchers found that the FIQ-LTC was highly reliable (α = .965). Results also indicated that a significant correlation between distance and overall involvement (r = -.121, p = .015) was no longer significant (r = .17, p = .740) when the effect of a question asking the frequency of visitation was controlled for. DISCUSSION: These results indicate that existing measures that use visitation frequency as the sole measure of involvement are insufficient. The newly developed FIQ-LTC can serve as a more complete measure of family involvement.

Age-Related Decline of Wrist Position Sense and its Relationship to Specific Physical Training.

Perception of limb and body positions is known as proprioception. Sensory feedback, especially from proprioceptive receptors, is essential for motor control. Aging is associated with a decline in position sense at proximal joints, but there is inconclusive evidence of distal joints being equally affected by aging. In addition, there is initial evidence that physical activity attenuates age-related decline in proprioception. Our objectives were, first, to establish wrist proprioceptive acuity in a large group of seniors and compare their perception to young adults, and second, to determine if specific types of training or regular physical activity are associated with preserved wrist proprioception. We recruited community-dwelling seniors (n = 107, mean age, 70 ± 5 years, range, 65-84 years) without cognitive decline (Mini Mental State Examination-brief version ≥13/16) and young adult students (n = 51, mean age, 20 ± 1 years, range, 19-26 years). Participants performed contralateral and ipsilateral wrist position sense matching tasks with a bimanual wrist manipulandum to a 15° flexion reference position. Systematic error or proprioceptive bias was computed as the mean difference between matched and reference position. The respective standard deviation over five trials constituted a measure of random error or proprioceptive precision. Current levels of physical activity and previous sport, musical, or dance training were obtained through a questionnaire. We employed longitudinal mixed effects linear models to calculate the effects of trial number, sex, type of matching task and age on wrist proprioceptive bias and precision. The main results were that relative proprioceptive bias was greater in older when compared to young adults (mean difference: 36% ipsilateral, 88% contralateral, p < 0.01). Proprioceptive precision for contralateral but not for ipsilateral matching was smaller in older than in young adults (mean difference: 38% contralateral, p < 0.01). Longer years of dance training were associated with smaller bias during ipsilateral matching (p < 0.01). Other types of training or physical activity levels did not affect bias or precision. Our findings demonstrate that aging is associated with a decline in proprioceptive bias in distal arm joints, but age does not negatively affect proprioceptive precision. Further, specific types of long-term dance related training may attenuate age-related decline in proprioceptive bias.

Bullying in Senior Living Facilities: Perspectives of Long-Term Care Staff.

Resident-to-resident bullying has attracted attention in the media, but little empirical literature exists related to the topic of senior bullying. The aim of the current study was to better understand resident-to-resident bullying from the perspective of staff who work with older adults. Forty-five long-term care staff members were interviewed regarding their observations of bullying. Results indicate that most staff members have observed bullying. Verbal bullying was the most observed type of bullying, but social bullying was also prevalent. Victims and perpetrators were reported to commonly have cognitive and physical disabilities. More than one half of participants had not received formal training and only 21% reported their facility had a formal policy to address bullying. The implications of these results support the need for detailed policies and training programs for staff to effectively intervene when bullying occurs. [Journal of Gerontological Nursing, 43(7), 34-41.].

Understanding Elderspeak from the Perspective of Certified Nursing Assistants.

Elderspeak is a form of patronizing speech that is often used with older adults. The current study attempted to learn more about the conditions under which elderspeak is used as well as the intent behind using elderspeak. The sample comprised 26 certified nursing assistants (CNAs) working with older adults in long-term care facilities. Data were collected using semistructured interviews. Findings indicated that the intended purposes of elderspeak were to (a) make residents feel more comfortable, (b) make caregivers seem friendlier, (c) help residents better comprehend verbal communication, and (d) increase the likelihood that residents would cooperate during caregiving tasks. In addition, one half of the CNAs reported that elderspeak is more appropriate with individuals with dementia; many also believed that the use of elderspeak was always inappropriate. The current findings may have implications for improving training and education programs for CNAs and other professionals working in long-term care facilities.

Differences in perception of gerotranscendence behaviors between college students and community-dwelling older adults.

Within the field of gerontology, several different theories have attempted to explain common psychological and social changes associated with the aging process. The Theory of Gerotranscendence is one such theory which purports that a shift in meta-perspective from a more materialistic and pragmatic view of the world to a more cosmic and transcendent one occurs as we age. Corresponding with this shift in meta-perspective, the individual exhibits certain behaviors that could be mistaken as signs of psychopathology if viewed based on the assumptions of more culturally-assimilated theories of aging. The purpose of this study was to examine the difference in perception of gerotranscendence behaviors between college students and older adults. Perceptions were quantified using an instrument that described many behaviors indicative of gerotranscendence within the context of a written narrative depicting an older adult living in an assisted living facility. Respondents were then asked to rate these behaviors in terms of how unusual they were and how concerning they were. As hypothesized, results indicated that several behaviors indicative of gerotranscendence were rated as more concerning and unusual by college students compared to older adults. Implications of these findings in terms of interactions between younger and older individuals occurring in the community and within healthcare settings are discussed.

Unexpected Results From a Change in Token Type.

We have noted an unusual phenomenon in our association with an inpatient behavioral health facility located in the midwestern United States. Most consumers treated in this facility exhibit conduct disorders, oppositional defiant disorder or attention deficit disorders. The facility also treats individuals with various anxiety disorders, posttraumatic stress disorder, and autism. Within the facility, we collected data from a unit that monthly serves a population of 38 to 47 children ages 3 to 11 years old.

The role of behavior analysis in the rehabilitation of persons with dementia.

With the rapidly aging population, it is expected that increases in cases of dementia will double over the next 20 years. Currently, there is no cure for diseases such as Alzheimer's disease or frontotemporal dementia (FTD) that cause progressive dementia, and only a few pharmacological interventions that slow the progression of the decline exist. Given that there is no cure available, a rehabilitation approach that emphasizes maintaining existing abilities and removing excess disability (as opposed to emphasizing cure or recovery) for as long as possible is warranted. The current paper proposes that nonpharmacological rehabilitation efforts need to target 5 broad areas/targets: memory enhancement, altering social contingencies and communication styles, improving self-care skills, the arrangement of physical environments to maintain and improve functioning, and increasing physical fitness/physical activity. The purpose of this paper is to review specific behaviorally oriented interventions that target these 5 areas and show promise for inclusion in comprehensive rehabilitation efforts for individuals with dementia.

Command use and compliance in staff communication with elderly residents of long-term care facilities.

Verbal communication between nursing assistants and individuals with dementia can be challenging, particularly during hands-on caregiving tasks. Although there are many aspects of verbal communication that can affect the quality of an interaction, one potentially important communication variable is the types of commands issued by nursing assistants when they need a resident to complete a task. The purpose of this study was to examine the kinds of commands used by nursing care staff when they interact with patients with dementia during activities of daily living. Commands were categorized according to their feasibility/specificity as well as form. An additional goal of this study was to measure compliance and noncompliance rates associated with the various categories of commands. Results indicate that alpha commands (clear, concise, and feasible) account for higher compliance and less noncompliance compared with beta commands (ambiguous, interrupted, and not feasible). In addition, commands that are stated directly, that clarify a previous command, and that are repeated exactly produce better compliance. It is concluded that training nursing staff to change the types of commands they provide during caregiving tasks may reduce distress experienced by both staff and residents.

Psychometric properties of the Pyramids and Palm Trees Test.

The Pyramids and Palm Trees Test (PPT) is a nonverbal measure of semantic memory that has been frequently used in previous aphasia, agnosia, and dementia research. Very little psychometric information regarding the PPT is available. The purpose of this study was to investigate the psychometric properties of the PPT in a population of healthy college students. Results indicated that the PPT achieved poor test-retest reliability, failed to obtain adequate internal consistency, and demonstrated poor convergent validity, but showed acceptable discriminant validity. The results of this study suggest that the PPT lacks acceptable reliability and validity for use with a college student population.

Functional assessment and noncontingent reinforcement in the treatment of disruptive vocalization in elderly dementia patients.

Noncontingent reinforcement (NCR) was used as an intervention with 2 elderly dementia patients who engaged in disruptive vocalization. Several assessment procedures, including functional analysis, were conducted to identify reinforcing stimuli for use in the NCR intervention. Functional analyses and the NCR intervention were implemented in each participant's natural environment. NCR was effective in reducing disruptive vocalizations.