Heather Menne - Academia.edu (original) (raw)
Papers by Heather Menne
Frontiers in public health, Jul 1, 2024
Frontiers in public health, May 1, 2024
Innovation in Aging, Nov 1, 2019
Generations, Feb 28, 2009
Research shows they are able to provide consistent responses to questions about a variety of pref... more Research shows they are able to provide consistent responses to questions about a variety of preferences, even in advanced stages. People with memory loss or dementia are a growing and increasingly visible segment of our national fabric. According to the Family Caregiver Alliance (2000), between 13 million and 15 million adults in the United States are living with chronic conditions that impair cognitive function (e.g., stroke, Alzheimer's disease, Parkinson's disease, traumatic brain injury). The conditions that cause memory loss are now being diagnosed more accurately and earlier in the disease process than has been the case in the past. People experiencing the early signs of memory loss are often very cognizant of their current decline and future deterioration at the same time as those around them experience a change in the person they once knew. Many people with dementia find themselves living for many years with conditions that lead to gradual loss of physical and cognitive functioning and self-identity. A Difficult Balancing Act Maintaining the autonomy of people with dementia is a difficult balancing act for their millions of families and friends, who face many tough decisions. These decisions are often made on behalf of impaired relatives who at some point will become unable to make decisions on their own and vary depending on stage and type of illness. Decisions about everyday care (when to eat, what to wear) are fairly predictable, routine, and must be made daily regardless of type or severity of memory loss. Conversely, decisions about acute care (when to seek medical treatment), decisions motivated by a crisis (such as a fall or the death of a caregiver), and decisions about nursing home placement or end-of-life care are of course less predictable, are more likely to occur later in the disease progression, and may require legal authorization. All these types of decisions are critical to the ongoing autonomy of people with dementia and to their quality of life and that of their caregivers. To ensure that both groups experience optimal health and well-being, it is essential that such decisions reflect and balance the needs and preferences of both members of this highly interdependent care dyad. Without this balance, it is likely that one or both parties will react negatively to the choices available and the decisions made. The assistance provided by caregiving families becomes additionally complicated and stressful when there are misunderstandings between caregiver and recipient about care values, preferences, and options. Often family members believe that the choices they make on behalf of their relatives are in accordance with the relative's preferences. Family members also often believe that their relatives with dementia "don't want to be bothered with making decisions," so the family intervenes sometimes before the impaired individual is ready to let go of decision making. Unlike decision making by others on behalf of the person with dementia, shared decisionmaking provides the opportunity for family members to be more fully informed about their relative's values and preferences concerning decisions to be made later in the disease progression (Kapp, 1992). High (1988) suggests that shared family decision-making, when properly used, can function as an extension of a person's autonomy and self-identity, in that "individual autonomy, fully understood, is interdependent with family autonomy" (p. 50). Effects of Involvement in Decision Making on Quality of Life The extent to which people with dementia prefer to be involved in making decisions about their everyday care varies a great deal, as does the extent to which they are actually involved. Many are capable of and interested in making decisions for themselves about healthcare, living arrangements, social interactions, and daily activities. Others instead indicate that they would prefer that a family member (typically the primary caregiver) make decisions for them, at the present time or later, when they are no longer able (High, 1988; Louis Harris and Associates, 1982; Whitlatch and Feinberg, 2003). …
Activities, Adaptation & Aging, Jul 1, 2012
Objectives: The aims of this study are (1) to describe the types of leisure activities preferred ... more Objectives: The aims of this study are (1) to describe the types of leisure activities preferred by persons with dementia in the past and present, as reported by family members and therapeutic recreation staff members, and (2) to examine the influence of demographic and functional abilities variables on the perceived current interest of persons with dementia. Method: Family members of persons with dementia and therapeutic recreation staff involved in the care of those persons completed an activities preference assessment concerning the persons with dementia. Participants were recruited from a nursing home and a senior day center. Family members completed the assessment for the past and present, and staff members completed the assessment for the present. Results: For present preferences, music was the most often preferred activity according to both family and staff, followed by reminiscence and reading, while the least desirable activity was cooking/ baking according to family and trivia games according to the staff. Current preferences were significantly related to past preferences. Gender was also related to preference for some activities. A significant reduction in preference from the premorbid past to the present was found for music,
Innovation in Aging, Nov 1, 2018
Innovation in Aging, Nov 1, 2018
Title III-C of the Older Americans Act (OAA) authorizes the delivery of nutrition services for ol... more Title III-C of the Older Americans Act (OAA) authorizes the delivery of nutrition services for older adults across the country. The OAA Nutrition Services Program is administered by the Administration on Aging within the Administration for Community Living (ACL), and is designed to promote the general health and well-being of older adults. The key delivery methods of the NSP are in group settings, known as congregate nutrition, and to the homes of older adults who live alone, known as home-delivered nutrition. A growing expectation for quality federal programs is to conduct rigorous evaluation. This session will highlight results of the recent client outcomes evaluation of the NSP. The first paper sets the stage by describing NSP services, participating clients, funding levels, and the rationale for the recent evaluation. The second paper, using data from surveys of over 2,200 participants and matched eligible nonparticipants focuses on the food insecurity of congregate and home-delivered meal participants. The third paper presents data on the diet quality of older adults using data on daily nutrient intakes as well as Healthy Eating Index (HEI)-2010 scores. The final paper evaluates the effect of the NSP on participants' healthcare utilization using survey data and Medicare enrollment and claims data for program participants and matched nonparticipants. To close the session, an expert in federal policy related to nutrition services programs will lead discussion about next steps for researchers, practitioners, and policy makers in light of the evaluation results.
Journal of Gerontological Social Work, Jun 24, 2014
There have been few replications of efficacious evidence-based programs for dementia caregivers o... more There have been few replications of efficacious evidence-based programs for dementia caregivers offered in community settings. This study highlights the replication of the evidence-based Reducing Disability in Alzheimer's Disease program and explores the changes in outcomes for participating caregivers and whether those changes are related to level of program utilization. With data from 219 caregivers, regression results indicate that more exercise sessions are associated with a decrease in caregiver strain and more behavior management sessions are associated with a decrease in unmet needs after 3 months. Findings demonstrate how a multicomponent program can have positive benefits for family caregivers.
The Journals of Gerontology: Series B, Apr 8, 2020
ObjectivesHome- and community-based services (HCBS) help older adults remain living safely in the... more ObjectivesHome- and community-based services (HCBS) help older adults remain living safely in their homes by delaying or preventing the need for institutionalization. This analysis is guided by the Andersen Behavioral Model of Health Services Use to examine the association between informal support and use of HCBS.MethodHealth and Retirement Study data from 2011 and 2012 are used in the bivariate analyses and multivariate logistic regression models to examine differences in HCBS utilization among extremely vulnerable older adults who have informal caregivers and those who do not.ResultsFor extremely vulnerable older adults who report difficulties with any instrumental or basic activities of daily living, use of HCBS is not strongly associated with access to informal caregivers. However, for this same population of extremely vulnerable older adults, those who live alone have roughly 3 times the odds of using any HCBS compared to those who do not live alone.DiscussionAmong already vulnerable older adults, this study revealed that living alone is an important enabling factor of the Andersen Behavioral Model as applied in HCBS research. Further investigation is needed to see if more resources should be allocated to senior centers and local providers to identify vulnerable older adults who live alone and may have unmet needs.
Purpose: This research applies a stress and support conceptual model to investigate the effects o... more Purpose: This research applies a stress and support conceptual model to investigate the effects of back-ground characteristics, personal and job-related stres-sors, and workplace support on direct care workers’ (DCW) job satisfaction. Design and Methods: Re-searchers collected survey data from 644 DCWs in 49 long-term care (LTC) organizations. The DCWs included nurse assistants in nursing homes, resident assistants in assisted living facilities, and home care aides in home health agencies. We examined the influence of components of the LTC stress and support model on DCW job satisfaction. Initially, we ran a multiple regression analysis by entering individual-level DCW predictors with job satisfaction as the outcome. Subsequently, we used hierarchical
Innovation in Aging, 2018
While cognitive health is a key determinant of independent living and quality of life in later li... more While cognitive health is a key determinant of independent living and quality of life in later life, higher prevalence of cognitive impairment among lesbian, gay, bisexual and transgender (LGBT) older adults is a major concern. Utilizing three time-point survey data (N=2,450) from the first longitudinal study of LGBT older adults and applying multilevel mixed models, this study examined the associations of the intersectionality of sexual orientation and race/ethnicity and social engagement through interpersonal relationships and community involvement with cognitive impairment after controlling for depressive symptomatology. Hispanic LGBT older adults and the intersection of sexual orientation and race/ethnicity discrimination were associated with higher cognitive impairment. Social participation and social support regardless of race/ethnicity were negatively associated with cognitive impairment. The overall findings demonstrate racial/ethnic differences in cognitive impairment among LGBT older adults and highlight the critical importance of enhancing opportunities for social engagement to promote cognitive health.
Innovation in Aging, 2018
While cognitive health is a key determinant of independent living and quality of life in later li... more While cognitive health is a key determinant of independent living and quality of life in later life, higher prevalence of cognitive impairment among lesbian, gay, bisexual and transgender (LGBT) older adults is a major concern. Utilizing three time-point survey data (N=2,450) from the first longitudinal study of LGBT older adults and applying multilevel mixed models, this study examined the associations of the intersectionality of sexual orientation and race/ethnicity and social engagement through interpersonal relationships and community involvement with cognitive impairment after controlling for depressive symptomatology. Hispanic LGBT older adults and the intersection of sexual orientation and race/ethnicity discrimination were associated with higher cognitive impairment. Social participation and social support regardless of race/ethnicity were negatively associated with cognitive impairment. The overall findings demonstrate racial/ethnic differences in cognitive impairment among LGBT older adults and highlight the critical importance of enhancing opportunities for social engagement to promote cognitive health.
Innovation in Aging, 2018
Title III-C of the Older Americans Act (OAA) authorizes the delivery of nutrition services for ol... more Title III-C of the Older Americans Act (OAA) authorizes the delivery of nutrition services for older adults across the country. The OAA Nutrition Services Program is administered by the Administration on Aging within the Administration for Community Living (ACL), and is designed to promote the general health and well-being of older adults. The key delivery methods of the NSP are in group settings, known as congregate nutrition, and to the homes of older adults who live alone, known as home-delivered nutrition. A growing expectation for quality federal programs is to conduct rigorous evaluation. This session will highlight results of the recent client outcomes evaluation of the NSP. The first paper sets the stage by describing NSP services, participating clients, funding levels, and the rationale for the recent evaluation. The second paper, using data from surveys of over 2,200 participants and matched eligible nonparticipants focuses on the food insecurity of congregate and home-delivered meal participants. The third paper presents data on the diet quality of older adults using data on daily nutrient intakes as well as Healthy Eating Index (HEI)-2010 scores. The final paper evaluates the effect of the NSP on participants' healthcare utilization using survey data and Medicare enrollment and claims data for program participants and matched nonparticipants. To close the session, an expert in federal policy related to nutrition services programs will lead discussion about next steps for researchers, practitioners, and policy makers in light of the evaluation results.
Alzheimer S Care Today, Jun 30, 2008
Frontiers in public health, Jul 1, 2024
Frontiers in public health, May 1, 2024
Innovation in Aging, Nov 1, 2019
Generations, Feb 28, 2009
Research shows they are able to provide consistent responses to questions about a variety of pref... more Research shows they are able to provide consistent responses to questions about a variety of preferences, even in advanced stages. People with memory loss or dementia are a growing and increasingly visible segment of our national fabric. According to the Family Caregiver Alliance (2000), between 13 million and 15 million adults in the United States are living with chronic conditions that impair cognitive function (e.g., stroke, Alzheimer's disease, Parkinson's disease, traumatic brain injury). The conditions that cause memory loss are now being diagnosed more accurately and earlier in the disease process than has been the case in the past. People experiencing the early signs of memory loss are often very cognizant of their current decline and future deterioration at the same time as those around them experience a change in the person they once knew. Many people with dementia find themselves living for many years with conditions that lead to gradual loss of physical and cognitive functioning and self-identity. A Difficult Balancing Act Maintaining the autonomy of people with dementia is a difficult balancing act for their millions of families and friends, who face many tough decisions. These decisions are often made on behalf of impaired relatives who at some point will become unable to make decisions on their own and vary depending on stage and type of illness. Decisions about everyday care (when to eat, what to wear) are fairly predictable, routine, and must be made daily regardless of type or severity of memory loss. Conversely, decisions about acute care (when to seek medical treatment), decisions motivated by a crisis (such as a fall or the death of a caregiver), and decisions about nursing home placement or end-of-life care are of course less predictable, are more likely to occur later in the disease progression, and may require legal authorization. All these types of decisions are critical to the ongoing autonomy of people with dementia and to their quality of life and that of their caregivers. To ensure that both groups experience optimal health and well-being, it is essential that such decisions reflect and balance the needs and preferences of both members of this highly interdependent care dyad. Without this balance, it is likely that one or both parties will react negatively to the choices available and the decisions made. The assistance provided by caregiving families becomes additionally complicated and stressful when there are misunderstandings between caregiver and recipient about care values, preferences, and options. Often family members believe that the choices they make on behalf of their relatives are in accordance with the relative's preferences. Family members also often believe that their relatives with dementia "don't want to be bothered with making decisions," so the family intervenes sometimes before the impaired individual is ready to let go of decision making. Unlike decision making by others on behalf of the person with dementia, shared decisionmaking provides the opportunity for family members to be more fully informed about their relative's values and preferences concerning decisions to be made later in the disease progression (Kapp, 1992). High (1988) suggests that shared family decision-making, when properly used, can function as an extension of a person's autonomy and self-identity, in that "individual autonomy, fully understood, is interdependent with family autonomy" (p. 50). Effects of Involvement in Decision Making on Quality of Life The extent to which people with dementia prefer to be involved in making decisions about their everyday care varies a great deal, as does the extent to which they are actually involved. Many are capable of and interested in making decisions for themselves about healthcare, living arrangements, social interactions, and daily activities. Others instead indicate that they would prefer that a family member (typically the primary caregiver) make decisions for them, at the present time or later, when they are no longer able (High, 1988; Louis Harris and Associates, 1982; Whitlatch and Feinberg, 2003). …
Activities, Adaptation & Aging, Jul 1, 2012
Objectives: The aims of this study are (1) to describe the types of leisure activities preferred ... more Objectives: The aims of this study are (1) to describe the types of leisure activities preferred by persons with dementia in the past and present, as reported by family members and therapeutic recreation staff members, and (2) to examine the influence of demographic and functional abilities variables on the perceived current interest of persons with dementia. Method: Family members of persons with dementia and therapeutic recreation staff involved in the care of those persons completed an activities preference assessment concerning the persons with dementia. Participants were recruited from a nursing home and a senior day center. Family members completed the assessment for the past and present, and staff members completed the assessment for the present. Results: For present preferences, music was the most often preferred activity according to both family and staff, followed by reminiscence and reading, while the least desirable activity was cooking/ baking according to family and trivia games according to the staff. Current preferences were significantly related to past preferences. Gender was also related to preference for some activities. A significant reduction in preference from the premorbid past to the present was found for music,
Innovation in Aging, Nov 1, 2018
Innovation in Aging, Nov 1, 2018
Title III-C of the Older Americans Act (OAA) authorizes the delivery of nutrition services for ol... more Title III-C of the Older Americans Act (OAA) authorizes the delivery of nutrition services for older adults across the country. The OAA Nutrition Services Program is administered by the Administration on Aging within the Administration for Community Living (ACL), and is designed to promote the general health and well-being of older adults. The key delivery methods of the NSP are in group settings, known as congregate nutrition, and to the homes of older adults who live alone, known as home-delivered nutrition. A growing expectation for quality federal programs is to conduct rigorous evaluation. This session will highlight results of the recent client outcomes evaluation of the NSP. The first paper sets the stage by describing NSP services, participating clients, funding levels, and the rationale for the recent evaluation. The second paper, using data from surveys of over 2,200 participants and matched eligible nonparticipants focuses on the food insecurity of congregate and home-delivered meal participants. The third paper presents data on the diet quality of older adults using data on daily nutrient intakes as well as Healthy Eating Index (HEI)-2010 scores. The final paper evaluates the effect of the NSP on participants' healthcare utilization using survey data and Medicare enrollment and claims data for program participants and matched nonparticipants. To close the session, an expert in federal policy related to nutrition services programs will lead discussion about next steps for researchers, practitioners, and policy makers in light of the evaluation results.
Journal of Gerontological Social Work, Jun 24, 2014
There have been few replications of efficacious evidence-based programs for dementia caregivers o... more There have been few replications of efficacious evidence-based programs for dementia caregivers offered in community settings. This study highlights the replication of the evidence-based Reducing Disability in Alzheimer's Disease program and explores the changes in outcomes for participating caregivers and whether those changes are related to level of program utilization. With data from 219 caregivers, regression results indicate that more exercise sessions are associated with a decrease in caregiver strain and more behavior management sessions are associated with a decrease in unmet needs after 3 months. Findings demonstrate how a multicomponent program can have positive benefits for family caregivers.
The Journals of Gerontology: Series B, Apr 8, 2020
ObjectivesHome- and community-based services (HCBS) help older adults remain living safely in the... more ObjectivesHome- and community-based services (HCBS) help older adults remain living safely in their homes by delaying or preventing the need for institutionalization. This analysis is guided by the Andersen Behavioral Model of Health Services Use to examine the association between informal support and use of HCBS.MethodHealth and Retirement Study data from 2011 and 2012 are used in the bivariate analyses and multivariate logistic regression models to examine differences in HCBS utilization among extremely vulnerable older adults who have informal caregivers and those who do not.ResultsFor extremely vulnerable older adults who report difficulties with any instrumental or basic activities of daily living, use of HCBS is not strongly associated with access to informal caregivers. However, for this same population of extremely vulnerable older adults, those who live alone have roughly 3 times the odds of using any HCBS compared to those who do not live alone.DiscussionAmong already vulnerable older adults, this study revealed that living alone is an important enabling factor of the Andersen Behavioral Model as applied in HCBS research. Further investigation is needed to see if more resources should be allocated to senior centers and local providers to identify vulnerable older adults who live alone and may have unmet needs.
Purpose: This research applies a stress and support conceptual model to investigate the effects o... more Purpose: This research applies a stress and support conceptual model to investigate the effects of back-ground characteristics, personal and job-related stres-sors, and workplace support on direct care workers’ (DCW) job satisfaction. Design and Methods: Re-searchers collected survey data from 644 DCWs in 49 long-term care (LTC) organizations. The DCWs included nurse assistants in nursing homes, resident assistants in assisted living facilities, and home care aides in home health agencies. We examined the influence of components of the LTC stress and support model on DCW job satisfaction. Initially, we ran a multiple regression analysis by entering individual-level DCW predictors with job satisfaction as the outcome. Subsequently, we used hierarchical
Innovation in Aging, 2018
While cognitive health is a key determinant of independent living and quality of life in later li... more While cognitive health is a key determinant of independent living and quality of life in later life, higher prevalence of cognitive impairment among lesbian, gay, bisexual and transgender (LGBT) older adults is a major concern. Utilizing three time-point survey data (N=2,450) from the first longitudinal study of LGBT older adults and applying multilevel mixed models, this study examined the associations of the intersectionality of sexual orientation and race/ethnicity and social engagement through interpersonal relationships and community involvement with cognitive impairment after controlling for depressive symptomatology. Hispanic LGBT older adults and the intersection of sexual orientation and race/ethnicity discrimination were associated with higher cognitive impairment. Social participation and social support regardless of race/ethnicity were negatively associated with cognitive impairment. The overall findings demonstrate racial/ethnic differences in cognitive impairment among LGBT older adults and highlight the critical importance of enhancing opportunities for social engagement to promote cognitive health.
Innovation in Aging, 2018
While cognitive health is a key determinant of independent living and quality of life in later li... more While cognitive health is a key determinant of independent living and quality of life in later life, higher prevalence of cognitive impairment among lesbian, gay, bisexual and transgender (LGBT) older adults is a major concern. Utilizing three time-point survey data (N=2,450) from the first longitudinal study of LGBT older adults and applying multilevel mixed models, this study examined the associations of the intersectionality of sexual orientation and race/ethnicity and social engagement through interpersonal relationships and community involvement with cognitive impairment after controlling for depressive symptomatology. Hispanic LGBT older adults and the intersection of sexual orientation and race/ethnicity discrimination were associated with higher cognitive impairment. Social participation and social support regardless of race/ethnicity were negatively associated with cognitive impairment. The overall findings demonstrate racial/ethnic differences in cognitive impairment among LGBT older adults and highlight the critical importance of enhancing opportunities for social engagement to promote cognitive health.
Innovation in Aging, 2018
Title III-C of the Older Americans Act (OAA) authorizes the delivery of nutrition services for ol... more Title III-C of the Older Americans Act (OAA) authorizes the delivery of nutrition services for older adults across the country. The OAA Nutrition Services Program is administered by the Administration on Aging within the Administration for Community Living (ACL), and is designed to promote the general health and well-being of older adults. The key delivery methods of the NSP are in group settings, known as congregate nutrition, and to the homes of older adults who live alone, known as home-delivered nutrition. A growing expectation for quality federal programs is to conduct rigorous evaluation. This session will highlight results of the recent client outcomes evaluation of the NSP. The first paper sets the stage by describing NSP services, participating clients, funding levels, and the rationale for the recent evaluation. The second paper, using data from surveys of over 2,200 participants and matched eligible nonparticipants focuses on the food insecurity of congregate and home-delivered meal participants. The third paper presents data on the diet quality of older adults using data on daily nutrient intakes as well as Healthy Eating Index (HEI)-2010 scores. The final paper evaluates the effect of the NSP on participants' healthcare utilization using survey data and Medicare enrollment and claims data for program participants and matched nonparticipants. To close the session, an expert in federal policy related to nutrition services programs will lead discussion about next steps for researchers, practitioners, and policy makers in light of the evaluation results.
Alzheimer S Care Today, Jun 30, 2008