February 2020
Today is National Caregivers Day ! This day was established to honor the caregivers who devote countless hours providing care to our loved ones. Whether you are a caregiver yourself or appreciate those who are, today is the perfect time to say thank you for all that they do
The Csomay Center sincerely thanks all caregivers for all the quality, compassionate care they provide every day!
Here are some quality resources to assist caregivers and support their efforts:
Improving Mood Study: Surprising Negative Outcomes
Depression-related outcomes of a study conducted by Dr. Marianne Smith and colleagues was published in PLOS ONE in October, 2019. The article reports on a 5-year study called Improving Mood in Assisted Living Settings Using a Cognitive Training Intervention that was implemented in partnership with 31 senior living settings in Iowa* and enrolled over 350 older adult participants. The purpose of the study was to evaluate if the cognitive speed of processing training (SOPT) known as Road Tour (later renamed Double Decision) would have a positive effect on depression in older adults who reside in supported senior living settings. The research was based on earlier studies in which the SOPT improved cognitive speed of processing time AND decreased depressive symptoms in community-dwelling adults. 
However, Smith’s study showed significantly increased depression scores and rates of major depressive syndrome among participants in assisted living who were assigned to the SOPT group. By contrast, no significant changes in depression were observed in the independent living SOPT group or either assisted or independent living attention control groups. This surprising finding underscores the importance of evaluating the effect of popular “brain games” for unexpected effects, as well as important differences among older people living on the same senior living campus. While the study was not designed to explain WHY depression may have increased (or might have decreased as expected) among the assisted living SOPT group, the authors recommend that Road Tour/Double Decision be avoided in this group, and that other SOPT interventions be combined with systematic depression monitoring.
Smith, M., Jones, M.P., Dotson, M.M., and Wolinsky, F.D. (2019). Speed of processing training and depression in assisted and independent living: A randomized controlled trial. PLOS ONE, 14 (10):e0223841. https://doi.org/10.1371/journal.pone.0223841
*Special thanks to the following organizations that were active partners in the Improving Mood study: Peterson Commons, Davenport; Simpson Home, West Liberty; Leland Smith, Wilton; Highland Ridge, Williamsburg; Bickford Senior Living, Clinton; Carlisle Center Assisted Living, Carlisle; Emerson Point, Iowa City; Friendship Village, Waterloo; Irving Point, Cedar Rapids; Kensington, Fort Madison; Keystone Cedars Assisted Living, Cedar Rapids; Lakeview Village- Amana Retirement Community, Amana; Fountains Senior Living Community, Bettendorf; Lutheran Living Assisted Living, Muscatine; Deerview Manor and Manor House Care Center, Sigourney; Melrose Meadows Retirement Community, Iowa City; Meth-Wick Community, Cedar Rapids; Oaknoll Retirement, Iowa City; Senior Star at Elmore, Davenport; Summit Pointe Senior Living Community, Cedar Rapids; The Villages at Marion, Marion; Western Home Communities, Cedar Falls; Woodlands Creek, West Des Moines; Prairie Hills, Cedar Rapids; Prairie Hills, Tipton; Martina Place Assisted Living, Johnston; Iowa Veteran's Home, Marshalltown; Valley View Village Assisted Living, Des Moines; Ridgecrest Village, Davenport; Silvercrest Garner Farms, Davenport, and Legacy Active Retirement Community, Iowa City.
Vocal Pattern Detection of Late-Life Depression Works
A second article in 2019 reported outcomes about vocal pattern detection of depression in the International Journal of Mental Health Nursing. The purpose of this study was to determine whether vocal patterns that have been associated with clinical depression in younger people (aged 18 to 65) would also signal depression in older adults. The study included 41 older adults who completed a depression rating scale and a recording their voice while reading phonetically balanced passages (the Grandfather and Rainbow Passage) and answering a series of open-ended questions. The vocal data were analyzed using machine learning algorithms which accurately predicted high and low depression scores between 86% and 96% of the time, and raw depression scale scores within 1.17 points.
These strong, positive results are being further evaluated in a new study, Vocal Pattern Detection of Late Life Depression, funded by the National Institute on Aging. This 2-year study plans to enroll 200 older adults using the same basic methods as the earlier study. Participants are being enrolled now through 2021. For more information contact Jill Colbert, Study Coordinator, at jill-colbert@uiowa.edu .
Smith, M., Dietrich, B.J., Bai, E. & Bockholt, H.J. (2019). Vocal pattern detection of depression among older adults. International Journal of Mental Health Nursing. Pre-print electronic access at doi.10.1111/inm.12678
The Iowa Geriatric Education Center (IGEC) is excited to announce the release of the new Dementia Training to Promote Involvement in Meaningful Activities , an online training program developed for caregivers in long-term care settings who work with older adults with dementia. Redesigned in collaboration with experts at The Meth-Wick Community (Cedar Rapids, IA), this program addresses recognizing unmet activity needs among persons with dementia; applying appropriate activity assessment methods; adjusting care routines to include enjoyable, person-appropriate activities; monitoring outcomes related to activity involvement; and using teamwork for successful implementation.
This evidence-based program is presented in four parts:
  • Part 1 – The CMS Activity Regulation: An Overview
  • Part 2 – Activity in the Context of High-Quality Dementia Care
  • Part 3 – Activity Options and Alternatives
  • Part 4 – Teamwork: Getting Ideas into Practice 

Each part includes a video presentation, a work place exercise, and informative handouts. The tools provided are intended to help participants put their learning into practice as they work through the program.
Everyone who comes into contact with persons with dementia benefits from understanding their needs, as well as methods to provide respectful, high quality, and individualized care. Dementia Training to Promote Involvement in Meaningful Activities is designed to increase the skills and abilities of all caregivers related to involving older adults with dementia in day-to-day activities that are enjoyable and meaningful to them. Engaging persons with dementia in meaningful activities can reduce behavioral and psychological symptoms of dementia, increase positive behaviors, and improve quality of life.
For additional information, or to get started with this free training program, visit https://http://igec.uiowa.edu/gerialearning/dementia-training
In July 2019 the US Department of Human Services Health Resources & Services Administration (HRSA) funded 47 Geriatric Workforce Enhancement Programs (GWEPs) across the nation. Iowa GWEP leaders Marianne Smith, Linda Seydel (College of Nursing) and Ryan Carnahan (College of Public Health) are working in close collaboration with Csomay Center leaders to advance two main social movements: Dementia Friendly Communities and Age Friendly Health Systems.
The Dementia Friendly Communities (DFC) movement increases awareness of dementia, promotes social inclusion, and challenges stigma. The movement embraces the belief that everyone has a role in recognizing people with dementia as part of their community, and supporting their independence, value and inclusion. Western Home Communities (WHC), a long-standing partner with Dr. Smith and the Csomay Center, is advancing these ideas throughout their 1000 life active senior living community – with plans to move ideas to the surrounding Cedar Falls Community in the near future. Karla Foust and Amy Chapman, designated Dementia Friendly leaders for WHC, are engaging leaders, staff, members (residents), family members and others to join the movement.
This exciting project will host a Kick-Off Event this spring, provide training throughout WHC, and then roll the movement into the surrounding Cedar Falls community. The model – of starting with a large active senior living community as the launching point before engaging the surrounding community – is the first of its kind. The Iowa GWEP and Csomay Center plan to replicate the approach in other locations in future years. Dementia Friendly training and resource materials will be available on the Center’s Gero Resources page as they are identified and developed. For more information, contact Karla Foust,  karla.foust@westernhome.org or Marianne Smith, marianne-smith@uiowa.edu .
The Age Friendly Health System movement is supported by the John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI). Being Age Friendly means that providers and health systems address the “ 4Ms ” – What M atters to the older person, M edications, M obility and M entation as a “package,” as each area influences the others. The GWEP Coordinating Committee that is funded by the Hartford Foundation and housed with the American Geriatric Society (AGS) is supporting GWEPs to engage their primary care partners to become Age Friendly. The program is modeled after the IHI initiative and engages participants to become part of an Age Friendly Action Community that runs from January through July of 2020. 
Iowa GWEP partners in the Action Community include Paul Volker, Des Moines University; Maritza Buenaver, Eastern Kansas Veterans Administration Health System; Scott Larson, UI Family Medicine; Sangil Lee, UI Emergency Medicine; Kim Bergen-Jackson, Oaknoll; and Nicola “Jane” Stickney, Jefferson County Health Center. As a member of the Csomay Center Leadership team, Dr. Stickney’s involvement promises to advance our working knowledge about the specific requirements of joining the Age Friendly initiative, and in turn, help us support and assist additional health systems to join – including acute care, primary care, nursing facilities, and specialty care like emergency departments. Age Friendly Health System training and resources will be available on the Center’s Gero Resources page as materials identified and developed. For more information, contact Marianne Smith, marianne-smith@uiowa.edu or Linda Seydel, linda-seydel@uiowa.edu .
The Geriatric Mental Health Training Series was developed collaboratively by Dr. Kathleen Buckwalter and Marianne Smith in the 1980s as a response to Nursing Home Reform that disallowed use of physical and chemical restraints.  The Series was developed as a “train-the-trainer” product that sought to help nurse leaders in nursing homes first gain skills, and in turn, train their own staff.  The Series was recognized by two awards, publication of 10 articles and presentations at 12 national meetings. 
The content of The Series addresses important mental health and illness care issues that persist in today’s care, such as knowing the person “behind the illness” (aka person centered care, and understanding and responding to mental distress, depression and dementia as a cause of behavioral symptoms. The Series has been updated over time, but is now being adapted to teach the main care principles in a shorter “micro-learning” format. This will allow users to select specific topics that are most relevant to their learning needs, and use the online training as “just in time” training at the point of care. When completed, the materials will be offered as a free training option by the Csomay Center in the Gero Resources page. For more information contact Ryleigh Maas at ryleigh-maas@uiowa.edu .
The Csomay Center welcomes the opportunity to share news from our community-based partners and readers. If you have a story, information about upcoming events, or news that you want to pass along to other, please do send to us! Send the information tor Ryleigh Maas for inclusion in an upcoming issue. And if you have any questions about the fit or timing of your news, just ask Ryleigh.  
American Association for Geriatric Psychiatry (AAPG)
  • Date: March 13-16, 2020
  • Theme: Translating Research Evidence into Clinical Geriatric Mental Healthcare
  • Location: Grand Hyatt - San Antonio, TX
  • Click here for more information

American Society on Aging (ASA)
  • Date: March 24-27, 2020
  • Location: Hyatt Regency Atlanta - Atlanta, GA
  • Theme: Aging 2020: Examining the Needs of Today’s Diverse Older Adults
  • Click here for more information

Midwest Nursing Research Society (MNRS)
  • Date: April 1-4, 2020
  • Location: Renaissance Schaumburge Convention Center Hotel - Schaumburg, IL
  • Theme: Advancing Nursing Research with Diverse Populations
  • Click here for more information
American Medical Directors Association (AMDA)
  • Date: April 2-5, 2020
  • Location: Chicago, IL
  • Click here for more information

Nurses Improving Care for Healthsystem Elders (NICHE)
  • Date: April 27 - May 1, 2020
  • Location: Marriott - New Orleans, LA
  • Click here for more information

American Geriatrics Society (AGS)
  • Date: May 7-9, 2020
  • Pre-conference date: May 6, 2020
  • Location: Long Beach, CA
  • Click here for more information
Leadership Team:
Marianne Smith , PhD, RN, FAAN, Director - Marianne-Smith@uiowa.edu
Keela Herr , PhD, RN, FAAN, AGSF, Co-Director - Keela-Herr@uiowa.edu
Nicola Jane Stickney , DNP, ARNP, NP-C, College of Nursing Faculty Practice -
Linda Seydel , MA, LNHA, Iowa Geriatric Education Center - Linda-Seydel@uiowa.edu
Mercedes Bern-Klug , PhD, MSW, MA, Professor; Director, Aging & Longevity Studies
 Program; Hartford Faculty Scholar - Mercedes-Bern-Klug@uiowa.edu
Ryan Carnahan , PharmD, MS, BCPP, Associate Professor, Director of Graduate Studies,
 College of Public Health - Ryan-Carnahan@uiowa.edu
Larry Newman, DNP, RN, AGPCNP-BC – Director of the Primary Care AGNP Program,   College of Nursing - Larry-Newman@uiowa.edu
Ryleigh Maas , BS, Center Administrator - Ryleigh-Maas@uiowa.edu
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Resources and Tools for Quality Pain Care
Please visit GeriatricPain.org