OBJECTIVES:The number of people living with dementia is growing and most patients go years without receiving a specific diagnosis or support services, leading to suboptimal care, negative impacts on the quality of life, and increased costs of care. To address these gaps, the State of Georgia Department of Human Services collaborated with academic and community partners to create the Georgia Memory Net (GMN).DESIGN:GMN is a hub and spoke model partnered with Emory University's Cognitive Neurology Clinic and Emory Goizueta Alzheimer's Disease Research Center to provide training and support for best practices in diagnosis and management to Memory Assessment Clinics (MACs) throughout the state.SETTING:Communities across the State of Georgia.PARTICIPANTS:GMN is a mix of academic and community providers, hospital systems, state and community agencies. Patients and families are evaluated at the MACs and connected to community services.INTERVENTION:A dedicated clinic workflow: primary care providers (PCPs) identify a memory problem and refer to the MACs for diagnostic evaluation; meeting with a community services educator, and development of a care plan. The patient is reconnected with the PCP for continuity of care.MEASUREMENTS:Initial metrics include numbers of unique patients, total patient visits, and referrals to state agency partners for community services.RESULTS:GMN established five MACs across Georgia with annual state funding. Partners at Emory University provided initial training; refined patient workflows for best practices; and provide ongoing support, guidance, and continuing education for MAC teams. Local PCPs and community services partners demonstrated strong engagement with the new model.CONCLUSIONS:GMN is an innovative care model to improve access to accurate and timely diagnosis in patients with memory loss. GMN may help improve the quality of life for patients and families through preventive and early care.
Using administrative data from Georgia covering January 2018-August 2020, we estimated the effect of services provided through the Older Americans Act (OAA) and the Supplemental Nutrition Assistance Program (SNAP) on food insecurity among older Georgians. Our sample included those who received services prior to and during the coronavirus disease 2019 (COVID-19) pandemic. For the entire sample period, we found home-delivered meals and other OAA services reduced food insecurity by 3% and 4%, respectively. During COVID-19, the effect of SNAP on reducing food insecurity significantly increased from 2.1% to 4.7%, while the loss of "traditional" congregate meals services increased food insecurity by 7%.
OBJECTIVES:In contrast to nursing homes, assisted living (AL) facilities emphasize independence and autonomy as part of their mission. However, we do not know to what extent this extends to sexual freedom and autonomy.METHOD:Using grounded theory methodology and symbolic interactionism, we examine how staff and administrators in AL facilities discuss residents' rights to sexual freedom and how this influences the environment of AL.RESULTS:Staff and administrators engage in a contradictory discourse of residents' rights that simultaneously affirms the philosophy of AL while behaving in ways that create an environment of surveillance and undermine those rights.DISCUSSION:A discourse of residents' rights masks a significant conflict between autonomy and protection in regards to sexual freedom in AL.
In assisted living (AL) facilities, workers are intimately involved in the lives of residents. Existing research on AL demonstrates the imbalance of this environment, which is a personal home for the residents and a workplace for staff. Using observational and interview data collected from six AL facilities, this grounded theory project analyzes how AL staff define, understand, and negotiate sexual comments, joking, and physical touch. We developed a conceptual model to describe how such harassment was perceived, experienced by AL workers, and how they responded. Sexualized behavior or harassment was experienced by workers of every status. We found that words and actions were contextualized based on resident and worker characteristics and the behavior. Staff members refused to engage residents, redirected them, or reframed the words and gestures to get the job done. Reporting the incidents was less common. We conclude by discussing implications for policy and research.
