TECHNOLOGY REDUCES DISTRESS IN A GERIATRIC COHORT WITH DEPRESSION AND NEUROCOGNITIVE IMPAIRMENTS

Abstract Many older adult Veterans with Depression and superimposed Neurocognitive Impairments may demonstrate behavioral agitation. To buffer patient agitation seen within a Veteran’s Affairs residential extended care facility, psychological services were expanded to include the use of mobile technologies. To evaluate the effectiveness of adding technology supported psychological services, outcomes were gathered as part of continuous process improvement efforts. 28 Veterans with Depression and NCI who received technology enhanced services were rated by staff on observed agitation behaviors prior and following clinical encounters. In addition, a subset of 17 Veterans also provided subjective unit of distress (SUD’s) ratings based on the Brief Interview for Mental Status inclusion criteria. Paired sample T-Tests were completed to assess if technology-enhanced interventions resulted in average reductions of clinician rated observations of Veteran agitation behaviors. Significant differences were found in observations of Veteran facial tension (t(27)=3.722, p=.001), agitated body movement (t(14)=2.020, p=.053), and threatening posture (t(27)=2.243, p=.044). Evaluation of a subset of those residents who also provided SUD’s ratings show a significant change in self-reported distress after intervention (t(16)=4.3, p=.001). Effect size for this difference was large (d=1.042). These results suggest that mobile technologies can help reduce agitation and Veteran self-reported distress among older Veterans with Depression and superimposed Neurocognitive Impairments.

influences staff-resident interactions and that profit status of facilities are associated with staff resident interactions. Future studies could explore staff factors such as consistent assignment, job satisfaction, staff characteristics, and training.

EXPLORING RELATIONSHIPS BETWEEN RELIGIOUS COPING AND GENERAL COPING STRATEGIES IN OLDER LONG-TERM CARE RESIDENTS
Nathaniel Andrew, 1 and Suzanne Meeks 1 , 1. University of Louisville, Louisville, Kentucky, United States Aging long-term care residents utilize a variety of coping strategies to manage stressors. While many older adults report religious faith is important in the coping process, it is unclear how religious coping appraisals and religious coping styles fit within a broader coping framework. This poster explores relationships between religious coping and general coping strategies in a convenience sample of older nursing home and assisted living residents (median age = 71.5). In this cross-sectional study, we interviewed residents (N = 102) from long-term care facilities (N = 11) in the Louisville metropolitan area and southern Indiana. Participants responded to questions about religious practices, religious coping, general coping, stress, life satisfaction, psychological distress, and health. The present analyses examined correlations between religious coping appraisals/styles and general coping strategies. We found: 1) small to moderate associations between theoretically adaptive religious coping appraisals/styles (e.g., positive appraisals, collaborative/deferring styles) and theoretically adaptive general coping strategies (e.g., positive reframing, instrumental support), and 2) small to moderate associations between theoretically maladaptive religious coping appraisals/ styles (e.g., negative appraisals, self-directing styles) and theoretically maladaptive general coping strategies (e.g., denial, behavioral disengagement). Our results identify interesting conceptual relationships suggesting residents who report positive religious coping appraisals and less independent religious coping styles use adaptive coping strategies more frequently. These constructs may be explored in future research through examining their theoretical uniqueness and whether they independently account for variance in clinically-relevant outcomes. Further study of religious coping in these settings may help promote resilience and optimal aging for long-term care residents. Many older adult Veterans with Depression and superimposed Neurocognitive Impairments may demonstrate behavioral agitation. To buffer patient agitation seen within a Veteran's Affairs residential extended care facility, psychological services were expanded to include the use of mobile technologies. To evaluate the effectiveness of adding technology supported psychological services, outcomes were gathered as part of continuous process improvement efforts. 28

TECHNOLOGY REDUCES DISTRESS IN A GERIATRIC COHORT WITH DEPRESSION AND NEUROCOGNITIVE IMPAIRMENTS
Veterans with Depression and NCI who received technology enhanced services were rated by staff on observed agitation behaviors prior and following clinical encounters. In addition, a subset of 17 Veterans also provided subjective unit of distress (SUD's) ratings based on the Brief Interview for Mental Status inclusion criteria. Paired sample T-Tests were completed to assess if technology-enhanced interventions resulted in average reductions of clinician rated observations of Veteran agitation behaviors. Significant differences were found in observations of Veteran facial tension (t(27)=3.722, p=.001), agitated body movement (t(14)=2.020, p=.053), and threatening posture (t(27)=2.243, p=.044). Evaluation of a subset of those residents who also provided SUD's ratings show a significant change in self-reported distress after intervention (t(16)=4.3, p=.001). Effect size for this difference was large (d=1.042). These results suggest that mobile technologies can help reduce agitation and Veteran self-reported distress among older Veterans with Depression and superimposed Neurocognitive Impairments. Previous studies reported that high Nursing Home Administrator (NHA) turnover correlates with low staff morale and poorer care outcomes. The purpose of this study was to assess how NHA job satisfaction (JS) (in five subscales: job content, coworkers, work demands, work load, work skills, and rewards) interacts with role conflict and ambiguity, autonomy, work conflict, and influence and to estimate the odds of having NHA's intent to quit by degree of job satisfaction. A total 208 responses were collected from the online survey in 2017 among NHAs currently working in nursing homes in 5 states. We analyzed the data using descriptive statistics and ordinal logistic regression models. The findings suggested that NHAs were generally satisfied in all JS subscales and expressed moderately high levels of autonomy, neutral levels of work conflict, role conflict and role ambiguity. NHAs with good coworker relations (adjusted odds ratio [AOR]=0.67), fair job demands (AOR=0.68) and rewards (A0R=0.8), were less likely to harbor quitting intents. Interestingly, NHAs reporting higher job skills were more likely to consider leaving nursing homes (AOR=1.46). Overall, study findings are consistent with previous JS research with the exception that higher perceived skill efficacy was found to be associated with greater likelihood of quitting in the near future. This suggests perhaps that more highly skilled NHAs may now have less tolerance for work discomfort. These findings are presented in the context of earlier studies on NHA turnover as well as likely implications of changing market conditions.

THE STRUCTURE OF CARE MANAGERS' PRACTICE RESPECTING THE AUTONOMY OF THE FRAIL ELDERLY IN JAPAN
Chiemi Hata, 1 and Sachiko Kasahara 1 , 1. Shitennoji University, Habikino, Osaka, Japan The objectives of current study are to clarify the structure of practice respecting the autonomy of the frail elderly under the Long-Term Care Insurance system in Japan and to discuss the related factors to the practice. The mailed self-administered questionnaire survey was conducted on 1398 care managers who working in In-Home Long-Term Care Support Providers in A City in Osaka with the condition that "office with multiple care managers engaged and one care manager with more than 5 years' experience". The response rate was 51.0% (713persons) and no missing data 615 (44.0%) was analyzed. Analysis was carried out using Mplus.ver8. The structure of practice respecting the autonomy of the frail elderly and the rerated factors were examined as a causal model using structural equation modeling. As the result, it was confirmed the goodness of fit to the data (RMSEA=0.049, CFI=0.927). By the confirmatory factor analysis, the care manager's practice respecting the autonomy of the elderly was confirmed associating with threefactors structure; (1)data collection and assessment, (2) strength perspective and (3) professional relationship. Furthermore the practice was significantly affected by self-esteem of caremanagers performance (β=0.494) and self-reflection to own work (β=0.269). In conclusion, the current study supported the hypothetical consideration in which self-esteem and self-reflection in care manager's practice significantly affected the practice respecting the autonomy of the frail elderly.

GENDER DIFFERENCES IN NURSING HOME RESIDENT QUALITY OF LIFE: WHY WOMEN DO BETTER
Heather Davila, 1 Tetyana P. Shippee, 2 Weiwen Ng, 2 Odichinma C. Akosionu, 2 and Beth Virnig 2 , 1. VA Boston Healthcare System,Boston,Massachusetts,United States,2. University of Minnesota,Minneapolis,Minnesota,United States Despite research documenting gender differences in numerous outcomes in later life, we know little about gender differences in quality of life (QoL) for older adults who