MERGING AN AGE FRIENDLY UNIVERSITY WITH AN AGE FRIENDLY HEALTH CARE SYSTEM: CASE STUDY FINDINGS

Abstract Age Friendly Health Systems (AFHSs) and Age Friendly Universities (AFUs) are distinct entities in the “Age Friendly” ecosystem. While Age Friendly entities function independently, they typically exist in close proximity (e.g., universities and community hospitals); yet they remain isolated in their Age Friendly efforts. We report on a collaboration between a mid-Atlantic Age Friendly University and a new AFHS using case study methodology. Our goal is to inform and inspire key stakeholders responsible for creating innovative healthy aging communities. The collaboration began with a shared stakeholder team who articulated focus areas and overlapping goals. A charter document was developed articulating commitments and responsibilities. Using a Quality Improvement (QI) approach, projects targeted the hospital’s older patient needs that linked to the AFHS 4 M’s of Matters, Medications, Mobility, and Mentation. University graduate students and faculty volunteered to teach and mentor hospital staff on the QI projects: 1) Get to Know Me Boards filled by staff caring for hospitalized older adults (Matters); 2) Medical Intensive Care Unit discharge opioid medication deprescribing (Medication); 3) UMove Mobility Screening addressing functional status (Mobility); 4) UB-2 Delirium Screening (Mentation). Data collection across projects demonstrated proof-of-concept and identified implementation challenges around communication, screening, data entry, and data extraction from electronic medical records. During Covid-19 pandemic, the collaboration allowed QI projects to conduct multiple Plan-Do-Check-Act cycles while contributing to the Age Friendly goals of both organizations. Partnerships between academic institutions and hospitals foster development of evidence- based healthy aging communities and provide opportunities for continuing education and research.

status, access to medical care, employed versus unemployed working-age adults, mitigating the risks of unemployment, and loss of health insurance via the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). As good as the findings are, they are methodologically limited by looking at only half the story. This research asks a different question: how might the humanities and arts-based perspective address the social problem? It aims at answering why the employment status is related to health and health insurance. Chinese poetry has a long rich tradition of expressing insights about the inner life since antiquity to the present. These reflections include practice wisdom and keen observations on aging. This poster presents case findings on the use of Chinese poetics to inform aging care in the West. Each case provides discussions on why social welfare system comes up short to solve the problem and how the social welfare system can be effectively changed. Researchers use survey data to compliment Chinese poetic insights about employment status and insurance status to illustrate the correlation between respondents' health status with versus without employment. Findings are hoped to interpret the role of family as a social unit where it consists in social welfare along with the speculative inquiry of poetry. Connie Corley, Laura Sherwood, Dibendu Ghosh, and David Willis, Fielding Graduate University, Santa Barbara, California, United States Life course theory is a framework for examining the role of elders in modeling altruistic behavior or "seva" (selfless service) in two homes for children: Unatti (Bhaktapur, Nepal) and Ramana's Garden (Rishikesh, India). Two American women, compelled to impact the plight of children subject to poverty, trafficking and/or caste discrimination (Dalits, the former "untouchables"), each founded homes 20+ years ago and modeled selfless service exemplified by children, some now in "emerging adulthood," who are giving back to their communities. In this intergenerational/ intercultural multiple case study, narratives of the program founders now in mid-to late adulthood are presented along with narratives of six young adults who continue to provide nurturance to younger children and engage in projects to educate and feed residents of the homes and nearby communities. The life course principle of time and place situates the children in areas of their countries with relatively low literacy rates. The founders saw the value of education to empower young people, especially girls, to expand their opportunities and serve as role models for children coming into the homes after them. The linked lives principle is evident through shared relationships with the founders as these young people navigate political crises, disasters like the Nepal earthquake, and health crises like the Covid-19 pandemic. Some become leaders themselves as they have been mentored over their life course. A sense of agency is experienced in their young adulthood as more choices for their lives become available as an alternative to subsistence existence and early marriage/childbearing.

Universidad Mayor, Las Condes, Region Metropolitana, Chile, 2. Simmons University, Boston, Massachusetts, United States, 3. University of California, Berkeley, California, United States
Data from the Health and Retirement Study (1992-2016) was used. All non-institutionalized respondents aged 50+ were included in our sample (n=12,618). Mixed models were conducted to study the association between transitioning to retirement and depressive symptoms (CESD) among retirees, and to test the mediation effect of alcohol use.
Results: Those retired for at least 6 years had increased probability of binge drinking. Additionally, binge drinking mediated the association between the retirement transition and depressive symptoms, making the effect stronger for those retired for 3 to 5 years (p< 0.05), and weaker and no significant for those retired for 6+ years (p>0.05). Thus, the decrease on depressive symptoms was higher for those retired between 3 to 5 years when being binge drinkers. Discussion and Implications: Addressing depressive symptoms and binge drinking among older adults is sorely needed. Binge drinking was associated with decreased depressive symptoms, consistent with the self-medication hypothesis. Treatment and screening for depression as well as binge drinking are especially important as both are associated with increased mortality. Treating depression would reduce the risk of increased alcohol use and its detrimental effects on health. Age Friendly Health Systems (AFHSs) and Age Friendly Universities (AFUs) are distinct entities in the "Age Friendly" ecosystem. While Age Friendly entities function independently, they typically exist in close proximity (e.g., universities and community hospitals); yet they remain isolated in their Age Friendly efforts. We report on a collaboration between a mid-Atlantic Age Friendly University and a new AFHS using case study methodology. Our goal is to inform and inspire key stakeholders responsible for creating innovative healthy aging communities. The collaboration began with a shared stakeholder team who articulated focus areas and overlapping goals. A charter document was developed articulating commitments and responsibilities. Using a Quality Improvement (QI) approach, projects targeted the hospital's older patient needs that linked to the AFHS 4 M's of Matters, Medications, Mobility, and Mentation. University graduate students and faculty volunteered to teach and mentor hospital staff on the QI projects: 1) Get to Know Me Boards filled by staff caring for hospitalized older adults (Matters); 2) Medical Intensive Care Unit discharge opioid medication deprescribing (Medication); 3) UMove Mobility Screening addressing functional status (Mobility); 4) UB-2 Delirium Screening (Mentation). Data collection across projects demonstrated proof-of-concept and identified implementation challenges around communication, screening, data entry, and data extraction from electronic medical records. During Covid-19 pandemic, the collaboration allowed QI projects to conduct multiple Plan-Do-Check-Act cycles while contributing to the Age Friendly goals of both organizations. Partnerships between academic institutions and hospitals foster development of evidence-based healthy aging communities and provide opportunities for continuing education and research.

University of Central Florida, Orlando, Florida, United States
Suicide is a major public health concern. Suicide rates have increased steadily in the U.S. and are highest among middleaged (ages 45-64) and older (age 75+) adults. Help-seeking represents an important coping behavior that can mitigate suicide risk. However, research on this topic is sparse, especially among older adults. To address this gap, a systematic review of the existing literature describing help-seeking for suicide risk among middle-to old-age adults was conducted. Using PRISMA guidelines, we searched electronic databases (e.g., ProQuest, EBSCOhost, PsycINFO, PubMed, Medline) and key journals with suicide and/or gerontology focuses for peer-reviewed publications in English between 2010-2020. The search yielded 4,732 unduplicated publications. After screening articles for relevance based on titles and abstracts, 52 articles were reviewed in full text. A total of 24 articles met inclusion criteria and were included in this review. The articles reviewed included a range of topics, including prevalence of service utilization, service use prior to suicide-related behaviors, and correlates of help-seeking. Overall, prevalence of service utilization was generally low and varied by suicidal history (e.g., greater prevalence among those with a history of suicide attempt, as compared to those with suicide ideation but no attempts). The systematic review also identified key service use facilitators (e.g., higher suicide literacy, previous or current suicidality) and barriers (e.g., stigma). Results of this systematic review highlight the need for future research and tailored services to improve suicide prevention and intervention strategies for middle-aged and older adults.

ACHIEVING UNIVERSAL HEALTH COVERAGE FOR OLDER ADULTS: A REVIEW OF GHANA'S NATIONAL HEALTH INSURANCE SCHEME
Samuel Asante 1 , and Grace Karikari 2 , 1. Northeastern State University, Broken Arrow, Oklahoma, United States, 2.

University of North Dakota, Grand Forks, North Dakota, United States
Universal Health Coverage (UHC) is defined by the World Health Organization (WHO) as ensuring that all people receive quality health services they need without financial hardship. Predicated on the idea of providing universal healthcare to all Ghanaians, Ghana's National Health Insurance Scheme (NHIS), established in 2003, has done considerably well among some age categories than others. While most studies on this healthcare program have focused on the health-seeking behaviors among users, its implementation, financial sustainability, and the role of national politics in its administration, little has been done to understand the program's effectiveness in achieving a universal health coverage for and its impact on older Ghanaians. Consistent with WHO's objective of achieving UHC, as enshrined in the Global Strategy on Aging and Health, this review examines Ghana's progress toward achieving UHC for all. The paper specifically provides a narrative review of the National Health Insurance Scheme in advancing the interest and welfare of older Ghanaians. Findings revealed that not all individuals considered as older adults, either conventionally or legally, are beneficiaries of the programs; that WHO's objective of obtaining needed care without financial hardship may be far from reach for most older Ghanaians; and the program only offers basic protection to current beneficiaries. We address these areas of concern to achieving UHC. We also make recommendations for a path forward where all stakeholders-older adults, families, healthcare providers, and policymakers-involved can play a role in ensuring all eligible older adults get the quality of health care they deserve. Frailty has become a public health priority in many advanced countries. However, the effects of national implemented intervention remained unclear. Taiwan implemented a disability prevention program nationwide targeting on people aged 65 and over in 2019. We aimed to identify the subtypes of function outcomes of the national disability prevention programs and compare the different outcome subtypes between frail and non-frail older adults. The current study analyzed participants' outcomes before and after the program. Two years of data (2019-2020) from the national disability program were used for analysis. Among the participants, 622 were frail (3.8%), and 13084 are non-frail (81.3%). Outcomes were nine domains of Kihon checklist assessed, including nutrition, depressive mood, oral function, fall risk, cognitive function, socialization, independent function, mobility and health knowledge. Latent Class Analysis is used to identify the subtypes of classes in frailty and nonfrail older adults. Four classes of outcomes subtypes for frail and non-frail older adults were identified, and both of them have groups of multi-aspect improvement and no improvement groups. The other two classes for frail people were cognitive and independent function improvement group and social and fall risk improvement group, whereas nonfrail group had independent function improvement group,