The Gerontology Institute and Programs of the John W. McCormack Graduate School of Policy Studies, University of Massachusetts Boston

Spring 2007 Vol. 10, No. 2

UMass Establishes the Rosalie WolfInterdisciplinary Geriatric HealthCare Research Center

3NEPAP ReachesNew Milestone

4-6News Notes

5Profile: Grace

Healey, PensionAction Center

7Elder Economic

Security StandardReports Available

WORCESTER, Mass. The Board of Trustees of theJohn A. Hartford Foundation, in association withthe RAND Corporation, has awarded the Universityof Massachusetts a two-year $200,000 grant for thedevelopment of a new center focused on improvingthe health of older adults through innovative, interdisciplinary research. The center, which will bejointly established by the University of MassachusettsMedical School (UMMS) and the University ofMassachusetts Boston, is one of just seven nation-wide to be established by RAND/Hartford this year.The receipt of this award, conferred by a NationalAdvisory Panel of experts, signifies both the ongoingimportance of the university’s work in the fields ofgeriatrics and gerontology, as well as the promise ofsignificant future contributions. Principal Investigatorsfor the project are Jerry Gurwitz, MD; KathleenMiller, EdD, RN; and Jan Mutchler, PhD.

(Con’t on page 2)

Using Event HistoryCalendars with ProxyInformants to DocumentResidential Pathways ofOlder Adults

The Gerontology Institute recentlyconducted a pilot study as ground-work for a National Institute onAging (NIA) proposal, for whichFrank Caro is PI and Jeff Burr Co-PI,that uses an innovative approach to collecting residential histories bytargeting informants, especially therelatives of deceased elders, to obtainresidential adjustment informationcovering 20 years prior to the deathsof the elders. The premise of the proposed study is that strategicchanges in housing type and location,household composition, and homemodifications can be helpful to eldersin preventing injury, coping withfunctional limitations, responding to major health events, avoiding ordelaying institutionalization, andmaximizing quality of life. To date,there are no systematic data providinga complete trajectory of elders’ residential adjustments over time.

This study piloted the feasibility of using follow-back surveys ofinformants (relatives of deceased elders) to obtain complete residentialhistories of adults (age 75+) over the last 20 years preceding death.Institute Fellow Alison Gottlieb led a team of three PhD students–KimSauder (coordinator), Judy Poey, andRobin Sherman–in the data collection.

AGEnotes

(Con’t on page 7)

UMass Establishes Research Center(Con’t from page 1)

Despite staggering statistics related tothe aging of America, few universitiesand medical schools have allocatedsufficient resources to advance geriatricresearch, clinical care, and education.With the support of the RAND/Hartford funds, UMass will establishThe Rosalie Wolf InterdisciplinaryGeriatric Health Care ResearchCenter to address this disparity.

The center, which represents the combined talent and efforts of facultyof the UMMS Graduate School ofNursing and Division of GeriatricMedicine and the UMass BostonGerontology Institute, will comprisefaculty from across both campusesfrom a multitude of disciplines,including geriatric medicine, geronto-logic nursing, social gerontology, economics, family medicine, humandevelopment, preventive and behav-ioral health, psychology, social welfare, sociology, and urban planning.

“Addressing the complex challengesthat face the elderly patient popula-tion will require research efforts thatbring together investigators from different disciplines, and the new center will facilitate this process,”said Dr. Miller, who is a professor inand director of the master’s programin the UMMS Graduate School ofNursing. Her research has examinedage and gender differences in patients’ perceptions of their recoveryafter coronary bypass surgery and transitional care for elders after this procedure.

According to Dr. Gurwitz, the newcenter will position the University of Massachusetts to have a nationalimpact on the quality of health care provided to older people.

Gurwitz holds the Dr. John MeyersProfessorship in Primary Care, is the Chief of the Division of GeriatricMedicine, and serves as ExecutiveDirector of the Meyers Primary CareInstitute, a joint endeavor of UMMS,the Fallon Clinic Foundation, andFallon Community Health Plan. Anationally recognized expert in theuse of drug therapy for seniors, hehas been at the forefront of researchefforts to identify the causes of medicalerrors in the senior population and todevelop effective solutions to strengthenquality of care for the frail elderly.

The new UMass center will honor thememory of Rosalie S. Wolf, PhD, aUMMS Assistant Professor of FamilyMedicine and Community Health andExecutive Director of the Institute ofAging at UMass Memorial HealthCare. After receiving her doctorate insocial welfare with a concentration inaging from Brandeis University, Dr.Wolf made important contributions tothe field of geriatrics, particularly inher efforts to bring the issue of elderabuse and neglect to internationalattention. In 1986, Wolf founded the National Committee for thePrevention of Elder Abuse and in1989 became founder and editor of the Journal of Elder Abuse andNeglect. Keenly interested in facilitatingexchanges between researchers andpractitioners, she also chaired theInternational Network for thePrevention of Elder Abuse and servedas a member of the WHO ConsultingGroup for the World Report onViolence.

Following in the tradition of Wolf,who passed away in 2001, the facultyof The Rosalie Wolf InterdisciplinaryGeriatric Health Care Research

Center will serve as advocates forexpanded geriatric research initiatives,advancing the center’s mission todevelop and study innovative clinicaland health services interventions forthe elderly, and to provide trainingopportunities for new investigators.In addition to fostering a multidisci-plinary community of physicians,nurses, students, and scientists com-mitted to improving the quality ofhealthcare for seniors, the center willspecifically focus research efforts onthree key areas: patient medicationsafety, chronic disease, and patientcommunication and health literacy.

“The new center will create a researchenterprise that will far exceed the sumof its parts,” according to Dr. Mutchler,who is a professor of gerontology and Associate Director of Social and Demographic Research at theGerontology Institute on the UMassBoston campus. “Nothing like thishas ever happened before at UMass,making this new initiative particularlyexciting.” Mutchler’s research interestsinclude race and ethnicity in agingpopulations, intergenerational supportin later life, health and well-being inlater life, and the social demographyof aging populations.

Supporting the efforts of the PrincipalInvestigators, Elizabeth Dugan, PhD,will serve as Project Director. Dr.Dugan is an Assistant Professor ofMedicine in the Division of GeriatricMedicine at the University ofMassachusetts Medical School. Her research interests include thepatient–healthcare provider relation-ship and health issues of special relevance to older women, such as urinary incontinence and breastcancer.

2

P E N S I O N S

NEPAP Reaches New Milestone

The New England Pension AssistanceProject (NEPAP) closed out severalcases in March that put the runningtotal of benefits obtained by theProject on behalf of its clients at justover $29 million. While the Project is justifiably proud of its work inhelping clients to obtain benefits, italso helps a significant percentage ofits clients by thoroughly investigatingcases where the answer turns out tobe, unfortunately, based on the factsand circumstances of the case, thatthe client is not entitled to a pensionfrom the particular employer. Whena case ultimately comes to this conclusion, our clients are usuallygrateful for the effort we haveexpended and for the clear explanationthat we are able to provide. Ourwork allows the client to have closureon an issue that may have nagged athim or her for months or years.

In another large group of cases, wehave to bang our heads on a seem-ingly never-ending succession ofbrick walls to obtain what the clientappears to be entitled to withoutquestion! One such case was recentlyresolved by our pension counselorMollie Feeney on behalf of a 62-year-old man from Derby,Connecticut. He had worked forSouthern New England TelephoneCompany for nearly 21 years, well inexcess of the legal requirements forvesting. He came to us in frustrationafter trying to get his pension bene-fits on his own for over a year.First, the company told him that theyhad no record of his employment.After he provided proof of hisemployment, they told him that hemust have worked in a position notcovered by the pension plan. Whenhe asked what that position was andwhy it was not covered, he was told

they didn’t know because they hadno records!

When Mollie began her investigationof the case, these same confusingstatements were initially repeated toher. When we insisted on getting thelegal documents that governed theplan, we found that there really wasno basis for these statements. Thedocuments specifically provided that“all employees” were pension planparticipants and would accrue bene-fits under the plan.

We filed a formal claim on theclient’s behalf, pointing out theseplan provisions and documenting hislengthy employment. After monthsof follow-up letters and phone calls,we finally received a favorable deci-sion in early March. The client willreceive a monthly pension of over$600 for his lifetime, thanks to ourefforts. The estimated value of thispension over the course of his life-time is more than $144,000.

We are gratified that we were able tohelp this client get the benefit he hadso clearly earned, but the amount of effort and persistence it took toobtain it is a bit sobering. What ifthe client had just given up after hisyear of rejected inquiries? Many people may have done just that. Orwhat if he had not known where toturn for help? It was through readingan article about the Project in theNew Haven Register that he evenrealized the Project existed andmight be able to help him.

We are continually challenged to getthe word out about our services.Please help us. Spread the word!

—Jeanne Medeiros

3

Joan Hyde Conducts Workshopand Symposia on AssistedLiving Concerns at GSA

Institute fellow Joan Hyde, PhD, wasco-convener and moderator at a day-long pre-GSA-conference workshop inNovember entitled “Assisted LivingConcerns from the Private Sector andPolicy Makers: Informing Researchers soResearch Can Inform Practice and Policy.”

The tremendous growth of assistedliving residences in the United Stateshas raised a variety of concerns thatdemand research clarification andassessment. Although the majority ofassisted living residences are developedand managed by the private sector, asmall but growing share of units is nowbeing subsidized through governmentprograms, most notably Medicaid.Thus, to assure that the research com-munity performs cutting-edge studieson the assisted living alternative, it iscrucial for its members to be continuallyinformed about private and publicsector developments. The purpose ofthe GSA forum, which consisted of anaudience of both new and seasonedresearchers and practitioners, was toallow leading representatives of bothof these groups to identify what theybelieve are the most important ques-tions demanding research from theirunique perspectives. In the morningsession, the workshop focused on theissues with which CEOs and other senior management of assisted livingcompanies grapple. In the afternoon,the fiscal and regulatory issues con-fronted by state and federal govern-ments and the challenges of integratinghousing and care were examined. Inboth sessions, the conference organizersserved as discussants and facilitators,allowing audience members to questionand discuss the issues raised.

Ms. Hyde was also co-convener anddiscussant at a symposium on “TrainingAssisted Living Leaders and Staff,”which was offered by the AssistedLiving Special Interest Group at GSA.

(Con’t on page 7)

New Chair for Graduate Programin GerontologyProfessor Ellen Bruce, JD, became theChair and Graduate Program Directorfor the Gerontology Department in fall 2006. Professor Bruce has been aresearcher and faculty member inGerontology at UMass Boston for morethan 15 years. In addition to her newadministrative duties, she will continueto teach in the PhD Program, direct thePension Action Center, pursue herresearch, and engage in service to boththe university and the larger community.(Reprinted from GeroNews, winter 2007.)

PresentationsNina M. Silverstein, professor of geron-tology, CPCS, and Gerontology Institutefellow, presented an “Overview ofDementia and Driving” to health careand law enforcement professionals at aseminar sponsored by the University ofCalifornia, Irvine, Center for Traumaand Injury Prevention Research, onFebruary 16.

Jeffrey Burr, professor of gerontologyand associate dean of the John W.McCormack Graduate School of PolicyStudies, and Kerstin Gerst, doctoral student, presented “Racial Disparities inDocumenting and Discussing End of LifeWishes” at the annual meetings of theGerontological Society of America,Dallas, TX, November 2006.

Jeffrey Burr, Jan Mutchler, professor ofgerontology and associate director of theGerontology Institute, Archana Prakash,Judith Poey, and Kerstin Gerst, doctoralstudents, presented “IntergenerationalLiving Arrangements among OlderImmigrants” at the annual meetings ofthe Gerontological Society of America,Dallas, TX, November 2006.

Professor Mutchler and various graduatestudents presented a number of posters atthe annual meetings of the GerontologicalSociety of America, Dallas, TX, inNovember 2006: With doctoral studentNgai Kwan, the poster “English LanguageProficiency among Older Asians in theUnited States”; with doctoral student

Lindsey Baker, the poster “GrandparentCare Households and Economic Hardshipamong Children”; with doctoral studentsLindsey Baker and Seungah (Hannah)Lee, the poster “Factors Associated with Claims of Responsibility amongGrandparents in Three-GenerationHouseholds: Evidence from the 2000Census.”

At the annual meetings of the AmericanPublic Health Association, Professor JanMutchler, doctoral student Judith Poey,and UMass Worcester Geriatrics facultymember Elizabeth Dugan presented theposter “Trust, Communication, andLanguage in the Patient-PhysicianRelationship in Later Life.”

Yung-Ping (Bing) Chen, professor andholder of the Frank J. Manning EminentScholars Chair in gerontology, presented“Promoting Labor Market Flexibility:How Do Savings and InsuranceComplement Social Security?” and, with Eskil Wadensjo of Sweden, “SocialSecurity and the Labor Market Policiesin Sweden: Could Some of Them BeAdapted for the United States?” at theResearch Conference of the InternationalSocial Security Association in Warsaw,Poland, during the first week of March.Following the Conference, ProfessorChen participated in a roundtable discussion on “Individual Accounts as a Policy Tool,” sponsored by the PolicyResearch Initiative in Human Resourcesand Social Development, Government of Canada.

Professor Chen, along with Sara E. Rix,chaired a symposium, “PromotingLonger Work Lives in the 21st Century:Research Findings from Europe and theUnited States,” and with John C. Scott,presented a paper on “Phased Retirement:Who Opts for It and Toward WhatEnd?” at the annual meetings of theGerontological Society of America,Dallas, TX, November 2006.

Professor Chen was one of two discussantsof papers, including one by the chiefactuary of Medicare, in the Reformingthe Health System session at the

Conference “Weighing the Interests of Younger and Future Generations,”sponsored by the Association forGenerational Equity and the AmericanBenefits Institute in Washington, DC,May 1 and 2.

Nina M. Silverstein, professor of geron-tology, CPCS, and Gerontology Institutefellow, and Kelly Fitzgerald, gerontologyPhD candidate, presented “DriveWell: A Train-the-Trainer Model to PromoteSafety Among Older Drivers” at theAssociation for Gerontology in HigherEducation Annual Conference, March 1-4, Portland, OR.

Professor Silverstein and Elizabeth Johns,gerontology PhD candidate, presented“Assessing Elder Livability in ThreeMassachusetts Communities: A StudentAction-Research Project” at theAssociation for Gerontology in HigherEducation Annual Conference, March 1-4, Portland, OR.

Professor Silverstein and Kelly Fitzgerald,gerontology PhD candidate, presented“Older Driver Re-Education, Re-Fitting,Responding” at the American Society onAging and National Council on Agingjoint conference, March 6-10, Chicago, IL.

Alison Gottlieb, fellow of the GerontologyInstitute, Kapolka, C., Todd, L.,Washako, M., and Wilson, K. conductedthe symposium “The Extended CareCareer Ladder Initiative: Results from aQualitative Evaluation” at the AmericanSociety on Aging and National Councilon Aging joint conference, March 6-10,Chicago, IL.

Professor Silverstein, Elizabeth Johns,gerontology PhD candidate, and spring’06 gerontology certificate studentsCynthia Duryee, Maureen Healey, MSN,GNP, Michele G. Hughes, ElizabethKilleen, Susan Lubin, and Lucia Vanassepresented “Livable Communities: TakingSteps from Vision to Reality” at theAmerican Society on Aging & NationalCouncil on Aging joint conference,March 6-10, Chicago, IL.

4

N E W S N O T E S

Professor Silverstein also presented“DriveWell: A Train-the-TrainerCurriculum” on March 21 to occupationaltherapists at the Boston UniversitySargent College, Department of OccupationalTherapy and Rehabilitation CounselingPrograms in Occupational Therapy.

Ellen Bruce and Laura Henze Russellpresented “The Elder Economic SecurityStandard” at the American Society onAging and National Council on Agingjoint conference, March 6-10, Chicago, IL.

In December ’06, at the Center forExcellence in Assisted Living Conferencein Washington, DC, Joan Hyde,Gerontology Institute fellow, presented“Assisted Living Resident Assessment,” a paper based on pilot work for whichMs. Hyde is seeking funding to do amore comprehensive project. The paperis a review of the literature regarding the

content areas, technologies, and bothclinical and research uses of residentassessments in assisted living, including areport on current state regulations thatrequire a standardized assessment form.

DissertationsOn February 7, Regula H. Robnett successfully defended her dissertationproject, “The Correlates of Cognitiveand Metacognitive Stability and Changein the First Five Waves of the Health and Retirement Study (1992-2000).”Professors Frank Porell and Barbara F.Turner, UMass Boston, co-chaired theDissertation Committee. ProfessorPatricia A. Tun, Brandeis University, was a dissertation committee member.

On March 12, Yaw Amoako-Addosuccessfully defended his dissertationproject, “Old-Age Pension Benefits inNorway: A Study of Differences in

Pension Benefits between Disabled andNon-Disabled Old-Age Pensioners.”Professor Francis G. Caro, UMassBoston, served as Committee Chair.Professor Yung-Ping (Bing) Chen, UMass Boston, and Axel West Pedersen,Norwegian Centre for Research onPoverty and Social Assistance, were dissertation committee members.

On March 15, Jennifer Sullivan success-fully defended her dissertation project,“Understanding Variation in PersonalAssistance Use: The Impact of StateAttributes Affecting Provision of Homeand Community-Based Services.”Professor Francis G. Caro, UMassBoston, served as Committee Chair.Professors Jeffrey A. Burr, UMassBoston, and Rosalie Kane, University ofMinnesota, were dissertation committeemembers.

P R O F I L E Grace Healey, Pension Action Center

The Pension Action Center welcomes the newCoordinator for Development and CommunityEducation, Ms. Grace Healey. Most recently,Grace was Executive Director of theAssociation of Developmental DisabilitiesProviders (ADDP) in Waltham, Massachusetts.

For most of her career, Grace has worked insettings on behalf of children or individualswith cognitive and developmental disabilities. Whether working in government (the U.S. House ofRepresentatives or the Massachusetts Department ofMental Retardation) or in the non-profit sector(Massachusetts Advocacy Center and the ADDP), Gracehas been motivated by the organization’s mission andgoals.

“Helping children obtain a free and appropriate publiceducation; getting a line-item in the state budget for children’s mental health; working to secure decentsalaries for direct support workers who enable peoplewith mental retardation to be all that they can is very satisfying work,” says Grace. “And helping individuals

achieve financial security in retirement fitsright in. You could say that I and my careerpath have gone from children to adults to elders.”

The challenge will be to find the means andresources to connect with women, who faceunique issues achieving a secure financialfuture. “While I have a lot to learn about pension law and regulations, I look forward to

applying my skills and knowledge to increase the public’sawareness of the Center’s valuable work.”

Ellen Bruce, Director of the New England PensionAssistance Project, is enthusiastic about having Grace inplace as Coordinator: “We feel very fortunate that Gracewill be working with us as we extend the reach of the NewEngland Pension Assistance Project and find new ways tohelp people as they prepare for and enter retirement.”

In her free time, Grace swims, reads history, and goes totheater. Oh, and she prays for the Red Sox.

5

N E W S N O T E S

Grants AwardedIn the fall of 2006, the New EnglandPension Assistance Project, the programof the Gerontology Institute that offerscounseling for citizens on their pensionrights, received grants from the followingsources: the U.S. Administration onAging (AoA), $150,000; the Boston BarAssociation, $10, 000; the MassachusettsBar Association, $10,000; and Secretaryof the Commonwealth, $10,000.

National Institute of Aging (2 R01AG013180), 2006-2011. MaximilianeSzinovacz, Principal investigator:Marriage, families, and retirement.($941,375, direct costs).

Publications (2007) Burr, Jeffrey A., Jan E. Mutchler,and Francis Caro. Productive ActivityClusters among Middle-Aged and OlderPersons: Intersecting Forms and TimeCommitments. Journal of Gerontology:Social Sciences (forthcoming).

(2007) Burr, Jeffrey A. and Jan E. Mutchler.Differential Impacts of Employment: AFocus on Race, Class, and Gender.Generations (forthcoming).

(2007) Mutchler, Jan E., Archana Prakash,and Jeffrey A. Burr. The Demography ofDisability and the Effects of ImmigrationHistory: Older Asians in the UnitedStates. Demography (forthcoming).

(2007) Choi, Namkee, Jeffrey A. Burr,Jan E. Mutchler, and Francis Caro.Formal and Informal Volunteer Activityand Spousal Caregiving among OlderAdults. Research on Aging (forthcoming).

(2006) Vanderbur, M., and Silverstein,N. M. Community Mobility andDementia: A Review of the Literature(http://www.nhtsa.dot.gov/people/injury/olddrive/CommMobilityDementia/index.htm), Washington, DC: Alzheimer’sAssociation Public Policy Division andThe National Highway Traffic SafetyAdministration.

(2006) Wu, B., Yue, Y. W., and Silverstein,N. M. Gender Differences in Contributory

Behaviors among the Oldest Old in theU.S. and China. Chinese Journal ofPopulation Science. No. 5, 33-41.

(2006) Bruce, E., Henze Russell, L.,Conahan, J. The Elder EconomicSecurity Standard for Massachusetts.Boston: Gerontology Institute, Universityof Massachusetts Boston, and WiderOpportunities for Women.

(2006) Bruce, E., Henze Russell, L.,Conahan, J. The Elder EconomicSecurity Standard: A Methodology toDetermine Economic Security for Elders.Boston: Gerontology Institute, Universityof Massachusetts Boston, and WiderOpportunities for Women.

(2006) Bruce, E., Henze Russell, L.,Conahan, J. On the Edge: Facing aChallenging and Uncertain Future. TheElder Economic Security Standard forthe Boston Area. Boston: GerontologyInstitute, University of MassachusettsBoston, and The Boston Foundation.

(2007) Forester, B., Vanelli, M., Hyde, J.et al. Report on an Open-Label ProspectiveStudy of Divalproex for the Behavioraland Psychological Symptoms of Dementia(BPSD) as Monotherapy and in Co-Prescription with Second GenerationAntipsychotic Medication. The AmericanJournal of Geriatric Pharmacotherapy(forthcoming).

(2007) Hyde, J., Perez, R., and Forester,B. Dementia and Assisted Living. Specialissue of The Gerontologist on assistedliving (forthcoming).

(2007) Hyde, J. Assisted Living ResidentAssessment. Assisted Living Consult,3(1). Also online at http://www.assist-edlivingconsult.com

(2007) Chen, Y-P (Bing). PhasedRetirement. Italian edition of EuropeanPapers on the New Social Welfare(February).

(2007) Chen, Y-P (Bing), and Turner, J.Raising the retirement age in OECDCountries. In Work Options for Older

Americans, by T. Ghilarducci and J.Turner (Eds.). Notre Dame, IN:University of Notre Dame Press, 359-369.

(2007) Bruce, E. Rethinking retirementpolicy in Massachusetts. New EnglandJournal of Public Policy, 22(1&2), 99-112.

(2007) Mutchler, J. E., Bacigalupe, G.,Coppin, A., and Gottlieb, A. Languagebarriers surrounding medication useamong older Latinos. Journal of Cross-Cultural Gerontology 22: 101-114.

Szinovacz, M. E., and Davey, A. Changesin adult-child caregiver networks. TheGerontologist (in press).

Szinovacz, M. E. Commentary: Thefuture of intergenerational relationships –variability and vulnerabilities. In K. W.Schaie and P. Uhlenberg (eds.), Socialstructures: The impact of demographicchanges on the well-being of older persons.New York: Springer (in press).

(2007) Szinovacz, M. Grandparenthood.In: G. Ritzer (ed.), The BlackwellEncyclopedia of Sociology. Malden, MA:Blackwell Publishing. Vol. 4 (2017-2020).

(2007) Ellenbecker, C. H., Samia, L.,Cushman, M., and Porell, F. EmployerRetention Strategies and their Effect onNurses Job Satisfaction and Intent toStay. Home Health Care ServicesQuarterly, 26(1) 2007: 43-58.

(2007) Caro, F. Productive Aging andVolunteering in the United States:Conceptual, Political, Empirical, andPolicy Issues. In Marcel Erlinghagen and Karsten Hank (eds.), ProductiveActivities of Elders: TheoreticalPerspectives and Empirical Findings from Germany and Europe. Wiesbaden(Germany): VS Verlag.

(2007) Choi, N., Burr, J., Mutchler, J.and Caro, F. (2007). Formal and infor-mal volunteer activity and spousal care-giving among older adults. Research onAging, 29: 99-124.

6

N E W S N O T E S

Using Event History (Con’t from page 1)

Cases were drawn from recent deathrecords filed with the MassachusettsRegistry of Vital Records and Statistics.The research team contacted informantsnamed on the death certificate (who livedlocally and for whom they could find avalid telephone number). Follow-backinterviews were conducted using an eventhistory calendar (EHC) to assist withrecall of past events.

The EHC documented the duration,sequence, and timing of residentialadjustments (moves, changes in house-hold size and composition, and majorhome modifications). It also recorded thesequences and timing of factors knownto influence residential changes, includ-

ing marital status, functional deficits,major health events, and driving capacity. Researchers interviewed 28 informants (primarily children and spouses). Prior tothe interviews, they mailed respondentsan event history calendar (personalizedwith the decedents’ age) and encouragedthem to prepare for the interview byreviewing records and speaking withother people about events. Researchersfound that informants could readily recallmarital status, household composition,driving status, and proximity to childrenof the deceased. They also could recallresidential moves and could characterizethe residences with confidence. Healthinformation (identifying the onset ofchronic diseases and number and timing

of hospitalizations) was more challengingfor some respondents, especially whenthe decedent’s health trajectory was particularly complex. For these topics,the EHC, with probes from the inter-viewers, was especially effective in aidingrecall.

This pilot study effectively demonstratedthe potential of using proxy informantsand EHC methodology to reconstructresidential and health histories ofdeceased older people. It also suggestedimprovements to the data-collectionstrategy that will be helpful if the proposal (to conduct the same study on a much larger scale) is funded.

—Alison Gottlieb

Reports Available on Elder Economic Security StandardThe Elder Economic Security Standardmeasures costs of living for older adultsin today’s economy. Institute researchersEllen Bruce, Principal Investigator, LauraHenze Russell, Project Director, andJudith Conahan, doctoral student, havedeveloped the Standard for older adultsliving in Massachusetts. Long-rangeplans include calculating the Standardfor other states as well.

Conahan, Bruce, and Russell pioneer the research in the first published report,On the Edge: Facing a Challenging andUncertain Future, which presents theElder Standard for the Boston Area. On the Edge is a significant contributionto the ongoing series “UnderstandingBoston,” the Boston Foundation’s sustained commitment to understandingthis city and region, and exploring howto make it an even better home.The Elder Economic Security Initiative:The Elder Economic Security Standardfor Massachusetts presents the ElderStandard for this state to benchmarkbasic costs of living for elder households.It expands upon On the Edge: Facing a Challenging and Uncertain Future by covering communities across theCommonwealth. It illustrates howexpenses vary both by geographic

area and by circumstances of elderhouseholds. This report is co-publishedwith Wider Opportunities for Women(WOW), with funding from theRetirement Research Foundation, The Boston Foundation, and the Charles H. Farnsworth Trust.

The cost components and methodologyfor the Elder Standard, developed by theresearchers with input and guidancefrom the National Advisory Board forthe Elder Economic Security Initiativeconvened by WOW, are presented inElder Economic Community Standard: AMethodology to Determine EconomicSecurity for Elders. The Elder Standarduses cost data from public federal andstate sources that are comparable, geo-graphically specific, easily accessible, andwidely accepted. In areas where existingpublic data sources are not currentlyavailable, such as long-term-care costs, a consistent methodology to derive comparable measures for costs has beenused. This report is also co-publishedwith WOW, with support by theRetirement Research Foundation.

The reports are available at:http://www.geront.umb.edu/eess/

7

The session identified current regula-tions regarding qualifications andtraining at the state level; describedfindings, conclusions, and recommen-dations from ten projects sponsoredby the Better Jobs Better CareInitiative related to training needs andoptimal training methods of directcare workers; discussed external andinternal challenges to organizationalcompetencies and adopting and sustaining new models of care, using atheoretical approach and extrapolatingfrom other industries; and communi-cated theory-based preliminary find-ings about the kinds of training thatenable management staff effectivelyto motivate direct care staff.

The symposium “Treating Behavioraland Psychiatric Symptoms of Dementiain Assisted Living Settings,” moderatedby Ms. Hyde, focused on the epidemi-ology of assisted living residents withsymptoms of dementia as well as phar-macological and non-pharmacologicalapproaches to treatment.

Joan Hyde ConductsWorkshop andSymposia (Con’t from page 3)

Gerontology InstituteUniversity of Massachusetts Boston100 Morrissey BoulevardBoston, MA 02125-3393

Non-ProfitOrganization U.S. PostagePAIDBoston, MAPermit No. 52094

Research Team Explores Barriers to Follow-Up Mammography Screening: Seeking Volunteers

Jan Mutchler, PhD, Associate Director of the GerontologyInstitute and professor of gerontology, along with colleagues at the University of Massachusetts MedicalSchool campus in Worcester, is exploring how survivorsdecide about follow-up care after they have been treatedfor breast cancer. The research team is especially interestedin learning about factors that serve as barriers to follow-up mammography screening, as well as circumstancesthat help survivors obtain care. Based on the results ofthis qualitative study, the team expects to identify targetsof intervention at the patient, family, provider, community,and system levels that may increase utilization of follow-up mammography. This pilot research is funded by theRosalie Wolf Interdisciplinary Geriatric Health CareResearch Center, a recently established collaborative center linking researchers from the University ofMassachusetts Boston campus with investigators from

the Medical School. The Wolf Center is funded by aRAND/John A. Hartford Foundation initiative to promoteinterdisciplinary geriatric research. (See “UMass Establishesthe Rosalie Wolf Interdisciplinary Geriatric Health CareResearch Center” in this issue.)

Volunteers WantedThe research team is currently seeking volunteers to participate in this study. Women who were diagnosedwith breast cancer between 3 and 10 years ago, and whoare willing to participate in a confidential interview witha member of the project team, are encouraged to contactJan Mutchler (617-287-7321, or jan.mutchler@umb.edu);or Katherine Dodd, study coordinator for the project(508-791-7392, or Katherine.Dodd@meyerprimary.org).

—Jan Mutchler

The Gerontology Institute and Programs are part of the John W. McCormack Graduate School of Policy Studies at theUniversity of Massachusetts Boston. Director: Maximiliane Szinovacz, Ph.D.; Associate Directors: Ellen A. Bruce, J.D., andJan Mutchler, Ph.D. Address: Gerontology Institute, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA02125; phone (617) 287-7300; fax (617) 287-7080; email: gerontology@umb.edu; Web site: www.geront.umb.edu.Managing Editor: Robert P. Geary; Designer: Suzanne Korschun.