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Background Older adults frequently defer decisions about their aging‐in‐place/long‐term care (AIP‐LTC) needs. As a result, when older adults experience worsening Alzheimer's disease, family members/friends become surrogate decision makers. We sought to understand what aspects of cognition impact older adult AIP‐LTC planning. Methods As part of the PlanYourLifespan (PYL)‐LitCog study, we longitudinally examined AIP‐LTC decision‐making among a cohort (LitCog) of community‐based older adults (65 years and older) recruited from hospital‐associated primary care clinics in Chicago, Illinois, with extensive cognitive testing. PlanYourLifespan.org (PYL) is an evidence‐based online intervention that facilitates AIP‐LTC planning. Subjects underwent baseline testing, received the PYL online intervention, and then were surveyed at 1, 6, and 12 months about AIP‐LTC decision‐making. Cross‐sectional logistic regression analysis was conducted examining cognitive variables that impacted AIP‐LTC decision‐making. Results Of the 293 older adults interviewed (mean age 73.0 years, 40.4% non‐White), subjects were more likely to have made AIP‐LTC decisions if they had adequate inductive reasoning (ETS letter sets total—OR = 1.14 (95% CI = 1.03–1.27; p < 0.05)) and adequate working memory (size judgment span total—OR = 1.76 (95% CI = 1.13–2.73; p < 0.05)). There were no differences in decision‐making observed in verbal abilities, long‐term memory, or processing speed. All analyses were adjusted for participant gender, race, age, and decision‐making response at baseline. Conclusion Inductive reasoning and working memory are critical to AIP‐LTC decision‐making. Screening routinely for these specific cognitive domains is important in targeting and helping older adults prepare in time for their future AIP‐LTC needs.

Background: Family caregivers of older people with Alzheimer’s dementia (PWD) often need to advocate and resolve health-related conflicts (e.g., determining treatment necessity, billing errors, and home health extensions). As they deal with these health system conflicts, family caregivers experience unnecessary frustration, anxiety, and stress. The goal of this research was to apply a negotiation framework to resolve real-world family caregiver–older adult conflicts. Methods: We convened an interdisciplinary team of national community-based family caregivers, social workers, geriatricians, and negotiation experts (n = 9; Illinois, Florida, New York, and California) to examine the applicability of negotiation and conflict management frameworks to three older adult–caregiver conflicts (i.e., caregiver–older adult, caregiver–provider, and caregiver–caregiver). The panel of caregivers provided scenarios and dialogue describing conflicts they experienced in these three settings. A qualitative analysis was then performed grouping the responses into a framework matrix. Results: Upon presenting the three conflicts to the caregivers, 96 responses (caregiver–senior), 75 responses (caregiver–caregiver), and 80 responses (caregiver–provider) were generated. A thematic analysis showed that the statements and responses fit the interest–rights–power (IRP) negotiation framework. Discussion: The interests–rights–power (IRP) framework, used in business negotiations, provided insight into how caregivers experienced conflict with older adults, providers, and other caregivers. Future research is needed to examine applying the IRP framework in the training of caregivers of older people with Alzheimer’s dementia.