Aim Analyze the concept “tipping point” in the older adult family caregiving context to further knowledge about caregiving families, enhancing transdisciplinary theory, research, and practice. Background While used commonly in some disciplines, how “tipping point” has been used in health care, generally, and in relation to caregiving families, specifically, is less clear. This project was conducted to offer conceptual clarity to tipping point. Design Walker and Avant's framework. Data Source Searches of scholarly literature in PsycINFO, CINAHL, and PubMed using the search term “tipping point” in either title or abstract. Review Methods Definitions used were extracted; instances when the concept was implied but the actual term “tipping point” was not used and contexts where the term was used or implied were identified. Results The composite definition of a caregiving tipping point is a seemingly abrupt, severe, and absolute change event involving either the older adult or caregiver(s), or both that indicates a breakdown in the status quo of the caregiving system. Conclusions Transdisciplinary research, care, and policy should treat caregiving families as complex systems, use longitudinal assessments, and include colloquial communication. Early detection of impending tipping points will provide family‐centered decisional support and enhance families’ quality of life and safety.

BackgroundSexual assault nurse examiners (SANEs) have received specialized education and clinical training in providing forensic care for sexual assault and abuse victims. SANEs provide compassionate and competent care that promotes emotional recovery for their patients; however, caring for this population puts SANEs at risk for secondary traumatic stress, professional burnout, and compassion fatigue. The research regarding SANEs indicates that there may be multiple personal and organizational factors that affect their development of negative outcomes related to professional quality of life.PurposeThis study explored challenges SANEs experience in their work and what resources are utilized to promote their resiliency and professional quality of life.MethodsSANEs were recruited to complete an anonymous online survey through the International Association of Forensic Nurses community; 69 SANEs completed the survey. Eight of the SANEs also participated in follow-up focus groups.ResultsThe participants reported many gratifying aspects of their work. They also described challenges related to personal, professional, organizational, and community factors. Many of the reported negative effects align with secondary traumatic stress and professional burnout. The SANEs identified multiple ways to support their resiliency in the context of this difficult work.ImplicationsThe nature of this work puts SANEs at risk for developing adverse symptoms related to professional quality of life. SANEs need better support and resources to cope with the demands of their work. Findings of this study will be used to design SANE Well, a support application to promote SANE wellness and resiliency.

Knowledge gaps exist about how to help Mexican American (MA) families seek assistance when their capacity to assist older family members is challenged. MA families may resist confronting unpleasant but real situations with the older adult, for example, the need to access long term support services (LTSS), because of cultural and structural barriers. The purpose was to describe stakeholders’ reactions to a culturally focused graphic novela created in partnership with a community advisory council. Qualitative description with content analysis of a focus group’s reactions to the graphic novela was used. Results included positive reactions as well as suggestions for improvement and dissemination. Graphic novelas can be an effective medium for modeling conversations about older adults’ needing additional care, and demonstrating how to identify and access available LTSS or other services. Included is a description of the researchers’ process of partnering with diverse stakeholders, which is essential for creating new solutions.

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