Senior Apartment Research Articles

PUBLIC BATH USE AT A JAPANESE SENIOR APARTMENT ASSOCIATED WITH NEIGHBORHOOD RELATIONSHIPS AND SOCIAL SUPPORT

Abstract The number of older adults who choose to move into senior apartments is increasing in Japan. The development of quality relationships within the senior apartment is important for the healthy aging of the residents. A “public bath” is a unique facility in Japanese senior apartment where residents can interact with each other. Historically, Japan has had a culture of bathing with family and friends in public baths, and the use of this facility is expected to lead to socialization. This study aimed to examine the association between the frequency of public bath use, and neighborhood relationship and social support within a senior apartment. A cross-sectional survey was conducted in a senior apartment in February 2022 (Saitama Prefecture, Japan) towards the entire residents (n=185). Frequency of public bath use (once a week or more vs. less than once a week) was used as the independent variable. Neighborhood relationship (can support or talk to each other vs. only light greetings or no relationship) and social support (have vs. do not have social support) within the senior apartment were used as dependent variable. A binary regression analysis (n=117, female=60.7%) revealed that a higher frequency of public bath use associated with deep neighborhood relationship (OR: 7.14, 95% CI: 1.39-36.63) and social support (OR: 3.44, 95% CI: 1.19-9.99). These results suggest the importance of having a public bath in Japanese senior apartment setting. Furthermore, integrating facilities that possess cultural significance at senior apartments could be important for fostering social relationships.

MULTILEVEL LIFESTYLE INTERVENTIONS ARE NEEDED TO IMPROVE DIABETES SELF-MANAGEMENT IN OLDER ADULTS

Abstract Type 2 diabetes (T2D) is a major public health concern in older adults. Physical activity (PA) and healthy eating (HE) are two major lifestyle intervention strategies in diabetes self-management for controlling glucose levels, preventing complications, and improving functionality and quality of life. This qualitative study aimed to explore perceived factors influencing PA and HE among predominately Latino older adults with T2D ((age=70.5±4.8; Latinos=73.3%). We conducted semi-structured interviews with 15 community dwelling older adults with T2D at the end of a 12-week pre- and post- study assessing self-monitoring on lifestyles and health outcomes. All interviews were recorded and transcribed. Two researchers analyzed the data independently using a combination of deductive and inductive thematical analysis. Codes were categorized into five themes based on the socio-ecological framework, and sub-themes were identified. The themes included five levels of factors: 1) individual (e.g., knowledge, self-efficacy, self-monitoring, perceived benefits and threats, health status,); 2) interpersonal (e.g., family, friend, health provider); 3) organizational (e.g., availability of physical activity equipment in senior apartments); 4) environment (e.g., culture norms); and 5) policy factors (e.g., health provider, retirement). The factors in one level could influence the factors in another level. Most current lifestyle interventions focus on individual level, and multilevel lifestyle interventions to promote healthy lifestyles, and improve health, independence, and quality of life in older adults with T2D are warranted. The input of additional stakeholders such as family members and community staff need to be accounted when designing multilevel intervention in older adults with T2D.

An analysis of the associated factors for falls, recurrent falls, and fall-related injuries among the older adults in senior Chinese apartments: A cross-sectional study

Older adults living in care facilities such as senior apartments may experience falls and severe falls (i.e., fall-related injuries or falls ≥2 times), which are associated with multiple risk factors. However, there are few studies on falls among older adults in senior Chinese apartments. The purpose of our study is to investigate the current situation of falls among older adults in senior apartments and analyze the related factors of falls and severe falls, to assist agency workers in identifying older adults who are at high risk of falls and reducing fall occurrence and fall injuries.

Developing best practices for outreach and recruitment: Updates from the Asian Cohort for Alzheimer’s disease (ACAD) study

AbstractBackgroundDespite investments in AD research to combat this public health crisis, racial/ethnic minorities such as Asian Americans and Asian Canadians (ASACs) remain underrepresented in AD research including clinical trials, biomarker, and genome‐wide association studies. The Asian Cohort for Alzheimer’s Disease (ACAD) is the first large AD cohort for ASACs with a focus on recruiting Chinese, Korean and Vietnamese. We present the outreach and recruitment strategies employed by the ACAD Recruitment and Outreach Workgroup (Workgroup) during the ACAD’s pilot phase.MethodCommunity‐Based Participatory Research (CBPR) principles are embedded through all activities as a fundamental strategy to increase research participant engagement of ASACs. CBPR engages the community in all phases of research (i.e., recruitment; resource sharing; study design; data interpretation). The Workgroup was tasked with a) coordinating and monitoring recruitment activities across all 8 recruiting sites in the US and Canada; b) developing and disseminating recruitment and community outreach/education materials; c) convening the community advisory board (CAB) to elicit feedback on participant referrals, study processes, outreach/recruitment materials and to address community partner needs; d) collaborating with academic and community partners on outreach; and e) developing best practices for community outreach.ResultThe Workgroup developed multilingual and culturally adapted ACAD‐wide outreach, recruitment and retention materials including study flyers, presentation template materials, animated videos, e‐cards, social media accounts and ads. ACAD CAB provided valuable input regarding study procedures and materials as well as promoting ACAD to their respective communities and networks. During the ACAD pilot phase, 26 outreach activities were conducted across sites. Given that ACAD was launched during the COVID‐19 pandemic, many (n = 16) activities were conducted online and some at community centers, clinics, senior apartments, and outdoor events, with an estimated reach of 3,500+ community members. Many (62.5%) events were conducted in English (n = 17), and others in Asian languages such as Cantonese (n = 5), Korean (n = 2), Mandarin (n = 9) and Vietnamese (n = 2).ConclusionACAD’s multifaceted approach to outreach and recruitment aims to optimize community engagement and a step towards representation of ASACs in AD studies. The Workgroup will continue to monitor outreach/recruitment metrics and provide support for overall and site‐specific community engagement needs.

The Relationship of Food Insecurity to Nutritional Risk in Independent Living Older Adults

Understanding the factors that augment optimal health during aging is critical as the US older adult population is increasing. Most research about food insecurity, nutritional risk, and perceived health among older adults are in urban areas or congregate living facilities. Thus, the purpose of this project was to study the relationships among these factors, plus activities of daily living, in community-dwelling older adults in a medium-sized city. Using a qualitative-quantitative study design, a cross-sectional survey was completed by 167 low-income senior apartment residents. Food insecurity in this group was higher than the national and state rate, yet nutrition assistance programs were underutilized and participants under 75 years were more food insecure than their older counterparts. Food insecure residents were at greater nutritional risk, had poorer self-reported health status, were more likely to be depressed, and had a less independent function, including limitations on the ability to shop for and prepare food. The study area is desirable to retirees due to lower cost of living; however, access to services, such as grocery stores, public transportation, and health care providers is limited. This research indicates the need for increased outreach, nutrition assistance, and support services to ensure healthy aging in these regions.

Older and feeling unsafe? Differences in underlying vulnerability, anxiety and life satisfaction among older adults

Objectives: Feeling safe in the daily environment is important in late life. However, research on configuration of vulnerability factors for perceived unsafety in older adults is scarce. The current study aimed to identify latent subgroups of older adults based on their vulnerability for perceived unsafety.Method: We analyzed the data from a cross-sectional survey of residents in senior apartments in a mid-sized Swedish municipality (N = 622).Results: The results of the latent profile analysis based on frailty, fear of falling, social support, perceived neighborhood problems, and trust in others in the neighborhood indicated the presence of three profiles. These profiles were labelled as compromised body and social networks (7.2%), compromised context (17.9%) and non-vulnerable (74.9%). Profile membership was statistically predicted by age, gender, and family status and profiles differed in perceived unsafety, anxiety and life satisfaction.Conclusion: Overall, the study findings suggested the existence of latent subgroups of older people based on patterns of vulnerability.

Monitoring summertime indoor overheating and pollutant risks and natural ventilation patterns of seniors in public housing

Indoor heat and air pollution pose concurrent threats to human health and wellbeing, and their effects are more pronounced for vulnerable individuals. This study investigates exposures to summertime indoor overheating and airborne particulate matter (PM2.5) experienced by low-income seniors and explores the potential of natural ventilation on maintaining good indoor thermal conditions and air quality (IAQ). Environmental and behavioural monitoring and a series of interviews were conducted during summer 2017 in 24 senior apartments on three public housing sites in NJ, USA (1930s’ low-rise, 1960s’ high-rise and LEED-certified 2010s’ mid-rise). All sites had high exposures to overheating and PM2.5 concentrations during heat waves and on regular summer days, but with substantial between-site and between-apartment variability. Overheating was higher in the 30s’ low-rise site, while pollutant levels were higher in the 60s’ high-rise. Mixed linear models indicated a thermal and air quality trade-off with window opening (WO), especially in some ‘smoking’ units from the older sites, but also improved both thermal and PM2.5 concentration conditions in 20% of the apartments. Findings suggest that with warmer future summers, greater focus is needed on the interdependencies among (1) thermal and IAQ outcomes and (2) technological and behavioural dimensions of efforts to improve comfort for vulnerable occupants.

Practice Models of Rural China’s Ageing in Place: From the Perspective of Multiple Collaborative Governance

China’s large-scale rural-urban migration and the ageing of its rural population has intensified the challenges of traditional family care. However, the majority of its rural elderly are reluctant to leave the village acquaintance society even after they are too old or sick to take care of themselves, and ageing in the village community is their primary choice. While various practice models of ageing in place (AIP) supported by the local government and communities have emerged in some pioneering areas of rural China, the existing literature has provided very little comparative analysis on these practice models. Based on firsthand data collected from field studies in rural Jiangsu, East China, this article compares and analyses three main AIP practice models, i.e., home-based care funded by the government and provided by volunteers, day care provided by community care centres, and institutional care provided by village-based “happiness homes” and senior apartments. The roles and operational mechanisms of the government, social organisations, market, and local community in promoting AIP in rural areas are discussed from a perspective of multiple collaborative governance. Moreover, effective partnership between different stakeholders for further development of AIP in rural China for the construction of rural age-friendly communities with improved socialised elder care facilities and systems is discussed. The research has significant implications for the promotion of AIP worldwide.

Geri Models of Care (MOC): An Immersive Preclerkship Curriculum Fostering Student Exploration of Residential Geriatric Models of Care.

Many older adults live in a community-based residential geriatric model of care (MOC; e.g., senior apartments, long-term care nursing facilities). While existing curricula focus on patient transitions to such care, none focus explicitly on MOC features, which are essential for creating effective care plans. We developed the Geriatric Models of Care (Geri MOC) curriculum to guide preclerkship medical students in comparing features of five MOCs. On day 1 of the 2-day session, all second-year medical students spent half a day at different sites, interviewing administrators and touring facilities. On day 2, students debriefed and peer taught in small groups with peers who had visited different care models. Students applied their new knowledge to complex patient cases. Students completed retrospective pre/post self-assessments and offered qualitative feedback on the experience. A summative exam essay question assessed student knowledge application. From 2017 to 2019, 267 students gave the site visit experience a mean rating of 4.6 on a 5-point Likert scale (1 = poor, 5 = excellent). Students' perceived confidence increased significantly (p < .001) for all four evaluated objectives. On the summative exam question, 89% of students passed. Students commented that the curriculum was a unique and effective learning approach, and 13 sites indicated a strong interest in ongoing annual participation. Community MOC visits were instructive and engaging for students and sites. The curricular materials are novel, adaptable for all levels of medical and health professions trainees, and adaptable for a virtual experience.

Evaluating changes in gait and activity associated with cognitive impairment using a home‐based technology platform

AbstractBackgroundChanges in mobility are associated with cognitive decline in older adults. Mobility is frequently assessed in the clinic setting at episodic intervals. Passive sensors within a home‐based technology platform allow for unobtrusive collection of mobility and gait information over an extended time period. This method of high‐frequency data collection could be sensitive to early changes in mobility associated with cognitive decline.MethodWe present data for a cohort of 32 participants living alone and enrolled in the Collaborative Aging Research Using Technology (CART) Initiative aging study with a pervasive sensing and computing system deployed in their homes. Sixteen individuals with a Clinical Dementia Rating (CDR) scale score of 0.5 were matched by age, sex and education to 16 participants with a CDR of 0; 80% lived in low‐income senior apartments; 6% were non‐white. Mobility and gait data is derived from a gait line, consisting of four ceiling mounted, field‐of‐view restricted passive infrared motion sensors placed 61 cm apart in a line, in each home. The number of walking events, defined as all four sensors being triggered, was analyzed between the two groups.ResultParticipants with a CDR score of 0 had a mean age of 72.1 years and a mean MoCA score of 26.1 (range 21 – 30). Participants with a CDR score of 0.5 had a mean age of 72.2 and a mean MoCA score of 22.1 (range 15 – 27). Fifty‐six percent of participants in each group were female. Preliminary data from the gait line from a combined 1400 days for CDR 0 participants and a combined 1250 days for CDR 0.5 participants is presented here. The mean number of daily walking events detected by the gait line was significantly greater for CDR 0 participants (101.4) compared to CDR 0.5 participants (92.8, p=0.03).ConclusionAmbient sensors are able to collect longitudinal data on gait and activity levels in individuals with a technology platform deployed within their home. This unobtrusive remote mobility assessment methodology identifies individuals experiencing cognitive impairment. Further evaluation of other gait metrics and home‐based activity patterns is ongoing to explore their association with changes in cognition.

Presence of Meaning in Life in Older Men and Women: The Role of Dimensions of Frailty and Social Support.

Presence of meaning in life is an important component of eudemonic wellbeing while aging. While subjective health and interpersonal relationships are among important sources of meaning for older adults, less research has explored the gender differences in the potential contribution of these sources to the presence of meaning in late life. The current study aims to examine the associations of frailty dimensions (daily activities, health problems, and psychosocial functioning) and social support with the presence of meaning in late life, and whether these associations differ for older men and women. The study employs the data from the 65+ and Safe Study – a cross-sectional survey of residents of senior apartments. The data were collected in 2019 in a mid-sized Swedish municipality (N=618; age range from 64 to 106years, 60.5% female). Results showed significant associations of health problems, psychosocial functioning, and social support with the presence of meaning in life. Further, the results demonstrated no statistically significant gender differences in the associations between frailty dimensions, social support, and presence of meaning. However, since the interaction between health problems and gender approached statistical significance, this association was further explored indicating a more detrimental role of health problems in relation to the presence of meaning in life among older men than among older women. Overall, the study highlights the importance of physical and psychosocial health and social support for the presence of meaning in life among older adults and warrants further research on possible gender differences in the relation between health problems and meaning in late life.

Telephone-Based Health Coaching: Reduction in Alzheimer’s Risk Behaviors

Objective: Explore the feasibility of integrating intensive, telephone-based health coaching programs in low-income senior housing communities to reduce Alzheimer’s risk behaviors. Design: Participants meeting study criteria: 60 years or older, a working telephone, no cognitive diagnoses, income below 1,000 USD monthly, and active cardiovascular or diabetic health symptoms were recruited from low-income housing units. Engagement in Alzheimer’s risk behaviors: Cigarette use, alcohol overuse, polypharmacy, inactivity, depression, and cognition status, were measured at enrollment, and 12 weeks post. Weekly coaching sessions focused on reducing behavioral risk for Alzheimer’s disease. Setting: Low-income senior apartments in Richmond, Virginia Participants: Twenty older adults, living in low income senior high rises. Participants were majority (95%) African-American (Mean= 69 years, SD=4.17, Range=61-77). Intervention: Participants engaged in a call with a coach for 12 weeks, focused on Alzheimer’s risk reduction. Participants identified with coach specific behaviors to target. Primary Outcome Measure: Feasibility of telephone-based health coaching to reduce Alzheimer’s Risk Behaviors. Feasibility is defined as participant engagement in health coaching and self-rated health outcomes. Results: Of the original 20 enrollees, 19 (95%) participated in coaching sessions. On average, 8.75 sessions were completed. All participants rated their experience as positive, and self-reported an improvement in health and healthy behaviors, in exit interviews. The coaching experience was rated 94.11 on a scale from (0-100). Participants rated their health coach, on average, 90.44 on a scale from (0-100). Participants rated their health improved as 92.37 on a scale from (0-100). Conclusion: Telephone-based health coaching was feasible based on participant engagement.

Recruitment of Hard-to-Reach Older Adults in Technology-Based Mental Health Services Studies: Lessons Learned

Homebound older adults are a hard-to-reach population with a high burden of depression and face substantial access barriers to mental health treatments. Internet-based psychotherapy is a promising strategy to address this persistent treatment gap, but older adults are severely underrepresented in internet-based psychotherapy trials. One challenge to advance this area of research and practice is the recruitment and retention of homebound older adults in clinical trials. Previous research has discussed the challenges of recruiting older adults in behavioral interventions and offered useful recommendations. However, recruiting homebound older adults, who face substantial mobility barriers, poses additional challenges not fully addressed in the literature. The expectation of using technology adds another layer of difficulty. In this presentation, we will discuss our group’s experiences working with community partners to recruit and retain homebound older adults for a study on technology-based mental health treatment. We partnered with home care agencies, senior apartment buildings, and Meals-on-Wheels and experimented with a few different ways to recruit study participants. Issues related to accessibility, trust, and stigma emerged as important considerations when designing recruitment strategies and materials. The discussion will be an integration of our experiences and a review of previous literature on the challenges and recommendations for recruiting older adults in mental health services research.

The Rules of Engagement: UtilizIng improve to Build Relationship-Centered Care

During this unprecedented time of older adults (specifically those living with dementia) requiring services, caregiving and social opportunities amongst their places of residence (including long term care facilities, senior apartment buildings, supportive living spaces and within the community), it is imperative that we adjust our current model of care from “patient-centered” to “relationship-centered”.

Association Between Improved Mobility and Distal Health Outcomes.

We examined the association between improved mobility and distal health outcomes in older adults using secondary analysis of data from a cluster-randomized controlled group exercise trial. Participants were 303 men and women aged ≥65 and older in 32 independent living facilities, senior apartments, and community centers who participated in 12-week group exercise interventions. Included were those who completed ≥1 follow-up phone call regarding outcomes assessment in the following year. Gait speed and 6-minute walk distance (6MWD) were assessed at baseline and immediately after 12-week interventions to determine mobility performance change status. Falls, emergency department (ED) visits, and hospitalizations were assessed monthly for 12 months following the end of interventions via interactive voice response phone calls. Incident rate ratios (IRRs) were calculated to quantify incidence of adverse outcomes with respect to mobility performance change. Each 0.05 m/s increase in gait speed resulted in an 11% reduction in falls (IRR = 0.89; 95% confidence interval [CI], 0.84-0.94; p < .0001); a similar decrease was seen for each 20 m increase in 6MWD (IRR = 0.89; 95% CI, 0.83-0.93; p = .0003). Those who improved gait speed had 61 falls per 1,000 person-months versus 135 in those who had no change/a decline. Those who improved 6MWD had 67 falls per 1,000 person-months versus 110 per 1,000 person-months in those who had no change/a decline. Differences in ED visits and hospitalizations were not statistically significant. Improvements in mobility performance are associated with lower incidence of future falls. Given the exploratory nature of the findings, further investigation is warranted.

Summertime thermal conditions and senior resident behaviors in public housing: A case study in Elizabeth, NJ, USA

As heat waves become more extreme, there is a growing concern for the health of elderly city dwellers who have poor living conditions and limited access to resources. Much research has documented socioeconomic links to heat vulnerability, but limited studies have investigated the detailed living conditions of vulnerable populations, despite increasing requests from local communities. In this paper, we examine the summertime thermal performance of 24 senior apartments within 3 public housing sites (2 conventional multifamily and 1 LEED-rated building), and the seniors' adaptive responses in Elizabeth, NJ, USA. Time-series data were collected from sensors, interviews and observations on the thermal environment and behavior, from May–October 2017. Our multi-level, occupant-centric approach utilizes the indoor heat index as a proxy for heat stress, against site and building characteristics, and environmental and personal variables. Panel regressions show thermal variations among sites/apartments and illustrate the significant effect of actions, such as window opening and air conditioner use. Results also show how the seniors' adaptive responses vary by site; residents with central air-conditioning use it, while residents from the two older sites engage in a wider range of adaptive actions, and in some cases achieve similar indoor heat indexes as apartments from the green building. Indoor heat stress experienced by low-income seniors can be greatly reduced through cost-effective strategies that target individual behaviors and outdoor amenities. This implies the need for integrated solutions to the heat waves problem across scales; including changes to residents' habits, building envelopes, building operations, and outdoor spaces.

About odor trouble of senior apartment and hotel

近年では建築資材・建材の改良により重篤なシックハウス症を発生する事例は非常に少なくなっている．しかしシックハウス物質が原因ではない室内での臭気苦情は後を絶たない．本報では今後需要が増えそれにつれて臭気トラブルの発生が懸念されるシニアマンション・ホテルの現状と調査事例，臭気発生の実情を述べる．

Differences in conventional and seniors-oriented apartment management

PurposeFrom the consumer side, this paper aims to highlight some of the various characteristics that older renters seek out from their apartment buildings, relative to conventional multifamily residential buildings and, from the operational side, to examine some of the costs involved in daily operation of such buildings.Design/methodology/approachThe Rental Housing Finance Survey provides data that enables scholars to test empirical differences in amenities and costs between senior-oriented communities and other apartment buildings.FindingsOccupancy rates outpace the rate for all other apartment communities. Regarding amenities, senior apartment communities are more likely than other communities to have a fitness center on premises, but less likely to have a swimming pool. Market value for senior properties is usually less than properties marketed toward multi-family property tenants. This difference may be due to a higher pattern of both operating/capital expenses within senior communities. Part of these increases in operating costs is due to a higher propensity to hire professional management companies and a higher fee for managing senior apartment communities.Originality/valueLiterature on seniors living within apartment communities is somewhat sparse, particularly regarding the operational aspects of managing apartment communities. There is a dearth of information on industry success measurements known as operating and capital expenditures. This study triangulates multiple sources of data to investigate differences in cost of senior housing apartment communities, as well as amenity structures.

A qualitative study to understand over-the-counter medication use and decision-making among residents of senior-living communities.

OTC medications are generally considered safe and convenient to use without requiring a prescription. However, the safety of an OTC medication and the final health outcome depends in part upon consumers' perceptions, beliefs, and their decision-making about OTC medication use. This study uses a qualitative approach to explore the knowledge, beliefs, and practices associated with OTC medication use and decision-making in adults aged 65 years and older. A set of focus groups (N = 10) were conducted in a sample of independently living older adult residents of senior apartment buildings (N = 80) using purposeful sampling. All focus groups were recorded, transcribed verbatim, and analyzed qualitatively. Most participants considered OTC medications safe and effective to use if following the drug label instructions appropriately. Brand name products were perceived as equally or more effective compared to generic products by participants. Two approaches to OTC treatment decision-making were observed: 1) a decision to treat their symptoms by themselves (self-recommended) or 2) a decision to ask and/or follow their physician's recommendation (physician-recommended). Each of these treatment approaches may lead to the other depending on the person's financial and healthcare resources, the severity of the symptoms, experiences with the medication, and relationship with the physician. Maximum and fast relief was mentioned as the most important attribute in the final OTC purchase decision, followed by the lower cost, and easy to swallow dosage forms. Aspirin and ibuprofen were the two most frequently reported OTC medications associated with adverse effects and inappropriate use. Older adults, in general, feel positive about OTC medications and are satisfied with using them. Considering the self-reported malpractices and side effects associated with OTC medications, older adults should be encouraged to make safe and responsible decisions about self-medication.

A cognitive function predicted method by Useful Field of View tests among elder people in Beijing

ObjectiveTo analyze the visual functions of the elder people in China by Useful Field of View (UFOV) to verify performances in Chinese elders. MethodsA total of 90 participants aged 60 years or above were recruited from residents in the Jiade Senior Apartment and the Fuchengmen Public Health Community in Beijing. Participants completed three tests, Mini Mental State Examination (MMSE), Digit Span test and UFOV. We also tested the digit span and UFOV the following year. ResultsThe correlation between age and MMSE score was significant (r = −0.422, P < .001). Digit Span scores showed significant negative relationships for all three subtests (P < .01) between ages. The scores of UFOV test 1 showed a non-significant correlation with age, r = 0.147, P > .1, while UFOV test 2 and UFOV test 3 showed significant positive relationships with ages, (both P < .01). Thirty-nine participants (out of 90) finished the digit span and UFOV the following year. Only UFOV test 3 has a significant differential performance between two years (t = −2.95, P < .01). We found UFOV tests showed the visual response capacity and had a strong correlation with ages (statistically significant). ConclusionUFOV could be an effective way to evaluate cognitive ability in Chinese elderly people and the selective-attention test of UFOV may be a more sensitive measurement.