Senior Centers Research Articles

Engagement in Non-Medical End-of-Life Planning by Older Adults

ContextWhile medical end-of-life planning has been well characterized, less is known about non-medical planning to prepare for the end of life. ObjectivesTo determine the prevalence of engagement in non-medical end-of-life (EOL) planning and its relationship to medical EOL planning. MethodsThree hundred and four persons age 65 and older recruited from physician offices and a senior center were administered an in-person interview asking about participation in the following non-medical EOL planning behaviors: moving to a location with more help, teaching someone to do things around the house, purchasing long-term care insurance, telling someone the location of important documents, preparing a financial will, conveying wishes for funeral arrangements, purchasing a cemetery plot, and prepaying for a funeral. ResultsPrevalence of participation in the different non-medical EOL planning activities varied widely, from 8% for prepaying for a funeral to 84% for telling someone the location of important documents. There was little overlap in the factors associated with participation in each activity. Conveying wishes for funeral arrangements and completing a financial will were associated with completing a living will (OR 2.69, 95% CI 1.51, 4.78; OR 6.70, 95% CI 3.18, 14.15) and communication about quality versus quantity of life (OR 4.52, 95% CI 2.54, 8.04; OR 2.47, 95% CI 1.25, 4.86). ConclusionThere is variability in both the prevalence of and factors associated with engagement in non-medical EOL planning activities. The association of non-medical with medical planning activities supports the utility of programs assisting individuals with broad engagement in EOL planning.

Reimagining Senior Centers for Purposeful Aging: Perspectives of Diverse Older Adults.

Senior centers must re-envision their programs to appeal to today's increasingly older and more diverse older adults. Using a purposeful aging framework, this study aims to inform senior center programming by capturing diverse older adults' perspectives on future goals, perceptions of aging, attitudes about senior centers, and experience with technology. Participants age 70 and older (N = 64) joined one of eight focus groups organized by race/ethnicity and preferred spoken language. Transcripts were coded using a grounded theory approach to identify perspectives in each domain. Across groups, shared perspectives included aspirations to make a difference, maintain health and independence, continue learning, and embrace positive perceptions of aging. However, both positive and negative attitudes about participating in senior centers and the effects of technology were presented. We discuss how to redesign senior center programming to meet members' proactive approach to aging and future goals, and facilitate more confidence with new technology.

41896 Surveying knowledge of quality of dementia care among Latino caregivers

ABSTRACT IMPACT: This qualitative study describes health system barriers to high-quality care for Latino older adults with Alzheimer’s Disease and Related Dementias OBJECTIVES/GOALS: Compared to non-Latino Whites, Latino older adults are more likely to receive low-quality dementia care such as high-risk medications or services. Caregivers play a critical role in managing medical care for persons with dementia (PWD). Yet little is known about the perceptions and knowledge of dementia quality of care among Latino caregivers of PWD. METHODS/STUDY POPULATION: We used a qualitative research design and conducted interviews with Latino caregivers of PWD and caregiver advocates. We recruited both from community organizations, senior centers, and clinics. Our interview guide focused on experiences of caregiving, interactions with medical system, and knowledge and experiences managing behavioral and eating problems. We used Grounded Theory methodology for coding and analysis, focusing on contrasting and comparing experiences within and between caregivers and caregiver advocates. RESULTS/ANTICIPATED RESULTS: Preliminary results from interviews with two caregivers and two caregiver advocates illustrate that caregivers of persons with dementia have a difficult time receiving high quality care from primary care clinicians. All participants noted that many primary care doctors didn’t know how to diagnose ADRD and dismissed critical symptoms as part of old age. Caregivers also reported that they wished they had more information on what to expect with ADRD disease progression, noting they received little information from the formal medical care system. With respect to behavioral problems, caregiver advocates noted that primary care doctors often did not provide non-pharmacological alternatives to behavioral problems. DISCUSSION/SIGNIFICANCE OF FINDINGS: Findings from our pilot study demonstrate that there is a clear need to train primary care physicians who serve Latino older adults on ADRD care. Improved diagnosis and management could improve outcomes among Latino older adults with dementia.

33149 Interventions and Education: What We Learned from the 'All Eyes on Us' Study

ABSTRACT IMPACT: This study identifies potential areas for community and clinical interventions to improve eye and vision health. OBJECTIVES/GOALS: The ‘All Eyes on Us’ study sought to understand perceptions of and barriers to eye and vision care, of residents over the age of 40 in the Broadway/Slavic Village neighborhood in Cleveland, Ohio. The goal of this study was to identify potential areas for community and clinical interventions to improve eye health. METHODS/STUDY POPULATION: Residents of the Broadway/Slavic Village neighborhood, an ethnically diverse, low socioeconomic status, neighborhood in Cleveland, Ohio were recruited from, and with the assistance of, University Settlement, a nonprofit that has been providing services to the neighborhood since 1926. The project’s Community Advisory Board assisted with the development of a semi-structured interview guide over the course of three meetings. Sixty interviews were completed, 30 with self-identified European Americans and 30 with self-identified African-Americans, all over the age of 40. Two research team members coded the interview transcripts and a thematic analysis was conducted. RESULTS/ANTICIPATED RESULTS: Participants identified barriers to obtaining eye and vision care for themselves as well as perceived barriers for others, including transportation, cost, insurance status, clinic locations, lack of education around eye and vision care, fear, forgetfulness, and priority management. To encourage people to go to the eye doctor more often, participants mentioned strategies related to access issues including lowering the cost of exams, operating on a sliding scale, improving insurance coverage, transportation services, and having mobile units that deployed to specific neighborhoods or senior centers. Additionally, participants suggested education and increasing awareness about the importance of eye and vision care. DISCUSSION/SIGNIFICANCE OF FINDINGS: Participants in this study identified that accessibility to and awareness about eye health and eye care is an issue. Interventions to address both access issues such as location, cost, and insurance as well as those that increase education could increase engagement with eye and vision care.

전남 동부도시 노인복지관의 공간적 특성

The senior welfare centers should provide integrated welfare services to the elderly whose needs are in change. So this paper tried to find a direction for improvement by identifying the spatial organization of the centers which are in Yeosu, Suncheon and Gwangyang. Classification of spaces of senior welfare center followed the guidelines 2020 for senior welfare center from Ministry of Health and Welfare which are consultation, medical rehabilitation, day or short-term protection, social education, home welfare, employment, welfare and public relations and PR planning and by adding management and public space. The above factors are invested and analyzed. The results of the survey and analysis of seven senior welfare centers are as follows. First, in the survey, the spatial organization of the senior welfare centers surveyed showed that the larger the size is, the dominantly lager the social education space is. Second, the space for day or short-term care, and employment is less than 1% of the total area, and most senior welfare centers do not have a basic space for this. Third, the space related to home welfare and counseling is very small, and more than half of the senior welfare centers do not have space related to it.

Sustainable Aging and Leisure Behaviors: Do Leisure Activities Matter in Aging Well?

A substantial portion of the gerontological literature has been directed towards the relationship between leisure and aging, particularly with the healthy life of older adults. The concept of leisure conveys varied meanings to persons, including identifying the leisure itself, the activity’s frequency, and its value to the participant. With increased longevity, the concept of aging well and related terms (e.g., “active aging”, “successful aging”, “productive aging”, “positive aging”, “healthy aging”, and “sustainable aging”) have been emerging themes for academic fields related to gerontology, exercise promotion, health care, and leisure activities. Thus, the aging population and human leisure activities must be considered sustainable as sustainability is primarily human-centered. This study explores older adults’ perceptions of leisure and aging well and their leisure behavior at senior welfare centers using qualitative data collection and methodology. Findings suggest that four main themes emerge: unfamiliarity with the concept of leisure and leisure engagement; evolving perceptions of senior centers and leisure benefits; limited physical functioning as a major leisure constraint; perceptions of major factors for aging well. Implications for researchers and policymakers are discussed.

Implementation and effectiveness of a multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres

To address the paucity of research investigating the implementation of multi-domain dementia prevention interventions, we implemented and evaluated a 24-week, bi-weekly multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres (SCs). It comprised dual-task exercises, cognitive training, and mobile application-based nutritional guidance. An RCT design informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance framework was adopted. Outcome measures include cognition, quality of life, blood parameters, and physical performance. Implementation was evaluated through questionnaires administered to participants, implementers, SC managers, attendance lists, and observations. The program reached almost 50% of eligible participants, had an attrition rate of 22%, and was adopted by 8.7% of the SCs approached. It was implemented as intended; only the nutritional component was re-designed due to participants’ unfamiliarity with the mobile application. While there were no between-group differences in cognition, quality of life, and blood parameters, quality of life reduced in the control group and physical function improved in the intervention group after 24 weeks. The program was well-received by participants and SCs. Our findings show that a multi-domain program for at-risk older adults has benefits and can be implemented through neighborhood SCs. Areas of improvement are discussed.Trial registration: ClinicalTrials.gov NCT04440969 retrospectively registered on 22 June 2020.

Physical Activity, Mental Health, and Technology Preferences to Support Cancer Survivors During the COVID-19 Pandemic: Cross-sectional Study.

BackgroundCOVID-19 has had significant health-related and behavioral impacts worldwide. Cancer survivors (hereafter referred to as “survivors”) are particularly prone to behavioral changes and are encouraged to be more vigilant and observe stricter social distancing measures.ObjectiveWe explored (1) changes in physical activity and sedentary behaviors since the onset of COVID-19, along with changes in mental health status, and (2) alternative strategies to support survivors’ physical activity and social health during and after COVID-19, along with the role of digital health in such strategies.MethodsA questionnaire was distributed among survivors participating (currently or previously) in the community-based physical activity program LIVESTRONG at the Young Men’s Christian Association (YMCA), from 3 sites outside an urban area in Massachusetts. Questions addressed pre–COVID-19 vs current changes in physical activity and sedentary behavior. Anxiety and depression were assessed using the 2-item Generalized Anxiety Disorder scale (GAD-2) and 2-item Patient Health Questionnaire (PHQ-2), and scores ≥3 indicated a clinical diagnosis of anxiety or depression, respectively. Digital health preferences were assessed through closed-ended questions. Open-ended responses addressing other preferences for physical activity programs and social support were analyzed, coded, and categorized into themes.ResultsAmong 61 participants (mean age 62 [SD 10.4] years; females: 51/61 [83.6%]), 67.2% (n=41) reported decreased physical activity and 67.2% (n=41) reported prolonged sitting times since the onset of COVID-19. Further, 24.6% (n=15) and 26.2% (n=16) met the GAD-2 and PHQ-2 criteria for clinical anxiety and depression, respectively. All participants owned a cellphone; 90% (n=54) owned a smartphone. Preferences for physical activity programs (n=28) included three themes: (1) use of digital or remote platforms (Zoom, other online platforms, and video platforms), (2) specific activities and locations (eg, outdoor activities, walking, gardening, biking, and physical activities at the YMCA and at senior centers), and (3) importance of social support regardless of activity type (eg, time spent with family, friends, peers, or coaches). The survey revealed a mean score of 71.8 (SD 21.4; scale 0-100) for the importance of social support during physical activity programs. Social support preferences (n=15) revealed three themes: (1) support through remote platforms (eg, texting, Zoom, phone calls, emails, and Facebook), (2) tangible in-person support (YMCA and senior centers), and (3) social support with no specific platform (eg, small gatherings and family or friend visits).ConclusionsPhysical activity and mental health are critical factors for the quality of life of survivors, and interventions tailored to their activity preferences are necessary. Digital or remote physical activity programs with added social support may help address the ongoing needs of survivors during and after the pandemic.

Daily Time Use by Activity of Community-Dwelling Older Koreans: Focus on Health Management.

This study aimed to examine the daily time use by activity and identified factors related to health management time (HMT) use among 195 older adults (mean age = 77.5, SD = 6.28 years; 70.8% women) attending a Korean senior center. Descriptive statistics were analyzed and gamma regression analyses were performed. Participants used the most time on rest, followed by leisure, health management, daily living activities, and work. The mean duration of HMT was 205.38 min/day. The mean score for the subjective evaluation of health management (SEHM) was 13.62 and the importance score for SEHM was 4.72. Factors influencing HMT included exercise, number of chronic conditions, fasting blood sugar level, low density lipoprotein level, and cognitive function. HMT and frailty significantly predicted SEHM. HMT interventions focus on promoting exercise and acquiring health information to improve health outcomes among older adults in senior centers.

Benefits of Dog-Assisted Therapy in Patients with Dementia Residing in Aged Care Centers in Spain.

(1) Background: Currently, the scientific evidence on the benefits of assisted therapy with dogs in dementia is not clear. In this study, we want to evaluate such benefits through a randomized controlled clinical trial in multiple centers across the country. (2) Methods: The participants were people over 65 years old with dementia, residing in senior centers in Spain (n = 334). The experimental group underwent assisted therapy with dogs based on the Comprehensive Cognitive Activation Program in Dementia, for 8 months, with weekly sessions of 45 min. Data were collected at the commencement, middle, and end of the program, to evaluate the aspects using the Mini-Examination Cognitive, the modified Bartell Index, the Cornell Scale for Depression in Dementia and the Neuropsychiatric Inventory. (3) Results: The results show significant improvements in the experimental group versus the control group in the affective (T1 = p 0.000; T2 = p 0.000) and behavioral (T1 = p 0.005; T2 = p 0.000) aspects, with the affective aspect displaying greater progress in participants with additional depressive (p = 0.022) or anxiety (p = 0.000) disorders, shorter institutionalization periods (r = −0.222, p = 0.004), and those undergoing complementary psychotherapy (p = 0.033) or alternative therapy (p = 0.011). (4) Conclusions: Dog therapy is effective in improving the affective and behavioral aspects of institutionalized patients with dementia.

The Effects on Cognitive, Emotional, and Physical Functions of the Elderly at Local Senior Center from Dementia Prevention Program for the Dementia Safety Village

This non-synchronized design research tested the effects of dementia prevention program on cognitive and emotional functions, and activities of daily living of subjects in The Dementia Safety Village by National Responsibility System for Dementia. The subjects were 11 elders at local elderly center of The Dementia Safety Village. Outcome variables include cognition (MMSE-DS: Mini-Mental State Examination-Dementia Scale), emotion (SGDS-K: Short form Geriatric Depression Scale-Korean version), and physical function (IADL: Instrumental Activity of Daily Living). The program provided two hours per a session per week for eight weeks. After completing the program, the score of MMSE-DS, a tool for cognitive function evaluation, increased with a statistically significant figure (t = –3.35, p = 0.007). The score of SGDS-K, which evaluated emotional function, increased, though it did not reach in a statistically significant level (t = –0.482, p = 0.640). The score of IADL showed no a statistically significant figure (t = 0.680, p = 0.512), but the mean showed a slight decreased figure (pre 12.00 ± 4.49, post 11.00 ± 2.19). Based on these results, the dementia program may be used for dementia prevention to the patients of The Dementia Safety Village. This research suggests that an appropriate program for the prevention of dementia needed to be developed further in the future.

Effectiveness of a Novel Implementation of the Otago Exercise Program in Rural Appalachia.

Despite evidence that falls can be prevented with specific exercise interventions such as the Otago Exercise Program (OEP), translation of these programs into practice is limited in rural and medically underserved areas. The Community Health and Mobility Partnership (CHAMP) addresses this problem through a community-based implementation of the OEP in rural Appalachia where medical resources are scarce. The purpose of this study was to examine the effects of the CHAMP on physical performance and balance confidence in community-dwelling older adults. This study was a retrospective analysis of quasi-longitudinal data. Older adults received fall screenings at local senior centers. Those with increased fall risk received individualized OEP home exercises and were advised to return for monthly follow-up visits. Three physical performance measures-Timed Up and Go test (TUG), Four-Stage Balance Test (4SBT), and chair rise test (CRT)-and the Activities-specific Balance Confidence scale (ABC) were assessed at the initial visit (IV) and each follow-up visit. Two groups were created to distinguish participants who returned for their second follow-up (F2) visit within 3 months from those who returned between 3 and 6 months. Within-group change from IV to F2 was calculated using repeated-measures t tests. Repeated-measures 2-way analyses of variance were used to test for main and interaction effects of group and visit. One hundred thirty CHAMP participants aged 76.1 (SD = 8.1) years demonstrated statistically and clinically significant improvements in the 3 physical performance measures (mean 4SBT: IV 29.5 seconds, F2 31.5 second, P = .001), (mean TUG: IV 12.7 seconds, F2 11.9 seconds, P = .021), (mean CRT: IV 0.258 stands/second, F2 0.290 stands/second, P = .002), but not in balance confidence (mean ABC: IV 62.2, F2 64.4, P = .154). A significant interaction of group by visit for the TUG was observed, suggesting that better TUG performance was associated with quicker return for follow-up. Results indicated that program participants improved from IV to F2 in measures related to fall risk.

Stories of the elderly in relation to Katharine Kolcaba's Theory

Comfort is a construct that has been described as a fundamental element in inpatient care, Kolcaba performs a conceptualization of comfort, distinguishing three types in four contexts. The objective was to describe the comfort provided in the elderly through an in-depth interview at the ATALAYA Senior Center. It is a qualitative study, with a phenomenological approach, non-probabilistic sampling, an interview focused on 4 contexts of Katharine Kolcaba's theory was applied, identifying the ty

Development of guidelines for enhancement of thermal comfort and energy efficiency during winter for Thailand’s senior centers using surveys and computer simulation

The objective of this study is to develop guidelines for thermal comfort and energy efficiency for senior centers during winter. The study was conducted in Phitsanulok, Thailand and it applied 3 study’s methods; field survey, laboratory study, and simulation in scSTREAM–a CFD program and DOE-2 program; to develop the guidelines. With a temperature set-point at 25.0°C in the existing air-conditioned senior centers, the study shows that occupants feel "Slightly cool". These feeling can be adjusted to "Neutral" by applying natural ventilation and fans to generate air speed of 0.57–0.60 m/s during 8:00 AM–1:00 PM, and by setting the temperature set-point at 26.0°C with air speed of 0.10–0.26 m/s during 1:00 AM–4:00 PM. The guidelines can help reduce energy consumption by 23.0 % and can apply for senior centers.

Effectiveness of Senior Center Programs in South Korea: A Meta-analysis

Effectiveness of Senior Center Programs in South Korea: A Meta-analysis

PREVALÊNCIA DA DEPRESSÃO EM IDOSOS QUE FREQUENTAM UM CENTRO DE CONVIVÊNCIA NO MUNICÍPIO DE CASCAVEL-PR

A depressão é um problema de saúde mental comum na terceira idade, tendo impactos significativos em todos os aspectos da vida. Dessa maneira, o ato de interagir socialmente em centros de convivência revela ser benéfico na grande maioria das vezes, não só pela questão de inclusão social, mas também pelo resgate da autonomia desses idosos. Esse trabalho contempla a incidência da depressão em idosos que frequentam um centro de convivência. Em relação a perspectiva metodológica da pesquisa, este estudo tem caráter transversal descritivo: foi aplicada a Escala de Depressão Geriátrica Yesavage (1983), com 15 perguntas, num período de 4 meses, em indivíduos acima de 60 anos de ambos os sexos, proveniente de um centro de convivência de Cascavel-PR. A amostra foi composta por 67 idosos, sendo estes, 91,04% mulheres e 8,96% homens. Dentre os idosos estudados, a prevalência de sintomas depressivos graves foi de 1,49%, depressivos Leves/Moderados 13,43%, e sem sintomas 85,07%. A partir desse levantamento, foi possível constatar a baixa incidência de casos depressivos àqueles que frequentam o centro de convivência, comprovando a sua capacidade em ressignificar a vida do idoso, ofertando a eles envelhecimento autônomo, saudável e ativo.

How do Senior Center Attendees Rate the Importance of Programs and Services Compared to Non-Attendees?

Senior centers provide a wide range of programs and services to meet the needs of the growing aging population. As senior centers aim to serve all older community-members, it is important to assess the value of these services through the lens of both attendees and non-attendees of senior centers. Using a sample of 4,750 community-dwelling adults age 60 or older from Massachusetts, this project aims to analyze perceptions of program importance by center attendees versus non-attendees. Almost 60% of the sample never attend a senior center. Nearly a third of center attendees ranked exercise classes and education opportunities as important, compared to about 20% of non-attendees. Almost half of attendees rated application assistance and nutrition programs as not important, compared to 38% and 40% of non-attendees, respectively. Conversely, for all programs listed, non-users more frequently checked “unsure” of program/service importance. This was especially true for exercise classes, professional services, social or recreational activities, educational opportunities, and trips, for which 18% of non-attendees selected unsure. Center attendees more frequently view the programs/services offered at the senior center as important or very important, likely because they have greater awareness. Results highlight that that non-attendees are unsure of the value of programs or have no interest the programs and services provided. Not only do these results provide an opportunity to senior centers to assess how valuable certain programs and services are, they also emphasize the need for continued information streams regarding programs and services offered at senior centers to those who are unfamiliar.

Identifying the Transportation Needs of a Rural Aging Community: Findings From a Community Assessment

Community senior centers are tasked with providing aging adults services and programs, congregate meals, and transportation, set forth by the Older Americans Act. The overall function of senior centers is especially critical for rural communities, as rural communities are home to a greater proportion of older adults compared to metropolitan and low-density urban areas. To assess the current needs of the aging population in rural Northwest, OH, a total of 9 focus groups were held (N=45) as part of a larger mixed-methodological study. Through this work, older adults identified limitations of the current senior center transportation. A lack of transportation and accessibility of current transportation were noted as barriers to full senior center use. Findings from this study confirm disparities in rural transportation; a lack of transportation is a major obstacle to program completion. Recommendations address the unique challenges and needs for transportation services for in rural communities are presented.

Which Seat at the Table? The Ways That Senior Service Organizations Are Engaged in Age-Friendly Community Efforts

Senior centers across the nation continue to serve as important access and focal points for older adults to voice their desires, get basic needs met, and to engage in opportunities that support many of the key concepts of Age-Friendliness (i.e. social participation, respect and social inclusion, civic engagement, transportation, and community supports and health services). Senior centers are the front line of aging services and thus in a position to implement programs and raise public awareness about age-friendly initiatives. The purpose of this presentation is to present and discuss the involvement of senior centers or other senior service agencies, as well as to characterize the mobilization of a community after joining the movement. We will present 5 case studies of age-friendly communities who are in the implementation phase of their initiative, to illustrate the challenges, opportunities, and outcomes associated with placing a senior center at the forefront of the movement. Based on the results of this work, we will present a typology of age-friendly community initiatives as a mechanism for supporting other communities make this transition. We conclude with a discussion of how age-friendly communities are part of the paradigm shift of aging in community and the ways in which this work intersects with other health policy initiatives with which cities and towns engage.

Having a Casino in the Community: Implications for Older Residents

Casino-going has been acknowledged as a common leisure activity for older adults, but what having a casino in the community means for the local older population has been understudied. Previous research has focused on problem gambling among older adults, but little is understood about how older residents perceive having a casino nearby and further how it impacts relevant senior services. This mixed-methods study gathered perspectives from 14 senior center directors and older residents (N = 411) of communities in Massachusetts that surround Plainridge Park Casino, the first casino that opened in the state in 2015. We conducted qualitative interviews with senior center directors and distributed a quantitative survey to older residents of the surrounding communities and those who visited the casino during the study period. We found that while most senior centers did not engage in trips to this “hometown” casino, many had other creative interactions with the casino, such as using casino space to host senior center events or seeking funding support from the casino. Older residents exhibited low rates of problem gambling risk, preferred to go to casinos outside of the state as an excursion, and attributed their reasoning to go to casinos to socializing rather than gambling aspects. While we must be aware of risks for problem gambling, this study also highlights the possibility of reframing a local casino as a potential asset that could contribute back to the community by providing resources for senior service providers and expanding social engagement opportunities for the older population.