Senior Living Communities Research Articles

Communicative and Methodological Challenges Related to Collecting Data with Older Adults with Dementia in Senior Living Communities During the COVID-19 Pandemic.

The COVID-19 pandemic presented significant challenges to researchers collecting data with older adults, particularly older adults with Alzheimer's disease and related dementias (ADRD). The goal of this article is to articulate the communicative and methodological challenges and lessons learned from collecting data with older adults in senior living communities with mild cognitive impairment and ADRD and their adult children (who were geographically separated) during the pandemic. Communication was much more than what we were studying; it was essential to the success and ethical implementation of our research. We were working with a vulnerable population during a pandemic where recruitment, consent, and data collection required heightened and adapted communication strategies to reduce confusion, promote safety, and ensure data could be collected in an effective manner. The way we communicated with the participants, their networks, and the senior living communities was crucial to establishing strong human connections and subsequently successful data collection.

Rethinking the Design of Bikes and Bike Networks for Seniors: Sustainability, Climate Change, Alzheimer’s Disease, and Caregivers

Bikes and bike networks are for younger fit bicyclists, and the U.S. continues to not serve older individuals, with and without dementia, and caregivers. Biking is a sustainable form of transportation, and expanding the biking population would address climate change while improving health. To our knowledge, research has not been conducted in which seniors indicate their preferences for bike styles and networks, health concerns, and desires to bike. Conducted in four senior-living communities in New England, the Visual and Verbal Preference Survey involved 178 participants (female—50%/male—29.8%; age 20–85 52.8%; age > 85 41.6% with 19.6% missing gender and 5.6% missing age). Bike test riding in two senior communities involved 50 participants (female—50%/male—40%; age 66–75 14%; 76–85 60%; age 86–95 16% with 10% missing gender and age). Seniors preferred the adult tricycle, followed by the three- and four-wheeled two-seated bikes, and to bicycle for 30 min 2 days a week, have a bathroom break every hour, and have a bicycle loop. Balance and fear of falling were major concerns, but they wanted to bicycle with family, children, and grandchildren. In two of the communities, seniors test rode three senior-friendly Van Raam bikes. The results mirrored the pre-test survey responses, where the adult tricycle (Easy Rider) was most preferred, followed by the three-wheeled two-seater bike (Fun2Go) and the low-step regular bike (Balance Bike). One community purchased the Fun2Go.

Communication Matters: Loneliness in Senior Living Communities During the COVID-19 Pandemic.

The purpose of this study was to investigate individuals residing in senior living communities (SLCs) amid the coronavirus disease 2019 (COVID-19) pandemic. One reason those living in SLCs often choose these communities is to have a readily available social network. Necessary social distancing disrupted this socialization, thus, possibly increasing perceptions of loneliness in residents of SLCs. This study examined relationships among loneliness, perceived provider communication about the pandemic and related restrictions, as well as individual characteristics. In December 2020, a survey was administered to older adults residing in a network of SLCs in Nebraska. Utilizing data from 657 residents aged 60 and older, ordinary least squares regression models were used to examine associations between 2 distinct measures of perceived provider communication and feelings of loneliness during the pandemic. The analysis also considered whether these associations varied as a function of education. The respondents were, on average, 84 years of age, primarily female (72%), and living independently (87%) in the SLC. The linear regression results revealed that 53% of respondents were very lonely during the pandemic. However, provider communication that was rated as helpful to residents' understanding of the COVID-19 pandemic was associated with lower perceived loneliness. There was not a similar association for provider communication regarding services and amenities, and the association was not present for those with the highest level of education. Provider communication in times of disruption from normal activities, such as with the COVID-19 pandemic, is important to perceptions of loneliness among those living in SLCs, particularly for those with lower educational attainment. SLCs are communities that individuals select to reside in, and through communication, providers may have the opportunity to positively affect resident experiences, especially in times of stress.

The Next Generation’s Intent to Move into Senior Living Communities

ABSTRACT Senior living is an emerging research topic among hospitality scholars. Drawing upon the theory of planned behavior, this study examines the determining factors of potential residents, Baby Boomers, moving into senior living communities. We developed a survey derived from expert interviews, and data (n = 400) were collected via Qualtrics. The results show that personal privacy and employee competency develop a positive attitude toward senior living; friends and church members are greater social influences than family members; and psychological preparation and being a decision maker improves seniors’ perception of behavioral control. The synergistic interaction indicates a sense of control over their life could further enhance the positive attitude toward Boomers’ decision to choose senior living. The managerial implications are discussed for industry practitioners.

Residents’ sense of safety in senior living communities: A conceptual paper

Senior living communities (SLCs) are the new frontier of hospitality management. They provide high-end amenities and customer-oriented services for residents and employ various strategies to prevent risks and guarantee residents’ safety because safety is an essential factor in older adults’ lives as they age. Although a few studies have assessed residents’ safety or perceptions of safety, none of these research studies were conceptual or grounded in a comprehensive safety model. This paper proposes a conceptualization of sense of safety to evaluate residents’ perceptions of four types of risks (i.e., physical, social, emotional and psychological, and financial) in SLCs. This conceptual research provides important suggestions for researchers to assess residents’ perceptions of risk and sense of safety and also offers practical recommendations for senior living community operators to consider when addressing the four different types of risks that could enhance residents’ sense of safety in their SLCs.

Holistic Wellness Coaching for Older Adults: Preliminary Evidence for a Novel Wellness Intervention in Senior Living Communities.

Although resident wellness is increasingly a priority in senior living communities, there are few programs that promote holistic wellness in later life. A total of 79 residents (ages 71 to 97; M = 84.27, SD = 6.46) from eight senior living communities completed a pilot study of a novel, staff-led wellness coaching program consisting of resident-driven goals and individual and group coaching sessions. Participants completed surveys at three time points (pre-program, post-program, and 1-month follow-up). Repeated measures ANOVAs revealed positive changes in resident health satisfaction, physical quality of life (QOL), psychological QOL, loneliness, relatedness, competence, and sense of purpose. Some of these results (i.e., psychological QOL, loneliness) persisted at follow-up. Residents reported high satisfaction with the program. These findings have implications for the application of holistic wellness frameworks in later life, as well as the development and implementation of wellness coaching programs with older adults.

Determining the Factors that Impede or Facilitate the Utilization of Telemedicine (Video Visits) for Geriatric Patients.

Objective:The objective of the study was to evaluate the barriers and facilitators of telemedicine utilization experienced by geriatric patients at the University of Iowa Family Medicine Clinic and selected Senior Living Communities in Iowa City, to inform recommendations for improving the telemedicine delivery process for older adults.Methods:The study population was elderly patients (65–85 years old) living independently, and in long-term care facilities, who received health care using telemedicine during the period of the study from March to July 2020. A Mixed Methods study design was utilized with qualitative data collected through semistructured telephone and Zoom interviews and quantitative data through surveys.Results:A total of 33 study participants (n = 33) were interviewed or surveyed, including 3 patients (n = 3), 4 caregivers (n = 4), 19 physicians (n = 19), 5 medical assistants (n = 5), and 2 schedulers (n = 2). The results showed that geriatric patients and their caregivers, as well as health and nonhealth care personnel experience barriers, including difficulty navigating technology, privacy concerns, and lack of technical support; and facilitators, such as customer service support and having protocols to guide patients on telemedicine use.Conclusion:Geriatric patients face certain barriers and facilitators (self-identified or identified by their caregivers, physicians, and other health and nonhealth care personnel) that can make it either more or less difficult for them to maximize the benefits of telemedicine. As a result, health systems should consider older adults' needs and preferences when implementing telemedicine systems in outpatient settings.

Provider Communication and Loneliness in Senior Living Communities During the COVID-19 Pandemic

Several cross-sectional studies have examined stressors and positive events among older adults during COVID-19. We extend these studies by examining changes across time in perceptions of stress and positive experiences. Older adults in Oregon (Mage = 71.1, SD = 7.3, range = 51-95) completed weekly surveys from April 28 to June 23, responding to an adaptation of the Daily Stress Inventory (DISE; Almeida et al., 2002). DISE examines stressors and positive experiences across six domains (health, spouse/partner, other relationships, work/volunteer, finances, and retirement) on a 7-point scale (1 = not at all to 7 = extremely). At baseline, those who felt more stressed were younger, female, and reported more chronic health conditions, while younger adults, especially males, reported more positive events. Positive and stress intensity scores were not correlated. Multilevel models found that for both positive, Blinear = -2.54, SE = 0.52, p < .001; Bquadratic = 0.21, p < .05, and stress, Blinear = -0.79, p < .001; Bquadratic = 0.07, p <.01, intensity showed decelerated decreases across time; residuals for both models were significant. Older adults had lower stress levels, while women and those with chronic health conditions had higher stress levels. Women also reported lower levels of positive events. In both models, neither age, gender, nor chronic health conditions predicted change. These results highlight the evolving experiences during COVID-19, as perceptions of stress and positive events decreased. Future studies should examine how the changing circumstances during COVID-19 affect adaptation, including perceived stress and positive events.

COVID-19 and Its Impact on Older Adults’ Routine and Urgent Health Care Visits

The COVID-19 pandemic has led to increased strains on the rapidly increasing aging population’s mental, emotional, and physiological health. COVID-19, which belongs to a family of respiratory viruses, was first detected in China before spreading to other parts of the globe. Due to underlying health conditions and weakened immune systems, the aging population is at greater risk for contracting COVID-19. To better prepare for a future pandemic, it is necessary to explore the psychosocial impacts of limited human interactions to make the aging population feel safer while mitigating harm to their mental and emotional health. The purpose of this study is to highlight the experiences of the aging population with COVID-19, including psychosocial, behavioral responses to the pandemic, and older adults’ overall well-being. We surveyed a total of 203 adults 55 and older regarding their experiences with the pandemic. Survey components included the COVID-19 Household Environment Scale (Behar-Zusman, Chavez, & Gattamorta, ND), selected items from the COVID-19 Impact Study and open-ended questions, the Generalized Anxiety Disorder Assessment (Williams et al., 2006), and the UCLA Loneliness Scale (Russell, Peplau, & Ferguson, 1978). Preliminary analyses indicate that most participants had not experienced any COVID-19 symptoms, nor did they know anyone who had passed away from the virus. However, participants did report loneliness and less family cohesion because of the pandemic. Findings from this study will be used to help older adults cope with the impact of the current pandemic and future pandemics.

Fitness Staff’s Perceptions of Offering the 3-Step Workout for Life Program in Senior Living Communities

As the population of elderly adults continues to rise, a greater strain will be placed on the healthcare system. Functional exercise programs, such as the 3-Step Workout for Life, have been shown to improve activities of daily living and delay the disablement process. However, the majority of senior living communities do not utilize functional exercise in their fitness programming. This research study aimed to understand the perceptions that fitness staff working at senior living communities have towards the 3-Step Workout for Life program in order to determine the program’s acceptability, feasibility, and appeal. Individual semi-structured interviews were conducted with five fitness personnel. Participants were recruited from independent living communities. Interviews were audio-recorded and transcribed. Using NVivo 12, data was analyzed using thematic analysis techniques to identify common themes. The participants’ perceptions touch on four key themes: 1) revision of screening process; 2) group resistance band exercise would be feasible after minor adaptation; 3) individualized one-on-one ADL exercise is not currently feasible for staff or residents; 4) program addresses a gap in senior fitness. The results of this study provided insight into the feasibility of this program and helped direct modifications needed to enable successful integration.

Factors affecting seniors’ decision to relocate to senior living communities

Abstract This study aimed to investigate the influence of push and pull factors and perceived barriers on seniors’ intention to relocate to senior living communities (SLC). The mediating role of perceived barriers on the proposed relationships were also examined. The data was collected from 363 seniors. Structural equation modeling analysis was conducted to test the study hypotheses. The results indicated that health-related, social and family/friend related, housing and property related push factors, and facility related pull factor positively; and family related, economic, socio-psychological, and knowledge and information barriers negatively influenced seniors’ relocation intention. The study results further indicated that the relationship between health-related push factors and intention to relocate was mediated by family related and socio-psychological barriers, and the relationship between facility related pull factors and intention to relocate was mediated by socio-psychological and economic barriers. The findings provide valuable implications for academicians, SLC operators, health care facilitators and government agencies.

Social Contact and Wellness Outcomes for Older Adults in Different Residential Settings

More frequent social contact with others has been shown to be associated with positive well-being outcomes for older adults, who may be at increased risk of loneliness or isolation. The current study investigates whether the potential benefits of social contact might vary by social contact medium and by residence type (senior living (SL) settings vs. the broader community). 5,148 older adults residing in SL communities completed surveys on health and well-being. Data were combined with responses from 1,000 demographically similar older adults residing outside SL settings who participated in a similar study. Participants in both studies reported their frequency of social contact with friends (4 types: in-person meet-ups, speaking by phone, writing or emailing, and communicating via social media), subjective overall health, and life satisfaction. Results of multilevel regression analyses revealed that more frequent in-person social contact with friends was associated with more positive ratings of overall health only for participants in non-SL settings, but not those in SL. More frequent in-person social contact was also associated with higher life satisfaction, and this effect was stronger for non-SL participants. More frequent contact by phone and written letters/emails was associated with better ratings of overall health, regardless of residence type. In contrast, more frequent social media use was associated with lower ratings of overall health. Analyses controlled for age, gender, education, marital status, income, chronic health conditions, and depressive symptoms. The observed patterns of results speak to the possible protective benefits of social engagement for older adults in different residence settings.

High-Intensity Telemedicine Reduces Emergency Department Use by Older Adults With Dementia in Senior Living Communities

ObjectivesIndividuals with dementia have high rates of emergency department (ED) use for acute illnesses. We evaluated the effect of a high-intensity telemedicine program that delivers care for acute illnesses on ED use rates for individuals with dementia who reside in senior living communities (SLCs; independent and assisted living). DesignWe performed a secondary analysis of data for patients with dementia from a prospective cohort study over 3.5 years that evaluated the effectiveness of high-intensity telemedicine for acute illnesses among SLC residents. Setting and participantsWe studied patients cared for by a primary care geriatrics practice at 22 SLCs in a northeastern city. Six SLCs were selected as intervention facilities and had access to patient-to-provider high-intensity telemedicine services to diagnose and treat illnesses. Patients at the remaining 15 SLCs served as controls. Participants were considered to have dementia if they had a diagnosis of dementia on their medical record problem list, were receiving medications for the indication of dementia, or had cognitive testing consistent with dementia. MeasuresWe compared the rate of ED use among participants with dementia and access to high-intensity telemedicine services to control participants with dementia but without access to services. ResultsIntervention group participants had 201 telemedicine visits. In participants with dementia, it is estimated that 1 year of access to telemedicine services is associated with a 24% decrease in ED visits (rate ratio 0.76, 95% confidence interval 0.61, 0.96). Conclusions/ImplicationsTelemedicine in SLCs can effectively decrease ED use by individuals with dementia, but further research is needed to confirm this secondary analysis and to understand how to best implement and optimize telemedicine for patients with dementia suffering from acute illnesses.

The teaching of gerontology: Seven years of course design, redesign, and assessment in a multigenerational classroom

ABSTRACT Intergenerational teaching using a multigenerational course design is certainly not a new pedagogical technique. However, the longitudinal assessment and redesign of three gerontology courses described here can offer educators and professionals insights into reflection as a requirement not only within the course but also about the course itself. Since 2009, the Gerontology Program at Nazareth College has collaborated with the St. John’s Senior Living Communities to offer college-level courses comprising both Nazareth students and elder residents. In these courses, the elders not only participate on an equal basis with the students but also, together with the students, engage in regular course assessments. This article offers a review of course designs, assignments linked to student-learning outcomes, service-learning projects, and the numerous opportunities created for both personal and professional growth. Utilizing three different courses, this comprehensive study of intergenerational and multigenerational learning provides examples of different forms of engagement between students and elders and serves as a model for course design.

Reducing Emergency Department Utilization Through Engagement in Telemedicine by Senior Living Communities.

High-intensity telemedicine has been shown to reduce the need for emergency department (ED) care for older adult senior living community (SLC) residents with acute illnesses. We evaluated the effect of SLC engagement in the telemedicine program on ED use rates. We performed a secondary analysis of data from a prospective cohort study evaluating the effectiveness of high-intensity telemedicine for SLC residents. We compared the annual rate of change in ED use among subjects who resided in SLC units that were more engaged in telemedicine services with that among subjects who resided in SLC units that were less engaged in telemedicine and control subjects who lived at facilities without access to telemedicine services. During the study, subjects had 503 telemedicine visits, with 362 (72.0%) in the more engaged SLCs and 141 (28.0%) in the less engaged SLCs. For subjects residing in more engaged SLCs, ED use decreased at an annualized rate of 28% (rate ratio [RR] = 0.72; 95% confidence interval [CI], 0.58-0.89), whereas in the less engaged (RR = 0.962; 95% CI, 0.776-1.19) and control (RR = 0.909, 95% CI, 0.822-1.07) groups there was no significant change in ED use (p = 0.036 for group × time interaction). Individuals residing in more engaged SLCs experienced a greater decrease in ED use compared with subjects residing in less engaged SLCs or those without access to high-intensity telemedicine for acute illnesses. We identified potential factors associated with more engaged SLCs, but further research is needed to understand resident and staff engagement and how to increase it.

Periodic Assessment of Walking Devices in Senior Living Communities

Currently, the proportion of the United States population age 65 or older is nearly 40 million [1]. Of these older adults, approximately 14 to 18% of them use an assistive ambulatory device (AAD) on a daily basis [2]. In senior living communities, canes (Figure 1 left) and rolling walkers or rollators (Figure 1 right) are the most common walking devices used by the older residents in order to improve mobility, prevent falls, and maintain functional independence [2].

Updated Beers Criteria: A more comprehensive guide to medication safety in older adults

P from all practice settings are likely familiar with the American Geriatric Society’s (AGS) Beers Criteria of Potentially Inappropriate Drugs, last published in 20121 and recently revised and updated in 2015.2 The AGS Beers Criteria—Beers Criteria for short—have proven useful in identifying drugs to potentially avoid in older adults, to reduce adverse drug events and drug-related problems, and to improve medication selection and overall medication safety in older adults. The Beers Criteria are designed for use in any clinical setting and can also be used as an educational quality measure and research tool. The latest version of the Beers Criteria uses a more comprehensive, systematic review and grading of evidence.

Promoting Positive Behavioral Health: A Non-pharmacologic Toolkit for Senior Living Communities

Promoting Positive Behavioral Health: A Non-pharmacologic Toolkit for Senior Living Communities

Promoting Positive Behavioral Health: A Nonpharmacological Toolkit for Senior Living Communities

Promoting Positive Behavioral Health: A Nonpharmacological Toolkit for Senior Living Communities

Pharmacist and medication detective cares for seniors

Kimberly Sasser Croley PharmD, CGP, FASCP, FAPhA, receives hugs' every day from her patients. As a clinical pharmacist at Laurel Senior Living Communities, Croley is responsible for performing medication reconciliation for every patient at the facility on an ongoing basis. get paid to take people off pills, she said. That doesn't happen very often in the pharmacy world, but my job is to continually look at [each patient's] medication regimen to see how can I make it better and avoid adverse events.