Feasibility of an electronic participant information system for adult day services: A qualitative study of staff perspectives.

Adult day services (ADS) professionals have begun to explore assessment systems focused on participants. Barriers include inadequate technology, software costs, and personnel requirements. We present data from staff interviews at an ADS with an electronic participant information system. Contrary to reports about difficulties learning to use electronic systems, staff found the system manageable and data meaningful. We identify ways that community-based centers can build partnerships and utilize software to integrate assessment and electronic records to improve center performance and participant outcomes. ADS programs should explore how outcome data systems can be used to improve care, promote family caregiver engagement, optimize staff workload, and promote fiscal stability.

Supporting Mealtime Participation Among People Living With Dementia at Home: Challenges and Strategies for Caregivers.

BACKGROUND AND OBJECTIVES: Approximately 60% of people living with dementia at home are unable to routinely participate in mealtime activities (e.g., eating, safe food preparation), warranting assistance to ensure people with dementia meet their health and nutritional needs. The purpose of this study was to characterize these barriers to mealtime participation and identify potential caregiver-led strategies to enhance mealtime activities. RESEARCH DESIGN AND METHODS: We used a qualitative descriptive approach and obtained semistructured interview data from (a) allied health professionals and (b) community-based nutrition program providers who frequently serve people with dementia. Interview data were examined by means of directed content analysis and framework methodology until data saturation was reached. Codes from our analysis were categorized according to constructs drawn from the Socio-Ecological Model for Developing and Implementing Comprehensive Dementia Care. RESULTS: Data were obtained from 20 participants who attributed common mealtime participation barriers to: impairments in functional status, cognitive status deficits, a lack of caregiver knowledge and skills, and unsafe living conditions. Caregiver-led strategies to overcome these barriers included: reducing auditory and visual distractions, providing written cues to perform mealtime activities, eliminating clutter and fall risk hazards, and leveraging community-based nutrition program providers (e.g., home-delivered meal providers). DISCUSSION AND IMPLICATIONS: People with dementia face several eating and mealtime participation obstacles. Caregiver-led strategies implemented by family, friends, or community-based nutrition program providers may enhance mealtime activities at home. Findings point to opportunities to develop decision-making tools and resources for caregivers to optimize the health and nutrition of people with dementia.

Intergenerational Programming Increases Solid Food Consumption for Adult Day Center Attendees.

We examined whether participation in intergenerational programming would impact daily food and liquid intake for adult day service center (ADSC) participants, many of whom are at risk for malnutrition and dehydration. Data came from 75 ADSC participants who, on average, attended the center for 472.32 days between 2007 and 2018. We analyzed daily data using multilevel modeling, nesting attending days within ADSC participants. On days when participants joined intergenerational programming, they consumed significantly more solid food (ß = 1.54, SD = .37, p < .001), but no different liquid (ß = -.16, SD = .09, p = .06), than their own average across all days they attended the ADSC. Intergenerational programming may be an effective way to support ADSCs participants' nutrition. Future research is needed to determine the longer-term health benefits of daily increases in food consumption and to explore why intergenerational programming may differentially impact eating and drinking.

Program Practices Predict Intergenerational Interaction Among Children and Adults.

BACKGROUND AND OBJECTIVES: Intergenerational programs, those engaging youth and adults of nonadjacent generations in shared programming for mutual benefit, are attracting increasing attention from funders, policymakers, and practitioners for the range of goals they can support. The mechanisms by which these goals are achieved are rarely studied. To address this gap, we analyzed the associations between specific intergenerational implementation practices and younger and older participant outcomes. RESEARCH DESIGN AND METHODS: Activity leaders at 5 sites serving adults and preschoolers received training to implement 14 evidence-based practices during intergenerational activities involving 84 adults (M = 75.25 years; range = 55-98) and 105 preschool participants (M = 3.26 years; range = 2-5) over 4 years. Measures of activity leaders' implementation of these practices and participants' behavioral responses to programming were gathered. We utilized multilevel modeling to test whether variations in implementation of practices were associated with variations in participants' responses to programming on a session-by-session basis. RESULTS: For both preschool and adult participants, analyses revealed that the implementation of certain practices was associated with significantly more intergenerational interaction. When more practices were implemented reflecting factors of (a) participant pairing and (b) person-centered care, both child and adult intergenerational interactions were higher. DISCUSSION AND IMPLICATIONS: Practices used by intergenerational activity leaders during programming help to explain within-person responses of both child and adult participants. Intergenerational relationships may be a powerful means to achieve diverse goals; they depend on skillful practice by trained activity leaders.

Intergenerational programming during the pandemic: Transformation during (constantly) changing times.

Intergenerational programs have long been employed to reduce ageism and optimize youth and older adult development. Most involve in-person meetings, which COVID-19 arrested. ​​Needs for safety and social contact were amplified during COVID-19, leading to modified programming that engaged generations remotely rather than eliminating it. Our collective case study incorporates four intergenerational programs in five US states prior to and during COVID-19. Each aims to reduce ageism, incorporating nutrition education, technology skills, or photography programming. Authors present case goals, participants, implementation methods, including responses to COVID-19, outcomes, and lessons learned. Technology afforded opportunities for intergenerational connections; non-technological methods also were employed. Across cases, programmatic foci were maintained through adaptive programming. Community partners' awareness of immediate needs facilitated responsive programming with universities, who leveraged unique resources. While new methods and partnerships will continue post-pandemic, authors concurred that virtual contact cannot fully substitute for in-person relationship-building. Remote programming maintained ties between groups ready to resume shared in-person programming as soon as possible; they now have tested means for responding to routine or novel cancellations of in-person programming. Able to implement in-person and remote intergenerational programming, communities can fight ageism and pursue diverse goals regardless of health, transportation, weather, or other restrictions.

Implementation of Evidence-Based Practices in Intergenerational Programming: A Scoping Review.

Evidence-based intergenerational practices are sought by practitioners interested in the potential value of intergenerational programs. These are often difficult to identify as intergenerational program research frequently consists of small samples and pre-post analyses of attitudinal data with little attention to implementation characteristics. We systematically identified evidence-based intergenerational practices linked to program outcomes from peer-reviewed journal articles (n = 21) published between 2000 and 2019. Scoping reviews facilitate synthesis of available evidence-based practices and identification of gaps in the literature. Fifteen evidence-based intergenerational practices were identified; each was coded in at least five articles. The practices informed program content (e.g., using technology), program considerations (e.g., environmental modifications), facilitator and participant preparation (e.g., training), and quality interactions among participants (e.g., incorporating mechanisms of friendship). While these identified practices reflect extant theory and research, rigorous implementation research is needed to advance evidence-based intergenerational practice as policymakers and practitioners advocate for intergenerational program growth.