The Link of COVID-19-Related Beliefs and Information Sources to Ageism: Myth or Reality?

This study aimed to understand ambivalent ageism among younger adults during the pandemic by examining whether younger adults' beliefs around COVID-19 and the sources from which they received COVID-19 information were associated with the intensity of their ageism. For this aim, survey data were collected from individuals ages 18 to 44 between July and September 2021. Multiple hierarchical regression analysis revealed that benevolent ageism was more intense than hostile ageism when two subscales of ambivalent ageism-benevolent and hostile-were compared. Hispanic or Latinx respondents showed less intense ambivalent ageism than non-Hispanic and non-Latinx respondents. The respondents' beliefs about safety measures and the prioritization of medical resources were significantly associated with the intensity of their ageism. Receiving COVID-19 information via traditional media and social media was also significantly associated with more intense ageism. These findings indicate that social work advocacy should continue to combat ageism in times of crisis.

Adult Day Services, Health Equity for Older Adults With Complex Needs, and the COVID-19 Pandemic.

Morbidity and mortality from COVID-19 have unduly affected older adults from racial and ethnic minority groups. In this article, we highlight the experiences and vulnerabilities of diverse older adults with complex health and social needs when their access to vital, but overlooked, community-based adult day service centers (ADSCs) was abruptly cut off during a pandemic. Pandemic-related ADSC closures left vulnerable older adults and their care partners without essential daily support and services, such as health monitoring and socialization. However, the magnitude of the impact of ADSC closures on well-being, particularly among members of racial/ethnic minority groups, has yet to be measured with any form of "big data" because large-scale, nationally representative data sets consisting of participant-level information and outcomes associated with ADSC participation do not yet exist. Unmet needs of older adults resulting from pandemic-related ADSC closures are underrecognized because of a lack of systematic data collection, undermining efforts to achieve health equity. We call on ADSCs to link rigorous collection of racial and ethnic data to quality measures of access to equitable "age-friendly" care as a means of better supporting diverse community-dwelling older adults beyond the COVID-19 pandemic. (Am J Public Health. 2022;112(10):1421-1428. https://doi.org/10.2105/AJPH.2022.306968).

Age-friendly communities during the time of COVID-19: a model for rapid community response.

With the COVID-19 epidemic disproportionately impacting older adults, cities across the United States (U.S.) and the world scrambled to meet the needs of their older residents. Members of the World Health Organization's Age-Friendly Communities (AFCs) network rely on cross-system community collaborations and resident voices to create age-friendly social, built, and service environments. These key elements of AFCs place them in a unique position to quickly identify needs of older residents, launch short-term targeted interventions, and support integration of new programs into existing systems for post-crisis sustainability. This essay discusses how one age-friendly community applied key tenets of the Centers for Disease Control's rapid response team model to meet the immediate, short-term needs of older residents for social connection, food, personal protective equipment (PPE), emergency preparedness, and technology utilization. Sustainability of the rapid response interventions was supported through the relationships and structures created by the AFC.

Guidelines to contain disease outbreaks are helpful when responding to outcomes of outbreaks.Age-friendly communities core values align with the tenants of disaster response.Age-friendly communities are well positioned to respond to the consequences of COVID-19.

The use of community advisory boards in pragmatic clinical trials: The case of the adult day services plus project.

Community advisory boards (CABs) have become increasingly common and important in translational research in health care including studies focusing on home and community-based services. CABs are composed of stakeholders who share interest in research projects and typically include patients/clients, practitioners, community members, policymakers, and researchers. CABs advise researchers on issues ranging from research design and recruitment to implementation and dissemination. In this article, the researchers detail their experiences with the CAB for a pragmatic clinical trail of Adult Day Services (ADS) Plus, an education and support intervention for family caregivers of older adults with dementia using adult day services. Lessons learned, guidelines, and best practices are then presented for developing and working with a CAB in healthcare research.

I Wanna help, but my Hands can be a Little Tied: The Challenges and Benefits of Formal Volunteering among Low-Income Diverse Older Adults.

Volunteering is often considered an important component of productive and active aging. Although there is a rich body of literature on the predictors and outcomes of volunteering among the general older adults in the United States (U.S.), few studies have explored the unique volunteering experiences of culturally and linguistically diverse older adults. Given the growing number of diverse older adults and the importance of optimizing their contributions to society, this study investigates the challenges and benefits of volunteering among low-income diverse older adults. We conducted eight 90-minute focus groups in six languages (English, Nepali, Khmer, Somali, Russian, and Chinese) with 70 older volunteers attending a Senior Companions monthly training in a U.S. Midwestern metropolitan area. Data analysis followed the Rapid and Rigorous Qualitative Data Analysis (RADaR) technique and thematic analysis through an interactive team approach. Three overarching themes highlighted the challenges of volunteering: (1) transportation, (2) community emergencies and workload, and (3) family caregiving; and three themes reflected the benefits of volunteering: (1) stress-relief, (2) training and information, and (3) peer support and socialization. Study findings shed light on diverse older adults' unique volunteering experiences with implications for recruitment and retention.

Using Community-Based Participatory Research Strategies in Age-Friendly Communities to Solve Mobility Challenges.

The number of older adults is steadily increasing in the United States and across the globe. Aging is linked to an increased risk of disability. Disabilities that limit one or more major life activities such as seeing, hearing, walking, and motor skills impact a person's ability to drive a car. Low utilization of alternative transportation by older adults and people with disabilities may put them at risk for social isolation. Social isolation is associated with a variety of negative health outcomes. While communities are challenged to create available, acceptable, accessible, adaptable and affordable mobility options, there are widely held, inaccurate biases around older adults' abilities to contribute to the development and improvement of alternative transportation options. Gerontological social workers are well-positioned to address this bias. This paper presents a case study of a large metropolitan county in the Midwest where community-based participatory research (CBPR) strategies were used to engage older residents to support the development of alternative transportation options supporting the tenets of environmental justice.

A Comprehensive Evaluation of a Lifelong Learning Program: Program 60.

Lifelong learning programs meet older adults' educational needs and further support their health and well-being leading to more successful aging. In particular, university-based lifelong learning programs have provided older adults with opportunities to not only develop skills and knowledge but also expand new social networks with people of different ages. This study evaluated a university-based lifelong learning program, Program 60, to identify the relationships between participants' experiences in the program and their quality of life. An online survey was employed, and 107 participants completed the self-report survey. The participants reported that classes helped increase their emotional satisfaction and that they enjoyed taking classes with younger students. Their experiences in the program reliably predicted psychological and social elements of their quality of life ( p = .004 and p = .019, respectively). Study results provide helpful information for the development of lifelong learning programs that are responsive to the increasing demands of older adults.

Beyond respite: the role of adult day services in supporting dementia caregivers.

Adult day services (ADS) are the leading provider of community-based care for persons with dementia and their caregivers. While the provision of caregiver respite is well-documented, little is known about the provision of other forms of dementia caregiver support. Logistic regression analyses of ADS providers (N = 297) in the MetLife Study indicated that the number of hours of social work support was a significant predictor of case management services, while nonprofit status was a significant predictor of caregiver education and support groups. These findings have implications for practice and policy related to this growing provider of dementia services.

Heterogeneity within adult day services: a focus on centers that serve younger adults with intellectual and developmental disabilities.

As the population of younger adults with intellectual and developmental disabilities continues to grow, adult day services is positioned to be a key provider of community-based care and support. In this article, researchers examine how adult day centers that serve younger adults with intellectual and developmental disabilities differ from centers that serve older and mixed age groups. One-way analyses of variance and post hoc analyses of 490 adult day services centers (N = 490) revealed significant differences in terms of participant, staffing, and organizational characteristics. These findings have important implications for service providers, researchers, and policy makers.

Embedding Caregiver Support Within Adult Day Services: Outcomes of a Multisite Trial.

BACKGROUND AND OBJECTIVES: Adult day services (ADS) provide quality-of-life benefits to people with dementia, but few provide systematic caregiver support. We report outcomes of a multisite, national trial testing a staff-delivered caregiver program, ADS Plus. RESEARCH DESIGN AND METHODS: Cluster-randomized trial involving 34 ADS: 18 sites provided ADS (controls) and 16 provided ADS and ADS Plus (intervention). Trained staff met with caregivers to provide dementia education, support/validation, referrals/linkages, and strategies for care challenges and self-care over 12 months. Main outcomes included depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D]) and well-being at 6 and 12 months, and client attendance over 12 months. RESULTS: Of 203 caregivers (Intervention = 102; Control = 101), 5.9% at 3 months, 12.8% at 6 months, and 22.7% at 12 months were lost to follow-up. Caregivers were predominantly female (80.3%), with 76.4% identifying as White/Caucasian, 14.8% Black/African American, and 12.3% Hispanic/Latino. Most (88.2%) had ≥college education and were 65.0 years old (SD = 13.46). For those with 6-month data, 40.4% control and 40.2% ADS Plus caregivers had depressed symptoms (≥16 CES-D) at baseline. By 6 months, 43.6% control versus 34.2% ADS Plus caregivers had ≥16 scores (odds ratio = 0.38, p = .072). By 12 months, after covariate adjustments, ADS Plus caregivers reported reduced total depression scores versus controls (p = .013) and lower depressed affect scores (p = .015). Of 18 sites providing 12-month client attendance data, 9 intervention sites reported 126.05 days attended versus 78.49 days for 9 control sites (p = .079). DISCUSSION AND IMPLICATIONS: Compared with ADS alone, by 12 months, ADS Plus improved caregiver mood and increased ADS utilization by 60.6%. Results support ADS staff delivering evidence-based caregiver support to enhance ADS benefits. CLINICAL TRIAL REGISTRATION: NCT02927821.

Age-Friendly and Climate Resilient Communities: A Grey-Green Alliance.

The world's population is aging while the Earth's climate is warming. The climate change crisis poses threats to our aging population and requires concerted action. Steps to address these threats present opportunities for improving livability for people of all ages while addressing the underlying drivers of climate change. Yet prominent action frameworks such as the World Health Organization's (WHO) Global Network of Age-Friendly Cities and Communities do not explicitly include climate resilience and sustainability as essential elements of age-friendly communities. In this essay, we argue for the creation of a cross-cutting and interdependent sustainability and climate resilience domain to complement the existing interconnected WHO age-friendly domains of community and healthcare, communication and information, housing, civic participation and employment, outdoor spaces and buildings, social participation, respect and social inclusion, and transportation. These domains drive the community engagement, planning, action, and evaluation required by the communities who join the Global Network for Age-Friendly Cities and Communities. The age-friendly network currently includes 1,445 communities, across 51 countries. We discuss how the alignment of age-friendly and climate resilience networks strengthens local action and global advocacy through a shared vision for an age-friendly and climate resilient future.

Qualitative Analysis of Implementation Factors of an Embedded Caregiver Support Intervention into Adult Day Services.

Background: Adult day services (ADS) are an important and often underutilized support resource for older adults. For persons living with dementia (PLWD), ADS is an optimal access point to not only receive therapeutic and rehabilitative activities, but as a vehicle for respite/relief for dementia caregivers. Yet, there is currently a lack of research on integrating caregiver interventions into home and community-based services such as ADS. Objective: This paper reports on qualitative findings from the Improving Outcomes for Family Caregivers of Older Adults with Complex Conditions: The Adult Day Plus (ADS Plus) Program Trial. Methods: Drawing from semi-structured interviews conducted with family caregivers and ADS site staff, we conducted a thematic analysis to examine the implementation process of ADS Plus. Results: Themes address the relational nature of the intervention, learning, influence of the administrative infrastructure, and receptivity of ADS Plus. Conclusions: Our analysis determined that implementation of ADS Plus was feasible and accepted by site staff and dementia caregivers but also calls for additional evaluation of embedded caregiver support interventions across different contexts (e.g., staff size, limited technology environments) to further identify and test implementation mechanisms across settings.

Adult day services: a service platform for delivering mental health care.

OBJECTIVES: The purpose of this study was to understand the degree to which mental health services targeting anxiety and depression disorders are offered by adult day services (ADS) centers in the US. In addition, researchers wanted to determine whether staffing and organizational characteristics are associated with the provision of medication management, individual counseling, and group counseling for participants with anxiety or depression. METHOD: Data were drawn from the MetLife National Study of ADS. Hierarchical logistic regression analyses were conducted to determine which staffing and organizational factors were associated with the provision of services to treat anxiety and depression. RESULTS: Approximately, three in four adult day programs provided medication management for the treatment of anxiety and depression while 38% provided individual counseling and almost 30% group counseling. Programs offering medication management were more likely to have more registered nurse (RN) service hours available per shift and higher costs. Programs that provided individual and group counseling for participants with anxiety or depression were more likely to have more hours of RN and social work services available and a lower percentage of participants who pay privately for services. CONCLUSION: The results suggest that ADS are well positioned to act as a platform for delivering mental health care to older persons with anxiety or depression.

A Mixed-Method Social Network Analysis of Low-Income Diverse Older Volunteers.

Although volunteering has been associated with numerous social benefits for diverse older adults, there is little information on how they establish relationships within a multicultural volunteering program outside of their co-ethnic communities. This convergent mixed-method social network study adopts the bonding and bridging social capital theory to explore the structures and dynamics of social interactions within a multicultural volunteer program. Low-income Russian, Khmer, Somali, Nepali, and English-speaking older volunteers in the Senior Companions Program (SCP) in a Midwest metropolitan (N = 83) participated in the surveys and focus groups. Homophily coefficients (r) show that the SCP volunteers mostly interacted with people who identified with the same nationality (r = .86), race (r = .87), and gender (r = .50). Qualitative results suggested that volunteers strengthened their social networks through within-cultural social bonding while appreciating opportunities for cross-cultural social bridging. Compared with within-cultural social bonding, cross-cultural social bridging in multicultural volunteer programs require intentional facilitation, resources, and organizational commitment.

The Loneliness of Low-Income Older Adults in a Federal Volunteering Program: A Network Perspective.

Volunteering has been associated with increased social interactions and reduced feelings of loneliness among older adults. However, a growing number of social network analyses (SNA) conducted in the general population outside of volunteering contexts suggest that lonely individuals tended to interact with other lonely individuals in the network, reinforcing loneliness through peer associations. To better understand the psychosocial impact of peer interactions among older adults within volunteer programs, this study examines how older adults' loneliness is correlated with their peers' loneliness within the Senior Companions Program (SCP). This study collected information on the social networks within an SCP in a Midwest Metropolitan and feelings of loneliness among low-income Russian, Khmer, Somali, Nepali, and English-speaking older volunteers (N = 41). A linear network autocorrelation model (LNAM) was constructed to quantify how volunteers' loneliness is correlated with their peers' loneliness within SCP. The LNAM results indicated that less lonely volunteers tended to make friends with lonelier volunteers (ρ = -.06, p < .05) in SCP even when accounting for statistical controls. The finding that more and less lonely individuals connect indicates an altruistic tendency for less lonely individuals to interact with those who are lonelier. This may be an important pathway by which volunteering addresses loneliness.

Social Cognitive Theory, Driving Cessation, and Alternative Transportation in Later Life.

Having viable alternative transportation options could help individuals stop driving when appropriate. This study employs the Social Cognitive Theory (SCT) to understand the barriers and facilitators of alternative transportation among a sample of adults aged 55 and older (N = 32). Using a daily transportation data collection app, MyAmble, the research team asked participants questions structured around environmental, individual, and behavioral factors as outlined in the SCT framework. Responses were analyzed using directed content analysis. Findings suggest a substantial reliance on motor vehicles and it was evident that many participants had never seriously considered what they would do if they could no longer drive. We posit that SCT principles may be applied to help older adults build self-efficacy to transition to driving cessation when needed.

Societal, Organizational, Relational, and Individual Perceptions of Sexual Violence Against Older Adults and Its Prevention: A Systematic Scoping Review.

BACKGROUND AND OBJECTIVES: Older adults are not regarded as sexual and are widely excluded from sexual violence (SV) research, policies, and practice; little is known about SV against older adults and its prevention. RESEARCH DESIGN AND METHODS: An 8-database scoping review explored perceptions of SV against older adults, barriers to prevention, and solutions for prevention. Included were peer-reviewed and gray sources published since 2010, supported by primary research, on perceptions of SV in later life and prevention. A thematic analysis was conducted to explore key themes. RESULTS: Of 148 potentially relevant sources returned, 95 were fully read after screening titles and abstracts; 19 were critically appraised and 18 were assessed for analysis. Seven overarching themes emerged, surrounding (a) knowledge and awareness, (b) research, (c) policy changes and development, (d) intersectional prejudice, (e) SV being taboo, (f) sociocultural differences, and (g) confusion regarding the definition and nature of SV. DISCUSSION AND IMPLICATIONS: These findings offer relevant considerations for practice, policy, and research, which will be further discussed.

White and Black Differences in Perceived Access to Health and Community Services and Self-Rated Health in an Age-Friendly Community Assessment.

OBJECTIVES: This study sought to identify the race differences in perceived access to health and community services and self-rated health (SRH) among White and Black older adult participants of an age-friendly community assessment. METHODS: Responses (n = 313) to a baseline assessment of Columbus, Ohio, residents aged ≥50 years were analyzed. RESULTS: Significant differences were found between White and Black older adults regarding SRH, with Black older adults reporting lower SRH. Black older adults reported significantly lower perceived access to 11 out of the 13 health and community services. There were no significant differences by race regarding ratings of Columbus and personal neighborhoods as a place for people to live as they age. Regression analyses found income was a significant predictor of SRH for both White and Black older adults. DISCUSSION: Opportunities to increase perceived access and knowledge of health and community services for older adults through targeted, equitable interventions are warranted.