Evidence-Based Community Fall Prevention Programs at Senior Centers Near 10 US Academic Centers.

BACKGROUND/OBJECTIVES: The Centers for Disease Control and Prevention recommends that patients at risk of falling engage in evidence-based community fall prevention programs (EBCFPPs). EBCFPPs are often delivered in senior centers (SCs). This is the first independent assessment of availability of EBCFPPs in SCs. DESIGN: Cross-sectional study of four types of EBCFPPs in the 25-mile radius of 10 US academic centers (ACs). SETTING: SCs. PARTICIPANTS: SCs. INTERVENTION: None. MEASUREMENTS: Number and types of EBCFPPs offered at SCs. RESULTS: Across the 10 ACs, 249 SCs were sampled. Of the SCs, 35% offered zero, 54% offered at least one, 9% offered at least two, and 2% offered at least three EBCFPPs. Tai Chi of any type was offered in 59.8%, A Matter of Balance was offered in 8.9%, Stepping On was offered in 8.0%, and Staying Active and Independent for Life was offered in 1.2% of SCs sampled. SCs near Columbia University offered all four of the programs, while those near the University of Utah, Johns Hopkins University, and Seattle University only offered three of the programs. In univariate analysis, the number of local SCs was significantly associated with quantity of EBCFPPs (odds ratio [OR] = 2.2; 95% confidence interval [CI] = 1.9-2.6; P < .001), but not with diversity of EBCFPPs (OR = 1.0; 95% CI = 1.0-1.1; P = .13). In multivariate regression, city, sex distribution, and average household income did not correlate with the overall number or the diversity of EBCFPPs, whereas locales with more SCs offered more EBCFPPs (OR = 2.2; 95% CI = 1.7-2.9; P < .001). CONCLUSIONS: A significant number of SCs still do not offer any EBCFPPs. From those that do, few offer a diversity of these programs. Opportunities exist to increase access to EBCFPPs in SCs.

Senior Centres in Canada and the United States: A Scoping Review.

ABSTRACTSenior centres have been identified as a "focal point" for delivering services to the rapidly growing older adult populations in Canada and the United States. Despite this important role, academic research studying senior centres has been limited. This scoping review identified English-language empirical research studies focusing on senior centres that were published in an academic journal in 2000 or later. A total of 58 studies were identified (n = 51 American and n = 7 Canadian). The majority of the articles focused on themes related to the participation of individuals at senior centres; a smaller number focused on themes related to the senior centre environment. Based on the findings, it is suggested that future research focus on benefits of senior centre programming, with specific focus on needs of baby boomers; key factors related to funding, space, and staffing; and the characteristics and role of senior centres in the Canadian context.

Loneliness in senior housing communities.

There are many studies on loneliness among community-dwelling older adults; however, there is limited research examining the extent and correlates of loneliness among older adults who reside in senior housing communities. This study examines the extent and correlates of loneliness in three public senior housing communities in the St. Louis area. Data for this project was collected with survey questionnaires with a total sample size of 148 respondents. Loneliness was measured using the Hughes 3-item loneliness scale. Additionally, the questionnaire contained measures on socio-demographics, health/mental health, social engagement, and social support. Missing data for the hierarchical multivariate regression models were imputed using multiple imputation methods. Results showed approximately 30.8% of the sample was not lonely, 42.7% was moderately lonely, and 26.6% was severely lonely. In the multivariate analyses, loneliness was primarily associated with depressive symptoms. Contrary to popular opinion, our study found the prevalence of loneliness was high in senior housing communities. Nevertheless, senior housing communities could be ideal locations for reducing loneliness among older adults. Interventions should focus on concomitantly addressing both an individual's loneliness and mental health.

Identifying Palliative Care Needs Among Older Adults in Nonclinical Settings.

Though palliative care is appropriate for patients with serious illness at any stage of the illness and treatment process, the vast majority of palliative care is currently delivered in inpatient medical settings in the past month of life during an acute hospitalization. Palliative care can have maximal benefit to patients when it is integrated earlier in the illness trajectory. One possible way to increase earlier palliative care use is to screen for unmet palliative care needs in community settings. The goal of this study was to assess the rates of unmet palliative care needs in older adults who attend New York City-based senior centers. The results of this study revealed that 28.8% of participants screened positive for unmet palliative care needs. Lower education and living alone were predictors of positive palliative care screens, but age, gender, marital status, and race were not. This study determined that the rate of unmet palliative care needs in community-based older adults who attend senior center events was high and that living arrangement and education level are both correlates of unmet palliative care needs. Screening for unmet palliative care needs in community settings is a promising approach for moving palliative care upstream to patients who could benefit from the additional supportive services prior to an acute hospitalization.

Motivation to volunteer among senior center participants.

Senior centers in the United States play a vital role in the aging continuum of care as the focal points of a community-based system of services targeting independent older adults to promote their social integration and civically engagement. Although several studies have evaluated the diversity of senior center programs, demographic characteristics of participants, and benefits of participation, very few have explored motivations to volunteer among participants. Many senior centers rely on a cadre of participants who volunteer there to assist with programs and meal services. However, a systematic examination of volunteering interests and the rationale for volunteering among senior center participants has been missing from the literature. This mixed-methods study, conducted at a large suburban senior center, explores the interests and motivations of volunteerism among the participants. The study found that there was limited interest in volunteering among senior center participants. Those who were motivated to volunteer wanted to do so in order to stay connected with their community. There was strong interest in volunteering for single events or projects rather than a long-term commitment. Implications for senior centers are discussed.

Senior Services that Support Housing First in Metro Vancouver.

Housing First is a model and philosophy for housing homeless people in immediate and permanent housing. In order to implement and deliver Housing First, research is essential to understand the system of support services as they currently exist. Guided by principles of community-based participatory research, this paper presents the findings from a senior-focused deliberative dialogue workshop in Metro Vancouver, Canada. Participants (16 service providers and 1 service recipient) identified services and resources available to support seniors in maintaining housing and barriers and facilitators for accessing services. Broadly, data were organized into seven themes: (1) Housing; (2) Home support; (3) Transportation; (4) Information availability, accessibility, and navigation; (5) Cultural diversity; (6) Discrimination; and (7) Funding and financial support. Results found that affordable housing that adapts to changing health conditions, income supports, health services, homecare, transportation, and culturally appropriate and nondiscriminatory informational resources are among the supports most needed for persons as young as 50 years old to succeed under the Housing First model in Metro Vancouver. Barriers to Housing First service provision, including rigid eligibility criteria for chronically and episodically homeless, should be revised to better support the growing number of older adults who are newly entering homelessness in Metro Vancouver.

Development, implementation, and evaluation of a service-learning series for pharmacy students using a public health tool.

BACKGROUND AND PURPOSE: The purpose of this article is to describe the utility of the Assessment, Development, Assurance: Pharmacist's Tool (ADAPT) during the design, delivery, and assessment of service-learning events by pharmacy students. EDUCATIONAL ACTIVITY AND SETTING: The ADAPT instrument was used to develop a series of five service-learning events that featured a health promotion program delivered by 19 pharmacy students and attended by over 200 senior citizens at local senior centers. Student competence was assessed prior to participating in the service-learning activities and each student completed a reflection following the event. Senior center directors evaluated both the quality of the health promotion program as well as the interaction with the sponsoring college of pharmacy. FINDINGS: Pharmacy students reported achievement of health promotion learning objectives based on self-evaluations. Responses to reflections also indicate that students gained insight to and appreciation for several of the public health essential services, which are the basis of the ADAPT instrument. Feedback from the senior center directors was consistently positive. DISCUSSION AND SUMMARY: Use of the ADAPT instrument helped to facilitate the delivery of a high-quality, comprehensive service-learning series at local senior centers that had a solid public health foundation. Colleges and schools of pharmacy should strongly consider consulting the tool prior to planning any future health promotion activities for students.

Funcionalidad y grado de dependencia en los adultos mayores institucionalizados en centros de bienestar / Functionality and degree of dependence on elderly home care centers in welfare

Introducción: La funcionalidad en el adulto mayor constituye un eje principal para los programas orientados a fortalecer el envejecimiento activo; ante el incremento de este grupo poblacional, las enfermedades como factor que limita la capacidad física, mental y social requieren acciones de control que disminuyan la dependencia que contribuye a un deterioro mayor. Objetivo: Determinar la funcionalidad y grado de dependencia en el adulto mayor institucionalizado como información básica para el diseño de un programa de intervención específica. Metodología: estudio descriptivo retrospectivo con una muestra de 60 adultos mayores institucionalizados y seleccionados por muestreo no probabilístico. Resultados: predomina el rango de edad de 75-84 años, un 26,66% de 60 adultos mayores y el género masculino con mayor frecuencia (53,33%). Por lo que respecta a la escolaridad, el 53,3% estudiaron primaria. Contacto familiar con la familia, el 70%; tiempo de institucionalización de los adultos mayores, el mayor tiempo (55%) de 1 a 5 años. Predominan los problemas cardiovasculares en el 34% de los adultos mayores. Valoración funcional: predomina el género masculino con dependencia leve (26,66%) y como independiente un 25% del género femenino. La valoración del grado de autonomía en el género masculino evidencia un grado de autonomía 1, con un 30% con respecto al género femenino, que tiene un grado de autonomía 3, con el 16,66%, sin significación estadística. Conclusiones: Se observa el predominio del género masculino en los adultos mayores institucionalizados y con dependencia leve, y al contrario en las mujeres, donde la frecuencia de independencia es mayor. En la autonomía predomina un grado mayor en los hombres que en las mujeres

Background: The functionality in the elderly is a major axis for programs oriented one strengthen active aging, with the increase of this population group, the diseases as factor limiting physical, mental capacity and require control actions decrease social dependency that contributes to further deterioration. Objective: To determine the functionality and degree of dependency in the elderly institutionalized as background information for the design an Intervention Program specific. Methodology: Descriptive retrospective study with 60 Institutionalized older adults and selected by do not probabilistic sampling. Results: Predominant age range 75-84 years 26.66% of 60 older adults, male gender with mayor frequency 53.33%; Schooling 53.3% studied primary (Prim.) Contact with family of 70%, time institutionalization of the elderly 55% of one to five years. Cardiovascular problems predominate is 34% of older adults. Functional Assessment Predominant male with mild dependence 26.66% and independently as 25% female. Assessing the degree of autonomy in the male gender evidence degree of autonomy 1 of 30% with respect to the female gender degree of autonomy 3 16.66% without statistical significance. Conclusions: The prevalence of male gender in Institutionalized older adults with mild dependence, a contrary in women frequency mayor Independence is observed. In Autonomy dominates the mayor degree in men than in women

Disaster preparedness: Assessment of older adults living in the NYC rockaways.

OBJECTIVE: To determine if there has been a measureable improvement in disaster preparedness among older adults affected by Hurricane Sandy in the NYC Rockaways and to identify if there are any characteristics among this sample that might be factors for vulnerability. DESIGN: A 16-item self-reported survey compromised of demographics and needs assessment questions. SUBJECTS: Senior citizens who are members of a local senior center and live in the Rockaways. MAIN OUTCOME MEASURES: Three hypotheses were tested. (1) H1: That there is a positive difference in level of the Pre- and Post- Sandy Storm Preparedness. (2) H0: That the level of Storm Preparedness is not related to relative advanced age factor in older adults. (3) H0: That the level of Storm Preparedness is not related to living arrangement, income level, and/or access to transportation RESULTS: The alternative hypothesis was accepted for hypothesis one. The null hypotheses were accepted for hypotheses two and three. CONCLUSIONS: It was found that the level of disaster preparedness has significantly improved. The age of the participants when analyzed as two groups, those under and those over age 70, is not related to storm preparedness. Also, demographic factors are not significantly related to disaster preparedness. These findings may be a result of older adult psychological development as discussed by Erikson or the participants may be homogeneous due to their shared traumatic experience of Hurricane Sandy.

Cross-cultural comparison of long-term care in the United States and Finland: Research done through a short-term study-abroad experience.

In May 2014, a short-term study-abroad experience was conducted in Finland through a course offered at Indiana State University (ISU). Students and faculty from ISU and Eastern Illinois University participated in the experience, which was created to facilitate a cross-cultural comparison of long-term-care settings in the United States and Finland. With its outstanding system of caring for the health and social needs of its aging populace, Finland is a logical model to examine when considering ways to improve the quality of life for older adults who require care in the United States . Those participating in the course visited a series of long-term-care facilities in the region surrounding Terre Haute, Indiana, then travelled to Lappeenranta, Finland to visit parallel sites. Through limited-participation observation and semistructured interviews, similarities and differences in experiences, educations, and policies affecting long-term care workers in the United States and Finland were identified and are described here.

Rede de atendimento comunitário a idosos em Florianópolis (SC): a estratégia dos grupos de convivência em foco / Community care for the elderly of network Florianópolis (SC): the strategy of focusing on Community Centers / Red de atención comunitaria a ancianos en Florianópolis (SC): la estrategia de los grupos de convivencia en foco

Este trabalho tem como objetivo investigar a rede de atendimento comunitário a idosos em Florianópolis (SC), por meio da estratégia dos Grupos de Convivência para Idosos (GCI), apresentando seu processo de criação e de desenvolvimento histórico e sociocultural, assim como a evolução no número de grupos e de idosos participantes. Realizou-se uma pesquisa bibliográfica, descritivo-exploratória e de levantamento, com abordagens qualitativa e quantitativa dos dados. Aplicaram-se entrevistas semiestruturadas com quatro assistentes sociais que participaram do processo de implementação da estratégia de GCI na cidade. Constatou-se a criação formal desses grupos, vinculada e impulsionada, principalmente, por órgãos governamentais da área da assistência social, sendo que, ao longo dos anos, o número de GCI e de participantes aumentou expressivamente em Florianópolis (SC).

This study aims to investigate the community service network for the elderly in Florianópolis (SC), through the strategy of Community Centers for the Elderly (CCEs), presented their process of creation and history and socio-cultural development, including also the increase in the number of groups and elderly participants. We conducted a literature search, descriptive and exploratory and survey with qualitative and quantitative approaches to data. They were applied semi-structured interviews with four social workers who participate in the implementation process of CCEs strategy in the city. the formal establishment was found these groups, bound and driven mainly by government agencies of the social assistance area, and, over the years, the number of CCEs and participants increased significantly in Florianópolis (SC).

Este trabajo tiene como objetivo investigar la red de atención comunitaria a ancianos en Florianópolis (SC), a través de la estrategia de los Grupos de Convivencia para los ancianos (GCI), presentando su proceso de creación y de desarrollo histórico y sociocultural, así como la evolución en el número de grupos y de ancianos participantes. Se realizó una investigación bibliográfica, descriptiva-exploratoria y de levantamiento, con abordajes cualitativo y cuantitativo de los datos. Se aplicaron entrevistas semiestructuradas con cuatro asistentes sociales que participaron en el proceso de implementación de la estrategia de GCI en la ciudad. Se constató la creación formal de estos grupos, vinculada e impulsada, principalmente, por organismos gubernamentales del área de la asistencia social, siendo que a lo largo de los años, el número de GCI y de participantes aumentó expresivamente en Florianópolis (SC).

Implementing an Evidence-Based Fall Prevention Intervention in Community Senior Centers.

OBJECTIVES: To evaluate the impact of implementing an evidence-based fall prevention intervention in community senior centers. METHODS: We used a single-group design to evaluate the Tai Ji Quan: Moving for Better Balance (TJQMBB) program's adoption, population reach, implementation, effectiveness, and maintenance among 36 senior centers in 4 Oregon counties between 2012 and 2016. The primary outcome measure, as part of the effectiveness evaluation, was number of falls as ascertained by self-report. Trained TJQMBB instructors delivered the program to community-dwelling older adults for 48 weeks, with a 6-month postintervention follow-up. RESULTS: TJQMBB was adopted by 89% of the senior centers approached and reached 90% of the target population. The program resulted in a 49% reduction in the total number of falls and improved physical performance. Participation was well maintained after the program's completion. The average cost-effectiveness ratio for the 48-week program implementation was $917 per fall prevented and $676 per fall prevented for multiple falls. CONCLUSIONS: TJQMBB is an effective public health program that can be broadly implemented in community senior centers for primary prevention of falls among community-dwelling older adults.

Shanghai: Front-Runner of Community-Based Eldercare in China.

Facing dramatic growth in its elderly population, Shanghai, China's economic center, has strategically exercised decentralized policy-making power to develop community-based service centers for the elderly. A growing number of elders have been using such services, particular dining services, since 2007. We discuss the evolution in community-based eldercare services in Shanghai, using dining services as an example. We also compare these service centers in Shanghai to multipurpose senior centers in the United States to offer policy recommendations for Shanghai and China's growing eldercare industry. Tailored policy recommendations are discussed.

A nurse-managed advocacy clinic in a Hispanic senior center: using a concept-based clinical practice site to enhance nursing education.

A nurse-managed advocacy clinic for vulnerable, low-income, non-English-speaking elderly Hispanic men and women was developed at a neighborhood community center as a clinical site for senior baccalaureate nursing students. In the clinic's 5 years of operation, nursing students and faculty provided health screenings and education as well as referrals to primary care providers, landlords, pharmacies, and social workers. In doing so, nursing students were introduced to the concept of patient advocacy in a real-world experiential clinical setting, providing an effective link between theoretical knowledge discussed in the classroom and professional nursing practice.

Propostas de gestão dos equipamentos de atenção ao idoso: Relatos de experiência do profissional gerontólogo / Proposals for management of elderly care facilities: Experience reports professional gerontologist

O objetivo desse estudo foi apresentar as primeiras experiências de atuação do gerontólogo, aplicadas no contexto da gestão de programas direcionados à população idosa. A pesquisa tratou-se de um estudo descritivo e de relato de experiência que examinou o relato de três profissionais bacharéis em Gerontologia, sobre a atuação em Centro de Convivência, Centro Dia e Instituição de Longa Permanência (ILPI). Nesse estudo, a habilidade que mais definiu o gerontólogo foi a aplicação das ferramentas da gestão, aliada a ações que objetivaram o bem-estar do idoso e família e a participação de diferentes atores, incluindo a comunidade, a rede de profissionais e os serviços.

The aim of this study was to present the first experiences of gerontologists professional practice gerontologist applied in the management of programs to the elderly. This study was descriptive study and examined the report of three professionals in Gerontology alumni about their involvement in the Living Center, Day Centre and the Long Term Institution (LPI). In this study the ability that most defined the gerontologist was the application of management tools, combined with actions that aimed well-being of older adults, families and the participation of different actors, including the community, a network of professionals and services.

Nuevas alternativas de la rehabilitación de las personas mayores: programas de rehabilitación psicofuncional en Centros de Día GERISER / No disponible

No disponible