Community-Based Aging Services

2020 ◽  
Author(s):  
Jan Ivery
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Social Workers ◽  
Healthy Aging ◽  
Community Based ◽  
Limited Mobility ◽  
Age In Place ◽  
Increased Risk ◽  
Aging Services ◽  
Community Based Services

As individuals age, their physical community continues to be a primary entry point of intervention because of their attachment to place, social connections, and limited mobility to travel as far and as often as they would like or desire. The environment provides a context for understanding an older adult’s social interactions and the availability of and access to supportive services that reduce isolation and increased risk for reduced health status. When individuals age in place, social workers need to understand how community-based services can work with older adults in their community where they have lived for some time and have developed social networks. This knowledge will better assist social workers in their ability to effectively connect clients with appropriate resources. Unfortunately, it is not uncommon for an older adult’s environment to not reflect or adapt to their changing health status and physical mobility. Healthy aging (also referred to as age-friendly) and NORC (naturally occurring retirement communities) initiatives have emerged as examples of how to provide supportive, community-based services that will enable older adults to remain engaged in their community as they experience changes in their health status, mobility, and financial security. These community-level interventions emphasize the adaptability to an older adult’s changing lifestyle factors that influence how they navigate their community. These initiatives engage older adults in planning and implementing strategies to connect older adults with services and activities that promote aging in place. Social workers play a very important role in the provision of community-based aging services because they can serve as a bridge between older adults and the local, state, and federal level programs that may be available to them.

scholarly journals THE SEARCH STUDY: A QUALITATIVE INQUIRY INTO DIVERSE STAKEHOLDER PERSPECTIVES ON HEALTHY AGING ACROSS CHICAGOLAND

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S961-S961
Author(s):  
Mushira Khan ◽  
Karen Graham ◽  
Tarisha Washington ◽  
Abigail Kim ◽  
Raj C Shah ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
South Asian ◽  
Healthy Aging ◽  
Cultural Beliefs ◽  
Qualitative Inquiry ◽  
Community Based ◽  
Age Related ◽  
Increased Risk ◽  
Diverse Communities

Abstract Older adults face increased risk of chronic diseases of aging such as Alzheimer’s dementia and other adverse age-related outcomes. However, the conceptualization of healthy aging and how age-related issues are addressed in community-based structures, particularly among racial and ethnic minorities, remain poorly understood, especially from the Stakeholder perspective. Stakeholders, such as faith leaders and members of community-based organizations, engage in regular negotiations to advance health equity in their communities by partnering and collaborating with older adults and their families as well as other local and federal organizations. The Stakeholder Engagement in Aging Research and Community Health (SEARCH) Study employs multiple research methods to illuminate Stakeholders’ perspectives on barriers and facilitators to healthy aging in diverse communities. This presentation highlights findings from in-depth, qualitative interviews with Stakeholders (N=37) serving African American, Latinx, and South Asian older adults. Emergent themes suggest that systemic racism, stigmatization, limited health literacy, and cultural beliefs serve as barriers to healthy aging across groups. Within groups, Stakeholders report precarious immigration status and fragile and fragmented life situations as barriers among Latinx older adults, while acculturative stress presents a challenge to healthy aging in South Asian older adults. Food insecurity and neighborhood factors such as exposure to violence and socio-economic disadvantages act as barriers among African American older adults. Conversely, religious faith and spirituality, familial support, and culturally-congruent care serve as facilitators across groups. The findings from this study underscore the continued need for intersectional, inclusive, and culturally-informed approaches to supporting healthy aging within diverse communities.

scholarly journals Hospitalization Trajectories in Home- and Community-Based Services Recipients: The Influence of Physician and Social Care Density

2020 ◽  
Author(s):  
Min Hee Kim ◽  
Xiaoling Xiang
Keyword(s):  
Older Adults ◽  
Primary Care Physicians ◽  
Social Care ◽  
Group Membership ◽  
Multinomial Logistic Regression ◽  
Community Based ◽  
Resource Density ◽  
Increased Risk ◽  
Trajectory Group ◽  
Community Based Services

Abstract Objectives Repeated hospitalizations among older adults receiving Home- and Community-Based Services (HCBS) may indicate unmet medical and social needs. This study examined all-cause hospitalization trajectories and the association between area-level resource density for medical and social care and the trajectory group membership. Methods The study participants included 11,223 adults aged 60 years or older who were enrolled in public HCBS programs in Michigan between 2008 and 2012. Data sources included the Michigan interRAI-Home Care, Dartmouth Atlas of Health Care Data, the American Community Survey, and the County Business Patterns from the Census Bureau. The group-based trajectory modeling was used to identify trajectories of hospitalization over 15 months. Correlates of the trajectories were examined using multinomial logistic regression. Results Four distinct hospitalization trajectory groups emerged: “never” (43.1%)—individuals who were rarely hospitalized during the study period, “increasing” (19.9%)—individuals who experienced an increased risk of hospitalization, “decreasing” (21.6%)—individuals with a decreased risk, and “frequent” (15.8%)—individuals with frequent hospitalizations. Older adults living in areas with a higher number of social service organizations for older adults and persons with disability were less likely to be on the “frequent” trajectory relative to the “decreasing” trajectory. The density of primary care physicians was not associated with the trajectory group membership. Discussion Area-level social care resource density contributes to changes in 15-month hospitalization risks among older adult recipients of HCBS.

Aging in Place: A National Analysis of Home- and Community-Based Medicaid Services for Older Adults

2018 ◽  
Vol 29 (4) ◽  
pp. 245-256 ◽  
Author(s):  
Carli Friedman ◽  
Joe Caldwell ◽  
Angela Rapp Kennedy ◽  
Mary C. Rizzolo
Keyword(s):  
Older Adults ◽  
Aging In Place ◽  
Nursing Facilities ◽  
Community Based ◽  
Age In Place ◽  
Services And Supports ◽  
Aging Adults ◽  
National Analysis ◽  
Community Based Services

The number of Americans needing long-term services and supports (LTSS) is projected to more than double in the coming decades largely due to an aging baby boomer population, meaning paying for LTSS will become an even greater challenge for American families and the country. Despite the benefits of aging in place, there remains a long-standing institutional bias within the Medicaid program, where services in nursing facilities are mandatory while home- and community-based services (HCBS) are mostly optional for states to cover. This study examined HCBS 1915(c) waivers ( n = 61 waivers) for older adults to categorize and compare service priorities. Findings revealed waivers for older adults were primarily focused on supporting individuals in their own homes to age in place. However, findings also revealed HCBS waivers are an underutilized mechanism for funding the LTSS of older adults. As states continue to deal with an increasing population of aging adults, with and without disabilities, the HCBS waiver option will continue to be an important component of a state’s service system.

scholarly journals Supporting Older Adults and Caregivers Through Integrative Service Learning During COVID

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 958-958
Author(s):  
Keith Chan ◽  
Sarah LaFave ◽  
Maggie Ratnayake ◽  
Christina Marsack-Topolewski ◽  
Jillian Graves ◽  
...  
Keyword(s):  
Older Adults ◽  
Service Learning ◽  
Community Resources ◽  
Learning Models ◽  
Process Data ◽  
Community Based ◽  
Age In Place ◽  
Home Based ◽  
Hands On ◽  
Hands On Learning

Abstract There is a growing population of older adults who are living longer and acquiring chronic illness and disabilities, making it difficult for them to complete everyday activities and age in place. More than 2 million of these older adults are homebound and 5 million need help leaving their homes. They experience social isolation, food insecurity, and lack of connection to community resources which has intensified since the pandemic. Integrative service learning models can provide home-based support to older adults while offering valuable, hands-on learning experiences for students. This study examined findings for a community-based program which trained university students to provide practical home-based support for older adults and their caregivers. Data was collected for 109 older adults who were connected with student trainees. Students provided services with groceries, companionship, and help accessing needed services. Findings from t-test results using the UCLA Loneliness Scale indicated that older adults reported less loneliness after engagement with students (mean difference = 6.15, t = 3.14, df = 82, p < 0.01). Qualitative process data suggested that older adults benefited from services and a connection to their assigned students prior to and during the pandemic. Student trainees reported that the experience enriched their learning and reaffirmed their commitment to working with older adults. Community-based service learning can address home-based needs of older adults and their caregivers and enhance learning opportunities for students. Policies and practice can support a pipeline of geriatric health professionals through innovative service learning models to benefit older adults, caregivers and students.

Screening and Priority-Setting to Determine Home- and Community-Based Aging Services for Older Floridians

2021 ◽  
pp. 073346482110125
Author(s):  
Lawrence Schonfeld ◽  
Jesse Bell ◽  
Mary Goldsworthy ◽  
Kevin Kip ◽  
Amber M. Gum ◽  
...  
Keyword(s):  
Service Delivery ◽  
National Standards ◽  
Third Party ◽  
Community Based ◽  
Older Americans ◽  
Caregiver Support ◽  
Aging Services ◽  
Optimal Health ◽  
Aging Network ◽  
Community Based Services

The National Aging Network serves millions of older Americans seeking home- and community-based services, but places others on waitlists due to limited resources. Little is known about how states determine service delivery and waitlists. We therefore conducted a process evaluation and analyzed data from one five-county Area Agency on Aging in Florida, where an algorithm calculates clients’ priority scores for service delivery. From 23,225 screenings over 5.5 years, clients with higher priority scores were older, married, living with caregivers, and had more health problems and needs for assistance. Approximately 51% received services (e.g., meals/nutrition, case management, caregiver support), 11% were eligible/being enrolled, and 38% remained on waitlists. Service status was complex due to multiple service enrollments and terminations, funding priorities, and transfers to third-party providers. More research is needed regarding how other states determine eligibility and deliver services, potentially informing national standards that promote optimal health in older Americans.

Determining the Long-Term Effectiveness of a Group-Based Physical Activity Program

2018 ◽  
Vol 20 (3) ◽  
pp. 401-408
Author(s):  
Anamica Batra ◽  
Richard C. Palmer ◽  
Elena Bastida ◽  
H. Virginia McCoy ◽  
Hafiz M. R. Khan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Healthy Aging ◽  
Population Level ◽  
The United States ◽  
South Florida ◽  
Community Based ◽  
Evidence Based Programs ◽  
The Impact

Objective. In 2015, only half (48%) of older adults in the United States (≥60 years) reported engaging in any kind of physical activity. Few studies examine the impact of evidence-based programs when adopted in community-based settings. The purpose of this study is to assess the effectiveness of EnhanceFitness (EF) upto 12-months. Method. EF was offered to older adults in South Florida. A total of 222 EF classes were offered between October 2008 and December 2014. Program consisted of a 1-hour session held three times a week. Even though participation was required for 4 months, 1,295 participants continued the program for at least 1 year. Results. All participants showed significant improvement in outcome measures. A mean change of 1.5, 1.7, and 1.9 was seen in number of chair stands at 4, 8, and 12 months (p < .001), respectively. The number of arm curls performed improved from 16.8 at baseline to 18.8, 18.8, and 19.2 at 4-, 8-, and 12-months, respectively. Participants improved their up-and-go time by decreasing from 9.1 (baseline) to 8.7 (4 months) to 8.6 (12 months; p = .001). Discussion. Randomized controlled trials are commonly used to determine the efficacy of an intervention. These interventions when disseminated at the population level have the potential to benefit large masses. EF is currently offered at more than 700 locations. This tremendous success of EF brings attention to an important question of continuous monitoring of these programs to ensure program consistency and intended outcomes. The model used by the Healthy Aging Regional Collaborative could be replicated by other communities.

Characteristics and Factors Associated With Intimate Partner Violence–Related Homicide Post-Release From Jail or Prison

2019 ◽  
pp. 088626051988819
Author(s):  
Cynthia Fraga Rizo ◽  
Annelise Mennicke ◽  
Tonya Van Deinse
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Correctional Facility ◽  
Intimate Partner ◽  
Correctional Institutions ◽  
Community Based ◽  
Homicide Victimization ◽  
Increased Risk ◽  
Informal Supports ◽  
Community Based Services

Intimate partner violence (IPV) victimization and perpetration are common experiences among incarcerated people. Despite knowledge regarding the challenges of re-integrating post-release from jail or prison, including an increased risk of homicide victimization, there is a dearth of research focused on IPV-related homicides post-release from a correctional facility. To address this gap, the current study used 2003-2015 data from the National Violent Death Reporting System from 27 states to examine the characteristics and circumstances surrounding IPV-related homicides soon after the homicide victim was released from jail or prison. Of the 126 post-release homicides, 13.5% were related to IPV. Post-release homicides involving either a female victim or perpetrator were more likely to be IPV-related. In the case of many of the IPV-related homicides, there was evidence of prior IPV as well as potential bystanders (including formal and informal supports) who were aware of the risk for IPV escalation and possible lethality. Compared with non-IPV post-release homicides, those related to IPV were more likely to occur in the victim’s home, have been immediately preceded by a physical fight, and have occurred by means other than firearm. These findings highlight the importance of enhancing the capacity of correctional facilities and community-based services to assess for and respond to risk of IPV and IPV-related lethality for individuals leaving correctional institutions.

scholarly journals ELDER ABUSE AMID THE OPIOID EPIDEMIC: APS CASES IN RURAL AMERICA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S763-S763
Author(s):  
Pamela B Teaster ◽  
Karen A Roberto ◽  
Jyoti Savla
Keyword(s):  
Older Adults ◽  
Elder Abuse ◽  
Standard Errors ◽  
Opioid Misuse ◽  
Rural America ◽  
Opioid Use ◽  
Care Needs ◽  
Community Based ◽  
Community Based Services ◽  
Physical Care

Abstract Older adults are hidden victims of the opioid crises, suffering abuse at the hands of those who seek resources to support their addiction. Using APS data from 2015-2017 provided by the Kentucky Department for Community-Based Services, we used a logistic regression model with robust standard errors to examine whether substantiated cases of elder abuse were associated with opioid misuse by perpetrators. Overall, 9% of the 462 substantiated cases over the three-year period involved perpetrators were substance users. The percentage of these cases rose from 5% in 2015 to 13% in 2016 before dropping to 7% of elder abuse cases in 2017. Opioid use was most prevalent among perpetrators of financial abuse of older adults with cognitive and/or physical care needs. The current study offers a first look at empirical linkages between opioid misuse and elder abuse and revealed consistencies across cases that call for further investigation.

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