Stimulating Research to Enhance Aging in Place

2021 ◽  
pp. 153944922110222
Author(s):  
Juleen Rodakowski ◽  
Tracy M. Mroz ◽  
Carrie Ciro ◽  
Catherine L. Lysack ◽  
Jennifer L. Womack ◽  
...  
Keyword(s):  
Older Adults ◽  
Occupational Therapy ◽  
Aging In Place ◽  
Family Members ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Priority Areas ◽  
Age In Place ◽  
Care Partners

Older adults may benefit from interventions to successfully age in place. Research has an opportunity to test interventions and implementation strategies to fulfill the needs of older adults through collective evidence building. The purpose of this article is to describe the proceedings of the American Occupational Therapy Foundation (AOTF) 2019 Planning Grant Collective and describe the areas of research that were identified as critical. The AOTF convened scientists with expertise in the area of aging in place to catalyze research on aging in place for older adults. Four priority areas in the aging in place literature were highlighted: (a) identification of factors that support aging in place, (b) classification of processes by which family members and care partners are included in aging in place efforts, (c) categorization of technology supporting older adults to age in place, and (d) development of science that clarifies implementation of evidence-based practice.

scholarly journals Beyond Housing: Perceptions of Indirect Displacement, Displacement Risk, and Aging Precarity as Challenges to Aging in Place in Gentrifying Cities

2019 ◽  
Vol 16 (23) ◽  
pp. 4633 ◽  
Author(s):  
H. Shellae Versey ◽  
Serene Murad ◽  
Paul Willems ◽  
Mubarak Sanni
Keyword(s):  
Older Adults ◽  
New York ◽  
Aging In Place ◽  
Neighborhood Change ◽  
Age In Place ◽  
Unique Character ◽  
Housing Costs ◽  
The Everyday ◽  
The Impact ◽  
Cultural Shifts

Neighborhoods within age-friendly cities and communities are an important factor in shaping the everyday lives of older adults. Yet, less is known about how neighborhoods experiencing change influence the ability to age in place. One type of rapid neighborhood change occurring across major cities nationally and globally is gentrification, a process whereby the culture of an existing neighborhood changes through the influx of more affluent residents and businesses. Few studies have considered the impact of gentrification on older adults, who are among the most vulnerable to economic and social pressures that often accompany gentrification. The current study explores one consequence of gentrification, indirect displacement. While gentrification-induced displacement can refer to the physical (e.g., direct) displacement of residents moving out of a neighborhood due to rising housing costs, it also references the replacement of the unique character and social identity of a neighborhood (e.g., indirect displacement). We examine perceptions of the latter, characterized by perceived cultural shifts and housing concerns among adults aging in place in a gentrifying neighborhood in New York City. The implications of indirect displacement for displacement risk and aging precarity are discussed as potential threats to aging in place in age-friendly cities.

scholarly journals Implementation strategies and outcomes for occupational therapy in adult stroke rehabilitation: a scoping review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
J. Edward Murrell ◽  
Janell L. Pisegna ◽  
Lisa A. Juckett
Keyword(s):  
Occupational Therapy ◽  
Scoping Review ◽  
Stroke Rehabilitation ◽  
Implementation Strategy ◽  
Implementation Strategies ◽  
Stroke Care ◽  
Stroke Survivor ◽  
Educational Outreach ◽  
Evidence Based ◽  
Implementation Outcomes

Abstract Background Stroke survivors often encounter occupational therapy practitioners in rehabilitation practice settings. Occupational therapy researchers have recently begun to examine the implementation strategies that promote the use of evidence-based occupational therapy practices in stroke rehabilitation; however, the heterogeneity in how occupational therapy research is reported has led to confusion about the types of implementation strategies used in occupational therapy and their association with implementation outcomes. This review presents these strategies and corresponding outcomes using uniform language and identifies the extent to which strategy selection has been guided by theories, models, and frameworks (TMFs). Methods A scoping review protocol was developed to assess the breadth and depth of occupational therapy literature examining implementation strategies, outcomes, and TMFs in the stroke rehabilitation field. Five electronic databases and two peer-reviewed implementation science journals were searched to identify studies meeting the inclusion criteria. Two reviewers applied the inclusion parameters and consulted with a third reviewer to achieve consensus. The 73-item Expert Recommendations for Implementing Change (ERIC) implementation strategy taxonomy guided the synthesis of implementation strategies. The Implementation Outcomes Framework guided the analysis of measured outcomes. Results The initial search yielded 1219 studies, and 26 were included in the final review. A total of 48 out of 73 discrete implementation strategies were described in the included studies. The most used implementation strategies were “distribute educational materials” (n = 11), “assess for readiness and identify barriers and facilitators” (n = 11), and “conduct educational outreach visits” (n = 10). “Adoption” was the most frequently measured implementation outcome, while “cost” was not measured in any included studies. Eleven studies reported findings supporting the effectiveness of their implementation strategy or strategies; eleven reported inconclusive findings, and four found that their strategies did not lead to improved implementation outcomes. In twelve studies, at least partially beneficial outcomes were reported, corresponding with researchers using TMFs to guide implementation strategies. Conclusions This scoping review synthesized implementation strategies and outcomes that have been examined in occupational therapy and stroke rehabilitation. With the growth of the stroke survivor population, the occupational therapy profession must identify effective strategies that promote the use of evidence-based practices in routine stroke care and describe those strategies, as well as associated outcomes, using uniform nomenclature. Doing so could advance the occupational therapy field’s ability to draw conclusions about effective implementation strategies across diverse practice settings.

scholarly journals Evidence-Based Approaches to Suicide in Older Adults—Zero Suicide

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 625-625
Author(s):  
Luming Li
Keyword(s):  
Older Adults ◽  
Suicide Prevention ◽  
Implementation Strategies ◽  
Essential Elements ◽  
Clinical Settings ◽  
Evidence Based ◽  
Term Care ◽  
Future Directions ◽  
Healthcare Settings

Abstract This individual symposium abstract will focus on evidence-based approaches to suicide in older adults, with particular focus on the Zero Suicide Model. Zero Suicide Model is a framework that applies seven essential elements of suicide care (Lead, Train, Identify, Engage, Treat, Transition, Improve). The model provides a systematic approach for quality improvement for suicide prevention and offers implementation strategies for “real-world” clinical settings using the Assess, Intervene, and Monitor for Suicide Prevention (AIM-SP) program for suicide-safer care. The authors will describe implementation of Zero Suicide in general healthcare settings that care for older adults, including health systems and outpatient clinics. The authors will also describe the value of Zero Suicide other settings such as long-term care centers, where older adults are cared for. In addition, the authors will describe future directions for research in the Zero Suicide Model and additional opportunities in public policy for suicide prevention.

scholarly journals Home and Community Features, Perceived Age-Friendliness, and Intention Toward Aging in Place

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 560-560
Author(s):  
Yeon Jin Choi
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Aging In Place ◽  
Linear Regression Models ◽  
Policy Makers ◽  
Age In Place ◽  
Outdoor Spaces ◽  
Perceived Age ◽  
Aging Societies ◽  
The Relationship

Abstract Promoting age-friendliness of communities and supporting aging in place (AIP) are of great importance in aging societies. However, little is known about the mechanism linking home and neighborhood features, older adults’ global assessment of community, and their willingness to age-in-place despite the importance in developing policies and interventions. This study used the 2015 AARP Age-Friendly Community Survey, which includes 66 home and neighborhood features under the eight domains specified by the WHO’s Age-Friendly Cities Guidelines. A series of linear regression models were estimated to examine the interrelationship between the availability of age-friendly features in eight domains, perceived age-friendliness of community, and intention toward AIP. Overall, a greater availability of age-friendly features was positively associated with perceived age-friendliness of community and AIP intention. The relationship between age-friendly features and AIP intention was mediated by perceived age-friendliness of community (50.3% to 96% of the total effects). When perceived age-friendliness of community was introduced to models, the direct effects of housing, outdoor spaces and buildings, and transportation domains remained significant. Findings suggest that a greater availability of age-friendly features influence older adults’ perception on their community, leading to the development of a desire to age-in-place. Domains of housing, outdoor spaces and buildings, and transportation may be the most importance features in promoting age-friendliness of community and the key determinants of aging-in-place. Policy makers and practitioners may need to prioritize promoting age-friendly built environment before social environment in building age-friendly communities.

scholarly journals Prioritizing supports and services to help older adults age in place: A Delphi study comparing the perspectives of family/friend care partners and healthcare stakeholders

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259387
Author(s):  
Megan Campbell ◽  
Tara Stewart ◽  
Thekla Brunkert ◽  
Heather Campbell-Enns ◽  
Andrea Gruneir ◽  
...  
Keyword(s):  
Older Adults ◽  
Affordable Housing ◽  
Assisted Living ◽  
Delphi Study ◽  
Future Research ◽  
Adult Care ◽  
Community Based ◽  
Sustainable Solutions ◽  
Age In Place ◽  
Care Partners

Background Aging in place (AIP) is a policy strategy designed to help older adults remain in their community. While planners internationally have modified aspects of the older adult care continuum (e.g., home care, assisted living, nursing homes) to facilitate AIP, further improvements to community-based supports and services are also required. This study compared and constrasted the community-based factors (e.g., supports, services and personal strategies or characteristics) that family/friend care partners and healthcare stakeholders (i.e., planners/providers) view as most important to help older adults successfully AIP. Methods An initial list of factors shown to influence AIP was created from the academic literature. These factors were used to develop a Delphi survey implemented separately on care partners and healthcare stakeholders. Respondents rated the importance of each factor using a 10-point Likert Scale (1 = not important; 10 = absolutely critical). Consensus in each group was defined when at least 80% of participants scored a factor ≥8 (“very important”), with an interquartile range ≤2. Respondents suggested additional factors during Delphi round one. Results Care partners (N = 25) and healthcare stakeholders (N = 36) completed two and three Delphi rounds, respectively. These groups independently agreed that the following 3 (out of 27) factors were very important to help older adults age in place: keeping one’s home safe, maintaining strong inter-personal relationships, and coordinating care across formal providers. While healthcare stakeholders did not reach consensus on other factors, care partners agreed that 7 additional factors (e.g., access to affordable housing, having mental health programs) were important for AIP. Conclusions Compared to healthcare stakeholders, care partners felt that more and diverse community-based factors are important to support older adults to successfully AIP. Future research should replicate these findings in other jurisdictions, examine the availability and accessibility of the priority factors, and develop sustainable solutions to enhance their effectiveness.

scholarly journals LIFE SPACE MOBILITY AND NEIGHBORHOODS: HOW HOME MODIFICATIONS IMPACT AGING IN PLACE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S249-S249
Author(s):  
Alan DeLaTorre ◽  
Ivis García ◽  
Julianne Reno ◽  
Ja Young Kim ◽  
Keith Diaz Moore
Keyword(s):  
Older Adults ◽  
Salt Lake ◽  
Aging In Place ◽  
Social Connections ◽  
Life Space ◽  
Lake County ◽  
Home Modification ◽  
Age In Place ◽  
Mobility Barriers ◽  
Home Modifications

Abstract This presentation details a mixed methods study funded by the National Institute for Transportation and Communities that was conducted with 50 older adults aged 65 and older who lived in Portland, Oregon (n=25) and Salt Lake County, Utah (n=25). The purpose of the study was to improve understanding of how home modifications affect older adults’ mobility in different life-spaces (e.g., one’s bedroom, neighborhood), their understanding of aging in place and neighborhood, and their ability to age in place. During each home visit, a series of research protocols (i.e., surveys, interviews, mapping exercises) were carried out with each participant. The study found that home modifications (e.g., grab bars, replacing showers with bathtubs, and adding raised toilets) were reported to increase in-home mobility and, for some, their independence; however, for certain participants, those same modifications were less useful, especially to those with the need for caregiver supports. Life-space mobility outside the home was impacted by home modification such as ramps and railings on stairs; for some, those modifications bolstered social connections and access to services. Overall, home modification were seen as enabling both mobility and aging in place. Furthermore, respondents’ understanding and description of their neighborhoods varied greatly and were influenced by mobility barriers (e.g., presence of sidewalks and crosswalks) and available amenities.

scholarly journals PROMOTING AGING IN PLACE VIA RESEARCH, POLICY, AND PRACTICE IN AGE-FRIENDLY COMMUNITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S26-S26
Author(s):  
Kathy Black
Keyword(s):  
Older Adults ◽  
Research Policy ◽  
Aging In Place ◽  
Policy And Practice ◽  
Community Based ◽  
Professional Groups ◽  
Age In Place ◽  
Community Model ◽  
The Social ◽  
Global Age

Abstract The majority of Americans overwhelmingly prefer to age in place and in the communities in which they reside. Age-friendly communities support aging in place by focusing attention on features both inside and outside of the home. The global age-friendly community model provides a framework that requires assessing community-based older adults’ needs and preferences about, and developing subsequent action towards, features of the social, service and built environment including housing and transportation which are considered essential to aging successfully at home. This presentation discusses the intersect between research, policy and practice in an age-friendly community which utilized micro-level findings from older adults (n = 1, 172) to enact macro-level collaborations across local and statewide government and professional groups to facilitate aging in place across the domains of housing and transportation.

scholarly journals Promoting Aging in Place in Social Housing

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 709-709
Author(s):  
Christine Sheppard ◽  
Tam Perry ◽  
Andrea Austen ◽  
Sander Hitzig
Keyword(s):  
Older Adults ◽  
Social Housing ◽  
Service Providers ◽  
Aging In Place ◽  
Policy Decision ◽  
Academic Community ◽  
Community Partnership ◽  
Service Model ◽  
Age In Place ◽  
Policy Decision Making

Abstract As cities around the globe plan for current and future older cohorts, there is a need to explore innovative housing models to help older adults age in place. This paper presents findings from an action-research academic/community partnership on a new service model at Toronto Community Housing, the second largest social housing landlord in North America and home to 27,000 older adults. As Toronto works to improve delivery of housing/support services, more knowledge was needed to understand the inadequate and inconsistent delivery of services to tenants. Interviews/focus groups with older tenants and service providers (N=116) identified challenges related to unit condition (e.g., pest control) and tenancy management (e.g., arrears), and that the fragmentation of housing and health services negatively impacts older tenants’ abilities to access supports and age in place. The presentation will conclude with discussion of planning and policy decision making approaches relevant to both Canadian and American contexts.

scholarly journals Architecture of a Smart Home for Aging in Place

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 39-39
Author(s):  
Neda Norouzi
Keyword(s):  
Older Adults ◽  
Independent Living ◽  
Aging In Place ◽  
The United States ◽  
Census Bureau ◽  
United States Department ◽  
Social And Emotional ◽  
Age In Place ◽  
Department Of Health ◽  
Private Homes

Abstract The United States Department of Health and Human Services (2017) estimates that there are 65 million people age 60+ residing across the fifty states. A national survey conducted by the American Association of Retired Persons (AARP) indicates that 76% of people ages 55+ prefer to age-in-place and live independently (2018). The Census Bureau American Community Survey (2015) estimates that 13 million adults have difficulties living independently, 80% of which receive assistance in their private homes. However, only 50% of these homes meet the physical needs of people who choose to age-in-place (AARP, 2018). Recent advancements in technology have led to the development of smart homes. Technology can support aging-in-place and independent living by offering necessary tools for building systems that identify behavioral patterns and offer automated decision-making. However, not all older adults are customed to using technology or comfortable with being monitored with artificial intelligence (Wang et al., 2019). In response to this concern, the current study used grounded theory framework to analyze 62 interviews of people ages 55-93 to indicate if and how older adults prefer to utilize technology in their homes. The results of the study presented that while some older adults felt they might be too old to learn and use technology, nearly 85% of the interviewers agreed that incorporating technology in the built environment could benefit them. They are especially willing to learn and use technology in their homes when the benefits are related to their health, social and emotional connection, entertainment, safety, and daily chores.

scholarly journals Challenges and Supports to Aging in Place in a Gentrifying Context

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 873-873
Author(s):  
Manish Kumar ◽  
Laura Richman
Keyword(s):  
Older Adults ◽  
Social Capital ◽  
Affordable Housing ◽  
Low Income ◽  
Healthy Aging ◽  
Aging In Place ◽  
Well Being ◽  
Neighborhood Change ◽  
Structured Interviews ◽  
Age In Place

Abstract Neighborhoods play a central role in healthy aging, with changes to neighborhoods having a profound impact on older adults’ ability to age in place. Using gentrification as an indicator of neighborhood change and applying the theoretical framework of the Environmental Press model (Lawton and Nahemow, 1973), this study examined the relationship between changing environments, affordable housing, and environmental attributes that support and hinder the health and well-being of older adults. A qualitative, case-study approach was used to interview low-income, majority Black older adults in a gentrifying area of Washington DC. 32 individuals (16 in non-profit and 16 in for-profit affordable housing) aged 55 and older participated in semi-structured interviews on perceptions of gentrification, neighborhood change, and challenges and supports to aging in place. Transcripts were then analyzed using the framework method of analysis. Although participants generally reported that gentrification improved their neighborhood’s built environment, many attributed it to a decline in social capital. Affordable housing provided an ability to age in place, though participants expressed uncertainty over their long-term ability to age in the context of continuing change. These findings suggest that while the physical changes accompanying gentrification may support older adults’ ability to age in place, its detrimental impact on social capital further increases their risk for social isolation. While affordable housing may enable older adults to age in place, fostering a greater sense of permanence and well-being will require additional policies that both increase accessibility to the physical amenities provided by gentrification and preserve older adults’ social capital.

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