Unsung Heroes: How Senior Centers Have Adapted to Provide Essential Services in the Face of COVID-19

This presentation will describe the ways in which senior centers in Massachusetts have adapted during the COVID-19 pandemic. Three surveys (distributed in April, August, and November, 2020) were conducted with 342 senior centers in the state to learn about current operations through the pandemic, challenges faced, and steps taken to solve those challenges. Results suggest that almost all senior centers (91%) continued to provide limited programming or essential services during the pandemic. Senior centers are prioritizing socialization and nutritional needs as critical services, but are changing the way they operate to continue to meet those needs. Despite facing uncertainty about the future, senior centers continue to adapt to changing conditions as they seek to meet their core mission. This presentation will discuss effects of COVID-19 on how senior centers will continue to operate through and post-pandemic times as well as local and state policy implications.

Aging services workers in the pandemic: Voiced experience of senior center staff & case workers

The pandemic necessitated immediate shutdown of senior centers, requiring a rapid pivot in the delivery of services to older adults by direct care workers. We provided psychosocial support to older adult service personnel-including Aging and Adult Services case workers and Senior Center Staff, and conducted focus groups with staff at intervals to capture the mid-point of the pandemic (peak of older adult deaths), onset of vaccine availability and the re-entry phase as programs re-opened. We evaluated coping and self-efficacy of workers and discerned sustained high levels of coping and perceived job performance. Using a phenomenological lens, we analyzed transcribed recordings, generated codes, and created categories of experiences. Several themes emerged: personal and professional resilience, passion for serving older adults, motivation to perform their job well, stress of not having face-to-face contact with clients, insufficient resources-especially in rural areas, lack of essential training, feeling disjointed as a team, and work-life balance. Over the course of the pandemic, workers expressed increasing resiliency and skills to navigate the pandemic, oscillations in their fears for their clients’ well-being, and gratitude that they kept their jobs and gained additional State resources. As the vaccine was available and utilized, and as senior centers were reopening, senior center staff were enthusiastic, yet case workers remained apprehensive about long-term consequences of the pandemic. This study affirms the role of direct care workers as essential and valuable. Yet, their expressed need for more education, psychosocial support, and community awareness of their service remains to be addressed.

Effects of a Web-based Intervention on Cardiovascular and Physical Health of Korean Older Adults During the Pandemic

During the lockdown, 97.5% of Korean senior centers in South Korea were closed to prevent the spread of the coronavirus disease 2019 (COVID-19). The threat of the COVID-19 presented the need for alternative interventions for Korean older adults to maintain cardiovascular and physical health. Korean senior centers implemented web-based interventions to provide physical health services, but their effectiveness was not yet assessed. Thus, our study aimed to identify the effects of a web-based intervention using a smartwatch and mobile app in older adults when compared to center-based intervention during the pandemic. This study collected 117 Korean older adults (≥ 60) who participated in the 12-week web-based and center-based physical interventions using a smartwatch and mobile app. This quasi-experimental study was conducted between August and December in 2020. We analyzed the pre-posttest of cardiovascular and physical health across two intervention types. Our regression results indicated that participants in the 12-week web-based intervention reported better cardiovascular (systolic blood pressure: b = -13.77, p < .001; cholesterol: b = -11.71, p < .05) and physical health (muscular function: b = 2.99, p < .001; body balance: b = -1.31, p < .001; cardiopulmonary endurance: b = 33.33, p < .001) than those in center-based intervention at posttest. The findings imply a web-based intervention is likely to become an innovative therapeutic strategy for older adults' health to respond to the rapidly changing social service systems amid the pandemic.

Senior Centers and LGBT Participants: Engaging Older Adults Virtually in a Pandemic

Upon the outbreak of COVID-19, recommendations to cease all non-essential in-person social services were mandated across the United States to prevent transmission to non-infected individuals. As a result, approximately 96% of all senior centers in the United States were closed to in-person programming (National Council on Aging, 2020). LGBT older adults in particular were at higher risk of isolation and declines in overall health as they were more likely to live alone, experience loneliness or have less immediate family support systems when compared to non-LGBT older adults (Yang, Chu & Salmon, 2017). The purpose of this presentation is to explore how LGBT older adult participants in senior centers transitioned to virtual programming during the pandemic. Using a risk-resiliency theory framework, the purpose of this presentation is to share the impact of virtual programming on the health and well-being of LGBT community-dwelling older adults. An exploratory, cross-sectional study was conducted utilizing an online survey to understand their needs, concerns and experiences. Participants reported a relatively easy adaptation to technology, steady participation in programs and services, satisfaction with virtual senior center programming and a consistent sense of engagement with their peers. Higher levels of engagement with senior center programs were associated with greater perceptions of social support. Additionally, stronger perceptions of social support and participation in exercise and fitness programming were associated with higher life satisfaction and lesser symptoms of depression and anxiety. Strategies for outreach, engagement and service provision will be presented.

Saving Senior Smiles: A Community Outreach Educational Program and Pilot Research Project

Globally, poor oral health has been evidenced more frequently among older adults. Thus, it is imperative to develop strategies for improving the oral health knowledge and access to dental care amongst the older adult population. The Saving Senior Smiles (S3) pilot outreach program was launched as an oral health education and awareness program for community-dwelling older adults across senior centers in the greater Boston area (Massachusetts, USA). The outreach consisted of oral health educational seminars presented by pre- doctoral dental students from three dental schools in the Boston area. The presentations highlighted the significance of oral health, and the importance of seeking routine dental care. Pre and post-test surveys were administered to assess the participants’ utilization of oral health services and oral health knowledge. The surveys were completed by 85 older adults (Female= 58.8%) across five senior centers. Questions pertaining to utilization of dental services revealed that 78.8% of the participants had a dentist. Expectedly, the center that reported the greatest number of missing teeth (Fenway center= 70.6%) had the least number of individuals who had a dentist (58.3%). With regard to oral health knowledge, before the seminars, less than half of the participants (42.2% ) across all the senior centers were aware of the common oral conditions that affected older adults ( dry mouth, gum recession and changes in oral bacteria) and after the presentation over 60% of the participants responded correctly to these knowledge questions. Overall, these findings emphasize the value of simple community-based interventions for older adults.

Impact of the HOP-UP-PT program on older adults at risk to fall: a randomized controlled trial

Background Reduced falls and fall risks have been observed among older adults referred to the HOP-UP-PT (Home-based Older Persons Upstreaming Prevention-Physical Therapy) program. The purpose of this study was to describe outcomes of HOP-UP-PT program participants and then to compare these outcomes to non-participants. Methods Six Michigan senior centers referred adults ≥65 years who were at-risk for functional decline or falls. 144 participants (n = 72 per group) were randomized to either the experimental group (EG) or the control group (CG). Physical therapists (PTs) delivered physical, environmental, and health interventions to the EG over nine encounters (six in-person, three telerehabilitation) spanning seven months. The CG participants were told to continue their usual physical activity routines during the same time frame. Baseline and re-assessments were conducted at 0-, 3-, and 7-months in both groups. Descriptions and comparisons from each assessment encounter were analyzed. Results Participants ages were: EG = 76.6 (7.0) years and CG = 77.2 (8.2). Baseline measures were not significantly different apart from the Short Physical Performance Battery (SPPB) which favored the EG (P = 0.02). While no significant differences were identified in the survey outcomes or home environment assessments, significant differences in favor of the EG were identified in common fall risk indicators including the Timed Up and Go (P = 0.04), Four Test Balance Scale (P = 0.01), and the modified SPPB (P = 0.02) at the 3-month assessment visit. However, these differences were not sustained at the 7-month assessment as, notably, both groups demonstrated positive improvements in the Four Test Balance Score and SPPB. For individuals at a moderate/high fall risk at baseline, 47.8% of CG reported falling at seven months; whereas, only 6.3% of EG participants meeting the same criteria reported a fall after HOP-UP-PT participation. Conclusions A prevention-focused multimodal program provided by PTs in older adults’ homes proved beneficial and those with the highest fall risk demonstrated a significant decrease in falls. A collaboration between PTs and community senior centers resulted in upstreaming care delivery that may reduce both the financial and personal burdens associated with falls in an older adult population. Trial registration This study was retrospective registered at Clinical Trials.gov, TRN: NCT04814459 on 24/03/2021.

Preparedness of senior centers for active shooter incidents

Objective: The main objective was to evaluate the preparedness of senior centers (SCs) for active shooter (AS) events and test the hypothesis that most SCs were not organized to properly handle AS incidents.Design: A cross-sectional study based on questionnaire with quantitative measures.Setting: A questionnaire-based multistate survey of SC Directors (SCDs) of public and private SCs. Participants: SCs were included upon receipt of answers from SCDs to questionnaire-based survey, resulting in 139 SCs from Ohio, Pennsylvania, Michigan, Maryland, Indiana, Illinois, New York, and West Virginia.Main outcome measure: SCs, SCDs, and SCs’ staff preparedness and vulnerability to an AS event.Results: Over half (56 percent) of SCDs replied that their center was not prepared for an AS event. A significant (p 0.01) association was found between the SCD’s perception of being prepared and the availability of a formal AS preventive policy. The lack of panic buttons and surveillance cameras was significantly (p 0.01) associated with the feeling of inability by SCDs to respond effectively to an AS event. Those SCDs who were confident about their AS preparedness felt significantly (p 0.01) better prepared to respond to an AS incident. Personal interviews with content experts agreed that all SCDs should take steps to develop an official AS preparedness policy, but its implementation should be the direct responsibility of local policymakers and legislators.Conclusions: Most SDCs and SCs are unprepared for AS incidents. SCDs should review or develop specific recommendations and implement plans for a better preparedness of SCs and SCDs for AS events. Considering the inherent high vulnerability of older adults, there is an urgent need to have such AS policy in place.

Can Neighborhood Social Infrastructure Modify Cognitive Function? A Mixed-Methods Study of Urban-Dwelling Aging Americans

Objectives: Socialization predicts cognitive aging outcomes. Neighborhoods may facilitate socially engaged aging and thus shape cognition. We investigated places where older adults socialized and whether availability of these sites was associated with cognitive outcomes. Methods: Qualitative analysis of interviews and ethnography with 125 older adults (mean age 71 years) in Minneapolis identified where participants socialized outside of home. This informed quantitative analysis of a national sample of 21,151 older Americans (mean age at baseline 67 years) from the Reasons for Geographic and Racial Differences in Stroke study. Multilevel generalized additive models described associations between access to key social places and cognitive function and decline. Results: Qualitative analysis identified eateries, senior centers, and civic groups as key places to socialize. We identified significant positive associations between kernel density of senior centers, civic/social organizations, and cognitive function. Discussion: Specific neighborhood social infrastructures may support cognitive health among older adults aging in place.