Self-management processes, sedentary behavior, physical activity and dietary self-management behaviors: impact on muscle outcomes in continuing care retirement community residents

Background Despite the known benefits of non-sedentary behavior, physical activity, and protein and caloric intake to health and muscle mass, strength, and function, many older adults do not meet physical activity and dietary recommendations. A better understanding of the factors associated with sedentary behavior, physical activity and dietary self-management behaviors, and muscle outcomes (muscle mass, strength, and function) is needed, particularly among continuing care retirement community residents. The objective of this study was to examine the factors associated with sedentary behavior, physical activity and dietary self-management behaviors, and muscle outcomes among continuing care retirement community residents. It also aimed to determine whether sedentary behavior and physical activity and dietary self-management behaviors mediate the relationships between self-efficacy, goal congruence, aging expectations, social support, and muscle outcomes. Methods A sample of 105 continuing care retirement community residents (age > 70 years) participated in this correlational, cross-sectional study. Questionnaires on pain, self-efficacy, goal congruence, aging expectation, social support, and daily protein and caloric intake were administered. Physical activity and sedentary behavior (ActiGraph wGT3X-BT), muscle mass (ImpediMed SFB7), muscle strength (Jamar Smart Digital Hand Dynamometer), and muscle function (Short Physical Performance Battery) were measured. Multiple regression, logistic regression, and mediation analyses were performed. Results Low goal congruence predicted engagement in sedentary behavior and light physical activity. Higher levels of self-efficacy and social support were associated with increased likelihoods of achieving greater moderate physical activity and meeting daily recommendations for caloric intake, respectively. Self-efficacy and goal congruence predicted muscle function and strength. Moreover, sedentary behavior and achieving greater moderate physical activity were found to partially but significantly mediate the relationship between self-efficacy and muscle function. Conclusion Future research should evaluate whether attempts to reduce sedentary behavior and promote physical activity and dietary self-management behaviors and muscle outcomes are more successful when modifications to the self-management process factors are also targeted.

Malnutrition–Sarcopenia Syndrome and Self-Management Behaviors in Continuing-Care Retirement Community Residents

Malnutrition–sarcopenia syndrome (MSS) might put older adults at higher risk for disability, frailty, and mortality. This study examined the prevalence and association of the self-management-process factors (i.e., self-efficacy and aging expectations) and behaviors (protein and caloric intake and sedentary and physical-activity behaviors) to MSS among older adults living in continuing care retirement communities (CCRCs). Using a cross-sectional correlational design, data of 96 CCRC residents (82.4 ± 7.4 years) were analyzed. Muscle mass, strength, function, nutritional status, sedentary time, physical activity levels, protein and caloric intake, self-efficacy for physical activity, aging expectations, and physical and mental health-related quality of life were measured. Results show that 36 (37.5%) had sarcopenia, 21 (21.9%) had malnutrition risk, 13 (13.4%) had malnutrition, and 12 (12.5%) had MSS. We also found that high time spent in sedentary behaviors (OR = 1.041; 95% CI: 1.011–1.071) was associated with higher odds of having MSS and high expectations regarding aging (OR = 0.896; 95% CI: 0.806–0.997) was associated with less likelihood of having MSS. Findings suggest that CCRC residents should be screened for MSS. Self-management interventions that consider the self-management-process factors are needed to prevent MSS and mitigate its negative outcomes among CRCC residents.

Challenges and Opportunities of Using Telenursing During COVID-19 Pandemic: An Integrative Review

Introduction: Telenursing during the COVID-19 pandemic with an emphasis on self-care is an effective approach to help patients, hospitals, as well as community. Despite the many challenges and benefits, tele-nursing can be used to help COVID 19 patients with new technologies. This study aimed to explore the challenges and opportunities of using tele-nursing in the COVID 19 Pandemic for helping patients with COVID 19 to gain better care.Material and Methods: An integrative review was conducted from December, 2019 to January, 2021. Databases of PubMed, MEDLINE, Web of Science, Scopus, CINHAL, and google scholar were searched on the concept of tele-nursing by using the following keywords, of COVID-19, Coronavirus, Telenursing, nurse roles, technology, Pandemics and Internet. DaA ta were analyzed according to Broome method.Results: The main results of tele-nursing in COVID 19 includes: implementation problems, insurance coverage, prevention of nurses, the problem of continuing care, and changing the roles of nurses’ infections, development of nursing knowledge, the emergence of technological care providing, emphasis on patient independence and transmission cycle control.Conclusion: Tele-nursing, this, despite the challenges, has many benefits that are effective in the current situation and effective, and reliable measure, through effective planning and implementation, help control COVID-19.

Preparing for the New Normal: Chronicling the Impact of COVID-19 on Older Adults and Providers

COVID-19 and social distancing heralded an unprecedented change in the way older adults and health care providers live, work, socialize and manage their health. Early “calls-to-action” included the call for researchers to chronicle the impact of the COVID-19 pandemic on care of older adults to inform models of care and best practices in the new normal. This symposium explores the impact of COVID-19 on the health of older adults across the care continuum and healthcare delivery augmented by technology. The perspectives of older adults living in the community and providers who care for this population are highlighted. Additionally, there is a focus on the most vulnerable, those living in skilled care facilities and continuing care retirement communities. Fisher analyzes the key themes in 37 COVID-19 video communiques over 11 months at a continuing care retirement community. Sefcik explores coping strategies including outdoor activities among community-dwelling older adults. DiMaria-Ghalili examined patterns of physical and mental health, technology usage and loneliness in older adults, including those living in the community and a continuing care retirement community. Using longitudinal data and COVID-19 supplemental survey data from the National Health and Aging Trends Study, Huh-Yoo discusses disparities in online patient-provider communication and implications for the Post-COVID era. Coates discusses the facilitators and barriers perceived by interdisciplinary providers deploying telehealth during the COVID-19 pandemic and implications for healthcare delivery in older adults. The symposium will conclude with a discussion by Dr. Sefcik on the implications for research, practice and policy in the post COVID-19 era.

Intergenerational Service-Learning During COVID-19

Mentor Up is a technology training program designed to reduce loneliness through technology training and intergenerational relationships. The program, which has similarities to Cyber Seniors, has been held at Eckerd College for four years and has traditionally been held in-person at a local Continuing Care Retirement Community (CCRC). During the pandemic we partnered with AARP to re-think the program and offer a modified version of Mentor Up on Zoom. Five one-hour one-on-one virtual technology training sessions led by 16 students were scheduled. Participants joined to ask questions about how to use features on their smartphones or how to navigate the Zoom virtual platform more effectively. The remote nature of programming allows for expanded 2021 participation, including AARP members across Florida and all three Westminster Communities of Florida in the area (CCRC, ALF, SNF). Participation rates, strategies to implement intergenerational programs on a virtual platform, and lessons learned will be highlighted.

Enhancing Collaborations between our Age-Friendly Community and University Initiatives

Community involvement and synergistic partnerships are key to fostering a holistic approach to programming and outreach that assess and meet the needs of the older adults in our communities. The University of Illinois Urbana-Champaign has created an Age-Friendly network to facilitate these partnerships featuring our designation of Age-Friendly City and Age-Friendly University as well as partnerships with our state and local governments, community aging services providers, and continuing care retirement communities. Through these partnerships, we have identified the landscape of the community, assessed the unique needs older adults, and identified novel solutions. We will discuss our plans for activities that will empower older adults in our community and at our university by promotion connection, collaboration, and inclusion.

Uncertain Times: A Continuing Care Retirement Community's COVID-19 Communication Response

The purpose of this qualitative inquiry was to explore conversational video recordings by top administrators from a faith based Continuing Care Retirement Community (CCRC) to help residents, staff, and family members manage the associated uncertainties of the pandemic. Six interdisciplinary researchers explored 37 video communiques from March 2020 to February 2021. Data was independently coded using latent content analysis with the team building consensus on major themes. Themes identified were: Building Trust through Transparency, We’re in this Together, Power of One/Individual Responsibility, Converting Challenges into Teaching Moments, and Gratitude/Resilience. Findings suggest attempts to inform, reassure, and encourage maintaining a safe environment (e.g., using masks, restricting visitors, vaccine promotion) for residents, staff, and family members, was met through these conversational videos. Leadership of this CCRC exemplified the mission to provide transparent information during the pandemic, serving as a model to inform other CCRCs’ communication during this pandemic and other crisis situations.

Malnutrition-Sarcopenia Syndrome and its Associated Factors Among Older Adults

Malnutrition and sarcopenia are present in parallel in older adults and characterized by a combination of inadequate nutrient intake and decreased muscle mass, strength, and/or function. The presence of both conditions has been termed Malnutrition-Sarcopenia Syndrome (MSS) and is associated with negative health outcomes. The objective of this correlational study was to identify the prevalence and factors associated with the malnutrition-sarcopenia syndrome among older adults living in continuing care retirement communities. A convenience sample of 104 older adults living in CCRCs participated in this study. Muscle mass, strength, and function were measured using bioimpedance analysis, Jamar digital hand dynamometer, and the Short Physical Performance Battery test, respectively. Physical activity, sedentary time, and nutritional status were measured using ActiGraph GT3X and Mini Nutritional Assessment, respectively. Questionnaires were used to measure self-efficacy for exercise and goal congruence for physical activity and protein intake. Of the 104 participants, 37 (35.2%) had sarcopenia, 19 (18.1%) had malnutrition, and 14 (13.5 %) had MSS. Compared with those without MSS, older adults with MSS were more than two times more likely to have a sedentary lifestyle (Odd ratio, 2.028; 95% confidence interval, 2.012–2.044). Findings showed that sarcopenia, malnutrition, and MSS are prevalent in older adults living in continuing care retirement communities. Older adults should be screened and assessed for both malnutrition and sarcopenia. The results also suggest that decreasing the sedentary time could help in preventing MSS among older adults living in continuing care retirement communities.

Older Adults as Virtual Subject Matter Experts in COVID Graduate Education

COVID-19 has further illuminated the need for educational approaches in gerontology that are person-centered and experiential. Ideally, this includes in-person experiences with students and older adults. Through their classroom participation as subject matter experts in aging, older adults share their personal experiences, and react to gerontological theories and ideas. Shared learning offers a platform for exploration of shared humanity, so that older adults are not seen as the “other”, but “us”. This prepares a generation of gerontologists to identify and reject ongoing ageism, again highlighted by the pandemic. COVID-19 has also challenged educators to offer these experiential opportunities. In this presentation we will outline how older adults from a Continuing Care Retirement Community participated virtually in a graduate course. We will discuss how their virtual involvement was structured, how their real-time COVID experiences were integrated, and share feedback from older adult participants and students on their shared learning experiences.