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.

Lessons On Using Health Research & Technology To Broaden Resources For Older Adults Across The State

The vision of the Michigan state unit on aging is for residents to live well and thrive as they age. The COVID-19 pandemic exacerbated the existing problem of older adult social isolation. Social engagement and community involvement are keys to healthy aging. Combining state resources with the GetSetUp virtual community allowed for statewide connections and extended resources, creating an almost around-the-clock virtual senior center. Through customized courses the state was able to offer vaccine navigation sign-up classes, among other classes, to help older adults interact with essential health and aging services. As Michigan continues to work to address health equity and social determinants of health beyond the pandemic, technology designed specifically for older adults is an important component of programmatic offerings. It also allows for a public-private partnership opportunity to support older adults as they age.

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.

Social Disengagement and Cognitive Function: Does the Association Vary by Gender?

Although social disengagement is considered to be a predictor of cognitive decline, and increase risk of Alzheimer’s and related dementias, little is known regarding the gender-specific association between social disengagement and cognition among Korean middle-aged and older adults. Korea’s Confucianism-based gender roles provide unique contexts to examine gender differences in the influence of social disengagement on cognition. This study investigated the association between social disengagement and cognitive function in a nationally representative sample of Koreans aged 45 years or older (N = 5,196 women and 2,707 men), using data from the Korean Longitudinal Study of Aging (2008-2018). Results from the generalized estimating equation model showed that compared to consistent social engagement, consistent non-engagement was significantly associated with lower cognitive function among both genders. Transitioning from social engagement to non-engagement was significant for males only. Of various types of social activities (religious, senior center, sport, reunion, voluntary, political), consistent non-engagement in a senior center was most associated with lower cognitive function among both genders, while consistent non-engagement in religious activities was significant for females only. While household arrangements were not associated with cognition in men, widowed women had increased risk of cognitive decline than married women, as did women living in households of three or more people. Depression was a predictor of cognitive decline among males only. In this gender-specific study, we found that consistent participation in social activities, especially via membership in a senior community center, is beneficial in preventing cognitive decline among both genders.

Formative Examination of a Multi-Focus Educational Exergame Designed for Older Adults

Exergames and digital health games have shown promising outcomes in older adults. Most games have had one focus (e.g., physical activity, cognitive functioning). We developed a demonstration version of a multi-focus educational exergame (i.e., healthy eating, physical activity, cognition) that builds on healthy aging theory. Community-engaged and mixed methods (e.g., surveys, focus groups) research approaches were used to examine preliminary game acceptability and usability. The game was demonstrated with 20 senior center members (95% female; 48% African American; 52% White; average age 64 years) and participants were able to play the game. The post-gameplay survey results support acceptability/usability of the game. For example, 87% of participants “agreed” or “strongly agreed” that they felt comfortable playing; the game instructions were clear; the text was readable; and gameplay was enjoyable. The majority also “agreed”/“strongly agreed” that the audio was appealing/helpful in playing the game (86%); sound quality was appropriate (78%); hand tracking was precise (57%), feedback on correct/incorrect responses was motivating (73%); they felt excited to get the correct answers (80%); they would play the game again (87%); and they would recommend it to a friend/family member (80%). When asked how often they would play it, the responses were: 33% five or more times/week; 27% three-four times/week; 20% one-two times/week; and 20% never. Observations and focus groups further clarified acceptability and identified areas for improvement (e.g., game instructions). Preliminary results support acceptability of this multi-component educational exergame with older adults and suggest the potential for future tailoring of this game.

Effects of a 6-week integrated dementia prevention intervention in community-dwelling older adults

This study examined the week of a 6-session integrated dementia p program on dementia knowledge, attitude toward dementia, fear of dementia, and dementia prevention behaviors among community dwelling elders. Using a nonequivalent control group, pre-posttest design, study participants were recruited from a senior center in Seoul, Korea. A total of 40 participants completed the study while half of them were in the experimental group and another half were in the control group. They completed survey questionnaires before and after the program. The findings showed that the program was effective only to decrease the fear of dementia of the older adults. Knowledge, attitude toward dementia, and healthy behaviors may be difficult to change in a short period of time. However, the integrated dementia prevention program may be effective to decrease negative emotions, particularly, fear toward dementia among older adults. The fear of dementia needs to be further assessed individually in order to identify particular causes and triggers and provide tailored interventions.

Stuck in Stage 3: The Case of an Effective Depression Intervention for African American Older Adults

Beat the Blues (BTB) is a culturally tailored depression program for older African Americans. Tested in an NIA Stage 3 efficacy trial, findings showed statistically and clinically significant benefits, including decreased depressive symptoms, improved depression knowledge and symptom recognition, and behavioral activation. The multi-component intervention was co-constructed in partnership with a large senior center. Drawn from previously tested depression programs and tailored to preferences/needs of the targeted population, its five components included care management, depression education and symptom recognition, resources/referrals, and stress reduction and behavioral activation techniques. Despite significant findings, strong effect sizes and high acceptability, moving BTB to NIA Stage 4 (effectiveness) or 5 (dissemination) has been challenging. Challenges that will be discussed include lack of senior center funding to support training and delivery and infrastructure to embed BTB in community-based programs, and reluctance of health systems to adopt BTB because of its focus on one racial group.

Development of an Inexpensive Harnessing System Allowing Independent Gardening for Balance Training for Mobility Impaired Individuals

Balance is key to independent mobility, and poor balance leads to a risk of falling and subsequent injury that can cause self-restriction of activity for older adults. Balance and mobility can be improved through training programs, but many programs are not intensive or engaging enough to sufficiently improve balance while maintaining adherence. As an alternative to traditional balance training, harnessed gardening sessions were conducted in an urban greenhouse as an example of a community activity through which balance and mobility can be trained and/or maintained. An inexpensive multidirectional harness system was developed that can be used as an assistive or rehabilitative device in community, private, and senior center gardens to allow balance or mobility-impaired adults to participate in programming. Two wearable sensor systems were used to measure responses to the system: the Polhemus G4 system measured gardeners’ positions and center of mass relative to the base of support, and ActiGraph activity monitors measured the frequency and intensity of arm movements in garden as compared to home environments. The harnessed gardening system provides a safe environment for intense movement activity and can be used as a rehabilitation device along with wearable sensor systems to monitor ongoing changes.

Social engagement and cognitive function among middle-aged and older adults: gender-specific findings from the Korean longitudinal study of aging (2008–2018)

Recent findings suggest that social disengagement in later life may result in cognitive decline and increase risk of Alzheimer’s and related dementias. However, little is known regarding the gender-specific longitudinal association between social engagement and cognition among middle-aged and older adults. Using data from a nationally representative sample of 2707 men and 5196 women from the Korean longitudinal study of aging, we examined the gender-specific association between social activity and cognitive function. Results from the generalized estimating equation model showed that compared to individuals with consistent social engagement (religious, senior center, sport, reunion, voluntary, political), individuals with inconsistent engagement had lower cognitive function. Transitioning from engagement to non-engagement was associated with lower cognitive function among men only. Not being part of a senior center was associated with decreased cognitive function among both genders, while not being part of a religious group was significant for women only. While marital status was a significant predictor of cognitive ability for women, depression was a significant predictor for men. These findings have implications for policy-makers as interventions targeting improved cognitive function among middle-aged and older adults may be more effective when gender-specific predictors are taken into consideration.