Behavioral Health, Social Engagement, and Long-Term Care Services Use Among Community Older Adults: USA vs. Taiwan

As healthcare advances, older adults are living longer. While 90% of older adults prefer aging in their own homes and communities, it is important to examine key factors influencing healthy aging-in-community and community-based long-term care (LTC) services available in different countries. This symposium examines behavioral health, social engagement, and LTC services utilization among community-dwelling older adults in the USA and Taiwan. Lessons learned from older adults across countries will provide insights for tailored community-based LTC services and program development. Dr. Hou from The University of Central Florida (UCF) will highlight similarities and differences in behavioral health profiles and the topics that most interest community-dwelling older Americans participating in three aging-in-community programs in Central Florida. Dr. Wang from Case Western Reserve University will examine the impact of neighborhood social cohesion on mobility among community-dwelling older Americans aged 65 and older from the national Health and Retirement Study. Dr. Liu from National Cheng-Kung University in Taiwan will share results of healthy lifestyle on quality of life among community-dwelling older adults in southern Taiwan. Dr. Young from State University of New York at Albany will compare long-term care use among community-dwelling older adults with and without dementia in Central Taiwan. Finally, Drs. Cao and Hou from UCF will analyze home and community-based services in the USA versus Taiwan. This symposium will further discuss similarities and differences of key factors related to healthy aging-in-community, along with practical recommendations and lessons learned across countries and cultural environments to improve community-based long-term care services and programs.

Age-Friendly Community Practice: Understanding the Role of Community Events

To advance an emerging empirical knowledge base for age-friendly community initiatives (AFCIs), we conducted a qualitative descriptive study to explore one manifestation of age-friendly practice: community events (CEs). We aimed to illuminate how AFCI core teams describe CEs as part of their practice and how they perceive the value of CEs for age-friendly progress. Using inductive coding, we analyzed data from semi-structured interviews (n=24) with eight core teams across three time points spanning the early to mid-implementation phases of the AFCIs. Two predominant themes emerged. First, CEs were described as important for working toward age-friendly goals concerning older residents’ social participation and inclusion. Second, core teams described the longer-term strategic value of CEs, such as building interorganizational partnerships; providing deeper insight on aging in community; and fostering older adults’ leadership as part of the initiative. We discuss implications for advancing transdisciplinary program theory to guide more sustainable and effective AFCIs.

Behavioral Health and Most-Interested Topics Among Older Adults in Three Aging-in-Community Programs in Florida

This study compares behavioral health and most-interested topics among older adults in three aging-in-community (AIC) programs: a university-based lifelong learning program (LLP; 38%), a county neighborhood lunch program (NLP; 29%), and a village program sample (33%) (total n=289). Mean age was 72.4 (SD=8.68) years. Although perceived health was similar (mean=3.76), LLP and village members reported higher quality of life than NLP participants (p=.004). Two-thirds of the participants indicated at least half of their daily plates filled with fruits and vegetables, and at least 10 min. walking in 4.5 days during a typical week. The duration of each walking was lower among NLP members (23 min.), compared with village (31 min.) or LLP members (35 min.) (p=.002). The top three most interested topics were brain health, giving back, and keep community healthy. Older adults in AIC programs were overall healthy and active. Results have implication on tailored program development.

Friendship and Loneliness Among People Living With Dementia: Social Practices and Identity

More people living with dementia (PLWD) are aging in place in the community. The number of PLWD aging in community is estimated to comprise 61-81% of the total number of PLWD in North America. Since most PLWD do not drive (Foley et al., 2000), many may (or may not) spend much of their time closer to home, barring occasional visits out of town. Yet, one’s everyday environment may not always provide “ways of being in the world that are more accepting and embracing” (Hillman & Latimer, 2017) and kind, to the varied socio-cognitive struggles of PLWD. Meaningful relationships are required to support continued social participation and citizenship (Bartlett & O’Connor, 2007; Swinton, 2020). In addition to dementia diagnosis, these everyday experiences in community may significantly alter PLWD’s self-perception and confidence. PLWD may feel more or less comfortable forging relationships depending on their past experiences. In other words, the identity of PLWDs are often challenged and (re)constructed (Saunders et al., 2011). Amid persistent power imbalances, malignant social practices may reshape one’s identity such that social isolation, whether self-imposed and/or due to restrictions from others, appear the best way to tide over overwhelming loneliness. This symposium explores how community and friendships may intercept the formation of such lonely self-identity among PLWD. We use advanced qualitative methods to elucidate the varied experiences and challenges of PLWD in community. Findings from three perspectives, namely sociolinguistics, sociology, and social work, will be discussed identify new social practices to undo stigma and support PLWD in community.

Housing Models Promoting Aging in Community-A Brief Report on Key Lessons Learned

The majority of older adults prefer aging in their own homes or communities. Four promising housing models promoting Aging-In-Community (AIC), including the village, Naturally Occurring Retirement Community (NORC), senior cohousing, and University-Based Retirement Community (UBRC) were reviewed.

Promising Aging in Community Models in the U.S.: Village, Naturally Occurring Retirement Community (NORC), Cohousing, and University-Based Retirement Community (UBRC)

Aging in Community (AIC) is the preferred way to age. This systematic review identified promising AIC models in the U.S. and analyzed model characteristics and push-pull factors from older adults’ perspectives. Push factors are those driving older adults to leave, while pull factors attract them to stay in a community. We conducted a two-phase search strategy using eight databases. Phase I identified promising AIC models and Phase II expanded each specific model identified. Fifty-two of 244 screened articles met the criteria and were analyzed. We identified four promising AIC models with the potential to achieve person-environment (P-E) fit, including village, naturally occurring retirement community (NORC), cohousing, and university-based retirement community (UBRC). Each has a unique way of helping older adults with their aging needs. Similar and unique push-pull factors of each AIC model were discussed. Analyses showed that pull factors were mostly program factors while push factors were often individual circumstances. Continued research is needed to address the challenges of recruiting minority older adults and those of lower socio-economic status, meeting older adults’ diverse and dynamic needs, and conducting comparative studies to share lessons learned across the globe.