Strategies and challenges associated with recruiting retirement village communities and residents into a group exercise intervention

Background: Randomized controlled trials (RCTs) provide the highest level of scientific evidence, but successful participant recruitment is critical to ensure the external and internal validity of results. This study describes the strategies associated with recruiting older adults at increased falls risk residing in retirement villages into an 18-month cluster RCT designed to evaluate the effects of a dual-task exercise program on falls and physical and cognitive function. Methods: Recruitment of adults aged ≥65 at increased falls risk residing within retirement villages (size 60–350 residents) was initially designed to occur over 12 months using two distinct cohorts (C). Recruitment occurred via a three-stage approach that included liaising with: 1) village operators, 2) independent village managers, and 3) residents. To recruit residents, a variety of different approaches were used, including distribution of information pack, on-site presentations, free muscle and functional testing, and posters displayed in common areas. Results: Due to challenges with recruitment, three cohorts were established between February 2014 and April 2015 (14 months). Sixty retirement villages were initially invited, of which 32 declined or did not respond, leaving 28 villages that expressed interest. A total of 3947 individual letters of invitation were subsequently distributed to residents of these villages, from which 517 (13.1%) expressions of interest (EOI) were received. Across three cohorts with different recruitment strategies adopted there were only modest differences in the number of EOI received (10.5 to 15.3%), which suggests that no particular recruitment approach was most effective. Following the initial screening of these residents, 398 (77.0%) participants were deemed eligible to participate, but a final sample of 300 (58.0% of the 517 EOI) consented and was randomized; 7.6% of the 3947 residents invited. Principal reasons for not participating, despite being eligible, were poor health, lack of time and no GP approval. Conclusion: This study highlights that there are significant challenges associated with recruiting sufficient numbers of older adults from independent living retirement villages into an exercise intervention designed to improve health and well-being. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12613001 161718. Date registered 23rd October 2013

Stories for Change

This compendium of nearly 50 best practices showcases the notable strategies that increase access to arts and culture for older adult and immigrant populations. Newcomers and older adults (65 +) are two of the fastest growing populations -- communities across the country are grappling with a demographic makeup that is increasingly diverse and proportionally older than in the past. Arts and cultural organizations have the opportunity to reach-out, to increase resources in the community, and to engage populations that are at risk for being overlooked."Stories for Change" is a compelling collection, brimming with new ideas brought to fruition by many types of organizations including: museums, libraries, community development organizations, theaters, orchestras, dance ensembles, area agencies on aging, transportation bureaus, parks, botanic gardens, universities, and more. Organizations that hope to enhance the lives of their older and immigrant residents can find approaches portrayed in these Stories that can be adapted to meet the needs of their communities.Best practices include the well-known Alzheimer's Project of the Museum of Modern Art, which has been adapted to museums around the country, and Circle of Care, a unique ride share program that partners young people with older adults to attend free arts performances in Boulder, Colorado. Stories are located in rural, mid-size, and metropolitan settings; many can be easily implemented, and do not require a major overhaul of staffing, operations, or an organization's mission

Collaborating to Create Elder Friendly Communities in New Hampshire: A Scan of the Current Landscape

The fact that the population of the United States is aging is no surprise; the demographic projections are well documented. There have never been as many older adults living as there are today, and this number will only increase. Northern New England is aging more rapidly than the rest of the country, with Vermont, Maine, and New Hampshire having the oldest populations in term of median age (U.S. Census, 2014). New Hampshire is expected to be the fastest aging state in New England through 2030, with nearly one-third of its population being over the age of 65 (Norton, 2011). This phenomenon is anticipated to place substantial pressure on publicly-funded health programs and long-term services and supports in the Granite State. But the story of the aging of the population is not only about increased numbers. As longevity increases, the average age of the older population will see a dramatic increase. The number of persons over the age of 85 in the United States is expected to increase five-fold by 2040. As the possibility for functional limitations and disability increases with age, the need for long-term, formal, and informal supports is expected to increase as the number of older adults, particularly those over the age of 85 increases. In addition, women continue to live longer than men; on average, life expectancy for women is three years longer than for men. These factors create a complex picture of aging, which includes a growing population of older adults, a majority of whom will be women; and a growing number of those over the age of 85, who are more likely to require some type of assistance as they age. It is a mistake to look at our aging population in a singular way. Although we tend to make generalizations about older adults, as a group, they are more physiologically and socially diverse than any other age group (Brummel-Smith & Mosqueda, 2003). As we age, we become more and more diverse, as there are no two people who have had the same life experiences, shaping who we are over our lifetimes. The baby boomers (those born between 1946 and 1964) are likely to be the most diverse cohort of older adults we have seen to date, and it is likely that they will redefine our conception of age and aging. Older adults bring a diverse set of skills, talents, and knowledge that should be tapped as a significant natural resource to support a new and exciting vision of aging

Perceptions of Group-Based Walks and Strategies to Inform the Development of an Intervention in Retirement Villages: Perspectives of Residents and Village Managers.

The aim of the present study was explore perceptions of group-based walking and gather suggestions to inform the development of a group-based walking intervention among older adults in retirement villages. Twenty-four physically inactive residents (16 female, 8 male; age range: 69-88) and 4 managers from four retirement villages were interviewed. Inductive thematic analysis revealed 6 broad themes: lack of motivation, values versus constraints, fears and confidence, need for structure, creating a sense of belonging, and the physical environment as a double-edged sword. Proposed intervention strategies included using trained walk leaders, using small groups, planning for flexibility, setting attainable goals, creating a routine, creating opportunities for sharing experiences, and planning a variety of walks. Group-based walking programs may be used to promote physical activity but careful planning of such programs is needed in order to make it appealing and feasible to a diverse group of residents

Development, Implementation and Evaluation of a Physical Activity and Nutrition Program for Older Adults Residing in Retirement Villages

Physical activity and a healthy diet are recognised as important lifestyle factors for maintaining a healthy bodyweight and preventing chronic disease. Retirement villages are a unique setting to reach older adults to test the effectiveness of approaches to increase physical activity levels. improve nutrition and maintain a healthy bodyweight. This cluster-RCT based in Perth, Western Australia evaluated the effectiveness of a 6-month physical activity and nutrition program for ‘insufficiently’ active adults aged 60-80 years

City flight migration patterns in the East Midlands

This paper investigates migration to and from the Three Cities of Derby, Leicester and Nottingham. It investigates whether these cities lose more migrants than they gain from more rural parts of the city-regions and the extent to which these flows impact on the demographic profiles of the Three Cities

A Review of Community Aging in Place Programs to Minimize Social Isolation in Older Adults

The aging baby boomer population calls for new solutions to enable older Americans to age in place in their communities of choice. Nine out of ten adults age 50 and older prefer to remain in their homes indefinitely as they age, or as long as they possibly can (Gonyea, & Burnes, 2013). However, program funding that supports aging in place does not come close to keeping pace with the rapid growth of the 65 and older population (American Institutes for Research, 2016). There are a limited number of programs in place to address socialization in community-dwelling older adults. The prevalence of social isolation has been well documented in the literature for community-dwelling older adults (Dickens, Richards, Greaves, & Campbell, 2011; Painter, et al., 2012; Levasseur et al., 2015; Masi, Chen, Hawkley, & Cacioppo, 2011; Sabir, et al., 2009; Steptoe et al., 2013; Vogelsang, 2016). Social isolation can have a variety of negative implications for older adults, including an increased rate of mortality, cardiovascular disease, infectious diseases, cognitive decline, diminished immune function, loneliness, depression, suicidal ideation, and suicidal behavior (Cornwell & Waite, 2009; Masi et al., 201; Steptoe, Shankar, Demakakos, & Wardle, 2013). A literature review was conducted to identify aging in place programs that address social isolation in older adults. Based on the results of the literature, a product entitled The Friendly Neighbor: Community Programming for Socially Isolated Older Adults was developed. This product is designed to provide a resource for occupational therapists to assess which aging in place programs may be the best to implement in their community. It contains a summary of the benefits, challenges, setting, participants, cost-effectiveness, and outcomes of each program. The product includes descriptions of community programs, table summaries of the aging in place programs previously discussed, a step by step guide for application of the PEO model, and a resource section. Occupational therapists can use this resource to compare characteristics of various aging in place programs to create an evidence-based program that will meet the specific needs of the community they are working with. It is proposed that these programs can be effectively used to help older adults build social networks and increase social participation in their community. Social isolation is a prevalent and often overlooked issue in community-dwelling older adults. This issue falls within the practice of occupational therapy, and occupational therapists have the skills necessary to create and implement community-based programs to address this issue (AOTA, 2016; Bacsu et al., 2012; Smallfield, Haag, Poston, Giger, Anderson, 2014; Dickens et al., 2011; Steultjens et al., 2004; Vogelsang, 2016). The purpose of this project was to support the implementation of aging in place programs to reduce the prevalence of social isolation in older adults that wish to remain in their homes as they age

Exploring the role of volunteers in social care for older adults

Purpose This paper aims to report the findings of a study that explores the contribution volunteers make to social care for older adults, identifying lessons for the social care sector and policymakers. Design/methodology/approach An exploratory multiple case study design was used to capture the perspectives and experiences of managers of services, volunteer co-ordinators, volunteers, paid care staff and older people. Seven diverse social care organisations took part in the study drawn from three locations in the South West of England. Findings This study identified three distinct models of volunteer contribution to social care services for older people. Although the contributions made by volunteers to services are valued, the study drew attention to some of the challenges related to their involvement. Research limitations/implications The organisations taking part in this small-scale study were all based in the South West of England, and the findings are therefore not generalisable but contribute to the growing evidence base related to this important field. Practical implications This study demonstrates the importance of the volunteer co-ordinator role and suggests that it is properly funded and resourced. It also confirms the importance of volunteers receiving appropriate training and support. Originality/value Given the increasing involvement of volunteers in the provision of social care, this paper provides lessons to ensure the role of volunteers in social care enhances rather than diminishes the quality of care provided

Investigating the Social Capital and Capacity of Older Adults in Rural Manitoba

Report: 51 pp.; ill., digital file.The report is composed of a review of the literature as well as key findings and recommendations illustrating how seniors are contributing to their communities, the factors that affect their involvement and the barriers that impede their participation. The discussion concludes with a look at future trends predicted for an emerging generation of older adults, the Baby Boomers