Older Adults in Nursing Homes: Assessing Relationships Between Multiple Constructs of Social Integration, Facility Characteristics, and Health

An extensive body of research has examined connections between older adults' social worlds and health and well-being, particularly for community-dwelling older adults. Yet, little is known about the social worlds of older adults living in nursing homes because of this population's exclusion from many studies and national databases. Further, the influence of social workers and culture change practices on the social lives of nursing home residents is not well-documented. This research assessed the relationships between multiple social integration (i.e., social networks, social capital, social support, and social engagement) and health (i.e., depression, functional health and well-being) constructs, and examined the influence of facility characteristics (i.e., culture change, role of social workers) on these variables. This study drew on a model based on social network theory developed by Berkman, Glass, Brissette, and Seeman (2000). Data were collected at 30 nursing homes in Northeast Kansas using a cross-sectional, quantitative, planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with social service directors and nursing home administrators. Data were imputed using multiple imputation, and multilevel confirmatory factor analysis was used to verify measurement properties. Multilevel structural equation modeling (MSEM) was used to answer the research questions and test hypotheses. Findings revealed that the data did fit the proposed model supporting social network theory, showing that social networks and social group participation indirectly influence depression and functional health and well-being primarily via social engagement. Social capital had a direct influence on both health constructs. Further, the relationships sub-scale of culture change involvement significantly influenced between-level differences in residents' social networks, and the number of social workers in a nursing home was positively associated with between-level differences in residents' social support. These findings inform social integration strategies for reducing social isolation and related declines in physical and mental health for older adults in nursing homes as well as nursing home and health care policies for improving quality of life of those utilizing long term care services

Successfully Collecting Quantitative Data From Random Samples of Nursing Homes and Residents

This case presents a rigorous approach used to successfully recruit and collect quantitative data from nursing home staff members and residents. The study presented in this case was conducted for my dissertation research. The goal of the study was to understand the complex phenomena of social integration for nursing home residents and its relation to health and well-being outcomes. To gather data, this study utilized a two-stage multilevel sampling technique to obtain a stratified random sample of nursing homes (N = 30) and a random sample of older adult residents from each of the nursing homes (N = 140, from each facility n = 3-6). This study utilized structured interviews with nursing home residents using a planned missing data design as well as brief surveys with staff members to collect data. Within the complex policy and program structures of nursing homes, the use of random sampling (as opposed to convenience sampling) at multiple levels (nursing home and resident) required the use of multiple, carefully planned steps. This included making phone calls, utilizing specific inclusion criteria, obtaining informed consent at multiple levels, and providing small monetary incentives. This case presents methodological considerations related to sampling, recruitment, and data collection. It also presents some of the lessons learned in collecting data for this study. This approach can be translated within various fields to recruit and gather health and related information from specialized populations

Assessment of Multiple Constructs of Social Integration for Older Adults Living in Nursing Homes

A variety of terms and measures have been used in the literature to denote being socially integrated, and many studies of older adults focus on only social networks or social support and often only include those living in the community. The purpose of this study was to assess multiple constructs of social integration (i.e., social networks, social capital, social support, and social engagement) for older adults in nursing homes. Data were collected from 140 older adults at 30 nursing homes in Kansas. We interviewed older adults\u27 in-person using a survey questionnaire, and used multilevel confirmatory factor analysis to analyze the data. The final model that included the four constructs had acceptable fit (χ2 = 174.71; df = 112; p \u3c .01; CFI = .93; RMSEA = .06; SRMR-W = .06; SRMR-B = .12). The results showed that the proposed model was supported at the individual level. At the between-level, social networks and social support were supported. Study results have methodological and practice/policy implications for the study of older adults in long term care settings. In particular, this study contributes to understanding how to operationally define and differentiate social integration variables in studies of older adults, particularly when study data are hierarchical

Older adults learning technology in an intergenerational program: Qualitative analysis of areas of technology requested for assistance

Adults 65 and older are adapting to technology at a slower rate compared to the overall population. Research has shown that programs can assist older adults in learning and embracing technology. However, little information exists about what specific forms of technology older adults are interested in learning and for what purposes. To describe areas of technology older adults are interested in learning and why this study examined qualitative data from an intergenerational service-learning program in which students in higher education assist and mentor older adults with and about technology that older adults want to learn. Data was analyzed from in-depth observation logs maintained by students after each educational session. Eight themes emerged related to areas of technology older adults were interested in learning about: basic functions, staying connected, organization, leisure, managing photos, productivity, managing money, and health. Of the 827 total phrases coded, the top themes related to technology use were: basic function (28%), staying connected (23%), and organization (15%). The majority of older adults requested help with their devices’ basic functions, including an orientation to mobile devices, tablet and/or computer, making tactile functions easier, creating accounts, setting and restoring passwords, and understanding basic cyber security. Findings from this study reinforce that older adults are interested in learning the technology basics, which may lead to utilization of technology for social, civic, and productive engagement purposes in addition to managing health. This study provides valuable information for organizations that help older adults learn technology and for entities that design technology or want to increase technology adoption for older adults

Engaging Older Adult Learners Through Intergenerational Learning Opportunities

The University of Rhode Island became a part of the AFU network in 2018, and much of our rationale for joining the network was based on our strengths and growing interest in intergenerational programs and learning. The URI Osher Lifelong Learning Institute (OLLI) currently has over 1,300 members, and a large aspect of their strategic plan and current efforts are focused on increasing intergenerational learning opportunities due to interest and successes in these areas. Some of the successful strategies that have been used include an intergenerational classroom of OLLI member and university students designed within a traditional college class, a matching program where students are partnered with OLLI members, intergenerational service learning opportunities for students to engage with OLLI members in different ways, and question and answer sessions with OLLI members within college classes. This presentation will highlight these efforts, lessons learned, and efforts to track participation and outcomes

Teaching Technology to Older Adults: Modalities Used by Student Mentors and Reasons for Continued Program Participation

The current study examined teaching modalities used by college students participating in an intergenerational, service-learning program that helps older adults learn technology and described reasons for older adults\u27 continued participation in this program. Qualitative data analysis was completed using student-maintained observation logs from approximately 200 older participants. Several different teaching modalities used by student mentors were identified, including observing and listening, writing down information or creating visual aids, explaining the significance and simplifying materials, using repetition/review, and using hands-on learning. Multiple reasons for older adults\u27 continued participation were identified, including continued progress on one topic or device; multiple topics for advanced use; learning multiple modalities to get connected; and continued learning through take-a-ways, practice, and homework. Service-learning programs can help educate health and human service professionals on best practices for working with older adults

Beyond employment: Lower-income participants’ experiences in a healthcare training program for medical assistants, pharmacy technicians, and certified nursing assistants

Purpose: The purpose of this study was to gain a deeper understanding of participant experiences in a healthcare training program for medical assistants, pharmacy technicians, and certified nursing assistants in areas beyond employment procurement or retention. During the year 2020, employment rates decreased and the cost of living increased. Those changes ultimately put lower-income populations at risk for not meeting the basic needs of life, as it became increasingly more difficult to obtain an adequately paying job. Healthcare training programs for lower income individuals allow for participants to gain the appropriate knowledge and experience required for working in the healthcare industry while also providing them necessary skills and confidence for securing and maintaining employment. While the primary objective of the Genesis Center Healthcare Training Program was to increase employment rates, this study found the program substantially contributed to participant’s lives in many ways that will contribute to their overall life satisfaction, financial well-being, and mental wellness for many years. Method: This current research adds to existing literature by utilizing a mixed methods sequential exploratory strategy that analyzes quantitative survey data (n=51) and qualitative data from phone interviews with program participants (n=19). Results: Findings from this study provide evidence that healthcare training programs for lower income populations may improve participant lives by increasing financial well-being and financial capability. Participants also reported enhanced opportunities, increased motivation, and improved mental health following participation. Conclusion: Employment programs for future allied health professionals targeting lower income populations should ensure that financial coaching and additional supports are included in their protocols. Future research on these types of training programs should include pre/post measures and ideally experimental design procedures using standardized measures for life satisfaction, financial well-being, and mental health

Beyond the Classroom: An Internship Model That Builds Age-Friendliness & Career Readiness

Since 2015, the University of Rhode Island (URI) Engaging Generations Cyber-Seniors Program has provided over 500 students from 19 different majors with the opportunity to mentor older adults through internships and service learning courses. Due to the pandemic, interest in the program significantly increased from the community and from students in need of opportunities to work with individuals. As a result, a robust internship program was developed that focused on building age and digital inclusivity across campus and throughout the state. The program integrates a three-pronged approach where students complete field hours, enhance the Career Readiness Competencies employers seek in graduates as determined by the National Association of Colleges & Employers (NACE), and complete the components necessary to earn the Rhode Island Geriatric Education Center Interprofessional Teamwork in Geriatrics and Gerontology Certificate. This paper will describe the key elements of this internship model and present survey data related to the student experience