Evaluating Your Age-Friendly Community Program: A Step-by-Step Guide

This guidebook was developed to help you document and evaluate your community’s progress in becoming more age friendly. Although this task may sound intimidating, with a small dose of courage and by understanding a few key terms, the building blocks of evaluation can come alive and help guide your work

Defining Dementia-Friendly Communities From the Perspective of Those Affected

More and more communities across the globe are pledging to become more dementia friendly, yet many initiatives lack direction as to what this pledge might entail. The intent of this qualitative study, conducted in the metropolitan area of Portland and several other cities in Oregon, was to better understand how communities can increase their dementia friendliness – from the perspective of people living with dementia and their care partners. The study further aimed to clarify if and how age- and dementia-friendly efforts can be integrated. Twenty-five community-dwelling individuals living with dementia and their 25 informal carers participated separately in semi-structured in-person interviews. The interview questions were centered on the participants\u27 day-to-day experiences, barriers to and opportunities for engaging in activities, and the interviewees\u27 thoughts on how communities might become more inclusive places for people affected by dementia. The analysis of the interviews yielded eight common themes constituting a conceptual framework of dementia friendliness that proved largely congruent with the World Health Organization’s (WHO) framework of age friendliness which served as the theoretical foundation for this research. Technology was added as an additional domain, and respite and peace of mind, as well as preserving self and identity were identified as important aspects interwoven with the nine domains. The results of this study can provide guidance for planning and implementing dementia-friendly initiatives and serve as foundation for a synergistic integration of dementia-friendly efforts into the greater context of age friendliness

Collaborative Treatment of Late-Life Depression in Primary Care (GermanIMPACT): Study Protocol of a Cluster-Randomized Controlled Trial

Background: Depression is not a normal side effect of aging, however it is one of the most prevalent mental health issues in later life, imposing a tremendous burden on patients, their families, and the healthcare system. We describe the experimental implementation of a collaborative, stepped-care model for the treatment of late-life depression (GermanIMPACT trial) in the German primary care context. GermanIMPACT was developed as an adaptation of a successful and widely used American model. The aim of the study is to evaluate the model’s applicability to the German primary care setting and its cost-effectiveness. Methods/Design: The study will be conducted as a cluster-randomized controlled trial comparing the development of depressive symptoms in primary care patients who either receive treatment as usual (control arm) or treatment according to the GermanIMPACT model (intervention arm). In two German cities (Freiburg and Hamburg), a total of 60 general practice offices will be selected and randomized. Each general practice office will be asked to enroll five patients into the trial who are 60 years of age or older and who show moderate depressive symptoms in the scope of a diagnosed depressive episode, recurrent depressive disorder, or dysthymia. General practices in the control arm will provide treatment as usual; general practices in the intervention arm will work closely with a specially trained care manager and a supervising mental health specialist. Evidence-based elements of the treatment plan manual include patient education, identification and integration of positive activities into the daily routine, relapse prevention, and training of problem-solving techniques as needed. The intervention period per patient will be one year. Data will be collected at baseline, 6, and 12 months. Primary outcome is the patient-reported change of depressive symptoms (Patient Health Questionnaire, PHQ-9). Secondary outcomes include measures of quality of life, anxiety, depression-related behavior, problem-solving skills, resilience, and an overall economic evaluation of the program. Discussion: The GermanIMPACT trial will provide evidence about the effectiveness, feasibility, and cost-effectiveness of collaborative stepped care in treating late-life depression in German primary care. Positive results will be a first step toward integrating specialized depression care managers into the primary care setting

Addressing the Needs of Nicaraguan Older Adults Living on the Edge: A University-community Partnership in International Service-learning

Nicaragua is a very low-income country entering a period of rapid aging with limited geriatric training for health care professionals. To help build capacity and to enhance student learning, a short-term international service-learning program was implemented in 2004 in partnership with the Jessie F. Richardson Foundation and Nicaraguan community stakeholders. Graduate and undergraduate students at Portland State University complete coursework for one term in the United States then travel to Nicaragua for about two weeks to participate in educational, research, and service activities, primarily in group homes for older Nicaraguans. Students learn about global aging, gerontology, community development, service learning, and Nicaraguan history and culture, then apply their gerontology-related knowledge by training direct care staff, older adults and their family members, and students. The authors describe the impetus for and evolution of the program, students’ evaluation of the program, faculty observations on program benefits and challenges, lessons learned, and future plans