Publication Date

Spring 5-29-2023

Item Type

Text

Executive Summary

Resources to Promote Senior Independence

Introduction

Our group of five students from Seattle Pacific University's Lydia Green nursing program assessed the community of an independent senior apartment complex that provides affordable housing for adults aged 65+ in the Seattle area run under Sustainable Housing for Ageless Generations (SHAG). This assignment is for our leadership project and occurred over an 8-week period. During this time, we applied the nursing process to assess, diagnose, plan, and implement an intervention specific to a population's needs. The community faced issues of resource access, exacerbated by the population's low income and age. Our focus was to provide greater accessibility and visibility of resources regarding transportation, food access, technology, financial assistance, health and wellness, and safety. We produced a resource booklet directed by the site's needs with the goal of improving quality of life and health related outcomes.

Background

Located in the Highland Park neighborhood of West Seattle, WA, this community functions as low-income housing. The site administrator reported that the average age is 73 and average income is $2,185 a month. Among the seniors living in the apartments, there are many living with mental and physical health requirements, as well as physical disabilities that limit their daily activities. There is a general disparity in the health care and maintenance of the elderly population, leading to poor health outcomes, delayed healthcare, and unmet needs (Yamada et al., 2015). Within this community they are at further risk due to low socioeconomic status (SES) (McMaughen, 2020). Associated with this age group and low SES there is a prevalence of depression among individuals over the age of 65 ranging from 7.2% to as high as 49%, which is influenced by access to care, resources, and availability of daily needs (Andrew et al., 2019).The combination of age-related disparities with limited income leads to a need for 3 outside resources. These are needed to help afford and attain their daily needs including transportation, food security, social services, and mental health. Not only do social services benefit older adults, but there is a high demand and utilization of these services in this population (Yang et al., 2021).

Activities and Methods

Our process began by establishing in-person connections with the site, meeting the Program Manager and Resident Volunteer onsite. We received a brief overview and learned what recent changes the community is going through. We learned they had recently lost a partnership with a resident site coordinator (RSC) who was able to provide on-site services to help residents access much-needed resources that are not easily accessible. After the loss of the RSC, residents struggled to find and access resources to adequately meet their needs. We concurred that the main risk for this population is a resource deficit leading to a risk for impaired health and care.

As the primary need became evident, we composed a survey to assess the more specific resources needed. This survey found the perceived needs are transportation, food security, health insurance, technological support, and mental health services. This demand led to our goal to provide a simple, accurate, and directed resource binder to address this community's self-reported needs by the end of our eight weeks.

The following weeks were spent compiling resources available in the greater Seattle area and ones locally accessible. We found help interviewing and obtaining tips from the past RSC and weekly feedback from the site manager. We also worked to make our resources accessible to the residents. We learned through our conversations as well as research that the prevalence of limited health literacy is high among older adults (up to 50%) and is associated with poor access to health care and decreased use of the internet (Scheerens et al., 2021). Studies that analyzed older adults use of technology for resources found that the number one barrier was access (Haase 4 et al., 2021). This prompted us to explore technology programs available that supply free or affordable phones and internet. To ease access, we also created an online version of our resource booklet.

Outcomes

Our project resulted in a resource binder that comes with phone numbers, websites, and in-depth instructions. This printed version will be available to the tenants in every housing unit, as well as the central office, with the addition of an online simplified version with hyperlinks directly to the resource (an application, an appointment, a number, etc.). Our goal was to make the resources accessible, simple, and easy to use. We used both evidence-based research and feedback from the residents and RSC to directly develop the tools around their needs. We believe our goal has been achieved.

Conclusion

Throughout the eight weeks of working with this site we were able to assess the population, find their specific needs, and work with them to formulate the resources needed. Through our binder and online version, we hope to provide this community with opportunities to increase and support their mental and physical needs and satisfaction at this site. One limitation we have recognized is the limited time for evaluation we have to see the effectiveness of our tools, as the binder is implemented in the final week of our project. We also acknowledge that our resources were limited by the number of survey responses we received and by those who have reached out for resources in the past. The use of our survey leads to report bias, which can result in missed resources by those who did not participate. In the end, our project is a tool for them to use to support their own health, bring awareness, and provide access to available resources. We hope future groups and management continue to contribute and update our resource binder and that it can be truly impactful and supportive to all those at this site.

References

Andreq, J. A., Brown, L. JE., Hawley, M. S., & Astell, A. J. (2019). Older Adult's Perspectives on Using Digital Technology to Maintain Good Mental Health: Interactive Group Study. Journal of Medical Internet Research, 21(2), https://doi.org/10.2196/11694

Haase, K., Cosco, T., Kervin, L., Riadi, I., & O'Connell M. E. (2021). Older Adults Experiences With Using Technology for Socialization During the COVID-19 Pandemic: Crosssectional Survey Study. JMIR AGING, 4(2), https://doi.org/10.2196/28010

McMaughan, D. J., Oloruntoba, O., & Smith, M. L. (2020). Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging. Frontiers in public health, 8(231), https://doi.org/10.3389/fpubh.2020.00231

Scheerens, C., Gilissen, J., Volow, AM., et al. (2021). Developing eHealth tools for diverse older adults: Lessons learned from the PREPARE for Your Care Program. J Am Geriatric Soc. 69(10):2939±2949. https://doi.org/10. 1111/jgs.17284

Yamada, T., Chen, C.-C., Murata, C., Hirai, H., Ojima, T., Kondo, K., Harris, J.R. (2015). Access Disparity and Health Inequality of the Elderly: Unmet Needs and Delayed Healthcare. International Journal of Environmental Research and Public Health, 12(2), 1745-1772. https://doi.org/10.3390/ijerph120201745.

Yang, L., Wang, L., Di, X., & Dai, X. (2021). Utilization of Community Care Services and self-rated health among elderly population in China: A survey-based analysis with propensity score matching method. BMC Public Health, 21(1936), 1-11. https://doi.org/10.1186/s12889-021-11989-x

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