The National Evaluation of Senior Mentor Programs: Older Adults in Medical Education

OBJECTIVES: To identify models for senior mentor programs (SMPs), critical factors in program development, achievement of goals and objectives, effect on medical school environment, and future of programs.
DESIGN: Ten SMPs were systematically selected to represent a variety of medical schools, geographic regions, and program types. The National Senior Mentor Program Evaluation relied upon archived data within the programs and new data collected during site visits. Archived data included internally conducted program evaluations, student course evaluations, and survey and focus group results. Site visit data were collected from key informant interviews with program staff and faculty, medical school leadership and students, and older adults serving as mentors.
SETTING: Ten U.S. medical schools with SMPs.
PARTICIPANTS: Evaluation participants at each site included program faculty, key medical school administrators, participating students, and mentors.
MEASUREMENTS: Program evaluation.
RESULTS: All 10 programs demonstrated a positive effect on student attitudes toward older adults. Student acceptance of the programs was strong, and mentor acceptance and support were extraordinary. Eight of the 10 programs were operating in 2008 and having considerable effect on medical school environments. Most of the operating programs expect to be continuing for 5 or more years into the future.
CONCLUSIONS: The findings of the national evaluation point toward continuation and likely growth of the senior mentor phenomenon in U.S. medical education.     

The longitudinal elderly person shadowing program: outcomes from an interprofessional senior partner mentoring program

The University of Saskatchewan's Longitudinal Elderly Person Shadowing (LEPS) is an interprofessional senior mentors program (SMP) where teams of undergraduate students in their first year of medicine, pharmacy, and physiotherapy; 2nd year of nutrition; 3rd year nursing; and 4th year social work partner with community-dwelling older adults. Existing literature on SMPs provides little information on the sustainability of attitudinal changes toward older adults or changes in interprofessional attitudes. LEPS students completed Polizzi's Aging Semantic Differential and the Interdisciplinary Education Perception Scale. Perceptions of older men and women improved significantly and changes were sustained after one year. However, few changes were seen in interprofessional attitudes.     

The Longitudinal Elderly Person Shadowing Program: Outcomes From an Interprofessional Senior Partner Mentoring Program

The University of Saskatchewan's Longitudinal Elderly Person Shadowing (LEPS) is an interprofessional senior mentors program (SMP) where teams of undergraduate students in their first year of medicine, pharmacy, and physiotherapy; 2nd year of nutrition; 3rd year nursing; and 4th year social work partner with community-dwelling older adults. Existing literature on SMPs provides little information on the sustainability of attitudinal changes toward older adults or changes in interprofessional attitudes. LEPS students completed Polizzi's Aging Semantic Differential and the Interdisciplinary Education Perception Scale. Perceptions of older men and women improved significantly and changes were sustained after one year. However, few changes were seen in interprofessional attitudes.     

Social work students’ Service Learning experiences with grandfamilies: Contact,comfort, and attitudes

ABSTRACT

One way to increase student learning about older adults and aging family issues is to engage in community-based field experiences. Results from pre- and post-surveys with 29 Bachelors of Social Work students enrolled in a year-long practicum course to assess their change in the level of contact, comfort, and attitudes with older adults and grandfamilies (i.e., grandparents/kin and the children in their home) are discussed. Students who met with grandfamilies (n = 9) were compared to students who met with older adults in a nursing home (n = 6) and students who met with children from an afterschool program or child treatment facility (n = 9). One-way ANOVA’s revealed group differences in contact and quality of contact with grandfamilies. No significant differences were found for contact with older adults or comfort working with older adults and grandfamilies, or for attitudes toward older adults between the three groups. As a result of this project, educators should develop learning opportunities for students to increase their contact and comfort with older adults and aging families.     

Identifying age-related stereotypes: Exercising with older adults

ABSTRACT

Kinesiology students represent a group of future professionals who might work with older adults in an exercise environment. These encounters may also be affected by the presence of age-related stereotypes. To identify these beliefs, kinesiology students (N = 22) provided two written reflections on a group of older adults participating in an exercise program. The students’ first response was written after viewing a 13-minute video of older individuals’ exercising; the second response occurred after their active exercise participation with the older adults. Thematic, qualitative analysis of the data suggested the students’ stereotypes concerning the exercise behavior of the older adults.     

Using Self-determination Theory to Understand Challenges to Aging,Adaptation, and Leisure among Community-dwelling Older Adults

Self-determination theory was used to help guide a study examining challenges to aging, adaptation, and leisure among community-dwelling older adults. Two focus groups (n = 21) explored perceptions; two follow-up focus groups (n = 8) solicited reactions to initial findings, resulting in revised categories and themes. Participants identified self-determination needs, age-related challenges to satisfying these needs, adaptation strategies, and using leisure engagement to meet these needs. Findings extend research by identifying: (a) challenges with ageism, (b) need to accept challenges before determining coping strategies, and (c) importance of maintaining relationships to compensate for shrinking social networks. Conversations highlighted perceptions about connections between needs and outcomes, challenges, adaptations, and leisure.     

The Promotion of Well-Being in Aging Individuals Living in Nursing Homes: A Controlled Pilot Intervention with Narrative Strategies

Objectives: The study aimed: (1) to compare levels of well-being and distress in older adults living in nursing homes with those living in community; and (2) to test the feasibility of a positive narrative intervention for improving well-being versus a control art-and-craft intervention in a nursing home setting.

Methods: Sixty older adults participated in the study (M = 77.37; SD = 5.00), Male = 20 (33.3%). In Study 1, 30 adults living in nursing homes were compared with 30 community-dwellers using the following measures: Satisfaction with Life Scale, Psychological Well-being Scale, Social Well-being Scale, Geriatric Depression Scale, and sleep quality. In Study 2, the same 30 adults living in nursing homes were allocated to a positive narrative intervention group (N = 20) or to a control group (N = 10) and assessed at post-intervention.

Results: In Study 1, older adults in nursing homes presented more depression and impairments in well-being, compared to community-dwellers. In Study 2, at post-treatment, individuals assigned to the narrative intervention reported significantly increased well-being and sleep quality.

Conclusions: Although preliminary, results showed that older adults living in nursing homes are more vulnerable than community-dwellers. These patients experienced improvement when given a short group positive narrative intervention applicable in nursing homes.

Clinical Implications: A brief group intervention based on fairy tales yielded improvements in well-being and sleep quality in nursing home residents, who enjoyed and appreciated its content. These promising results need to be confirmed by future randomized controlled trials.     

CyberEx Internet-Based Group Exercise for Rural Older Adults: A Pilot Study

The purpose of this study was to examine satisfaction with and outcomes of a real-time Internet-based group exercise program for older adults. Men and women age 50 and older (mean = 66.5) were recruited to participate in a 10-week distance group exercise program. Paired sample t-tests revealed that Sit-To-Stand (STS) repetitions increased significantly (p = .009), while Timed Up-and-Go(TUG) time decreased significantly (p = .000). Connectivity, visibility, and communication emerged as themes related to the use of technology; but overall, real-time Internet-based technology was shown to be an effective way to present group exercise programs for older adults in this rural setting.     

An interprofessional education approach to fall prevention: preparing members of the interprofessional healthcare team to implement STEADI into practice

ABSTRACT

An aging population benefits from healthcare providers trained in the care of older adults. Interprofessional education (IPE) and service-learning activities focused on geriatric conditions like falls may address this need. A fall prevention IPE activity using the Centers for Disease Control and Prevention (Stopping Elderly Accidents, Deaths & Injuries (STEADI) initiative was implemented to prepare health sciences students to manage older adult falls. Students (N = 31) and faculty (N = 10) from five health sciences programs and local older adults (N = 27) participated. Students were trained in STEADI and conducted a fall risk screening, assessment, and intervention activity with older adults using STEADI tools. We observed a statistically significant improvement in student knowledge of fall prevention and STEADI as assessed by pre and postactivity measures. Student surveys indicated improved understanding of the roles and responsibilities of participating disciplines, related to management of falls in older adults. The CDC’s STEADI initiative may provide an effective framework and resources for fall prevention IPE activities and geriatric health sciences education.     

Dyadic,Self-Administered Cognitive Intervention for Healthy Older Adults: Participants’ Perspectives

ABSTRACT

Dyadic, home-based wellness interventions may reach older adults with transportation, mobility, scheduling, and caregiving barriers. This qualitative study aimed to examine participants’ experiences with dyadic cognitive training. Participants (n = 14; age M = 74.36) completed self-administered, paper-and- pencil cognitive training where they took turns training one another. The dyads included spouses, friends, neighbors, and previously unfamiliar adults. Post- intervention interviews were analyzed. Individuals reported that intervention flexibility overwhelmingly contributed to their ability and willingness to participate in the program. Thus, dyadic format is accessible, flexible, and relatively low cost, and may be applicable to a variety of behavioral interventions in aging.     

Changes in Functional Status After Aquatic Exercise in Adults with Type 2 Diabetes and Arthritis: A Pilot Study

Background: Arthritis is highly prevalent among older adults with type 2 diabetes mellitus (T2DM) and presents a barrier to participating in regular land-based physical activity.

Aim: To examine the effects of a 12-week community-based aquatic exercise program for overweight older adults (≥55 years of age) with T2DM and lower body arthritis.

Methods: For this quasi-experimental study, participants completed an exercise specialist-led program consisting of 60-min, twice/week, of aquatic activities at intensities that increased at 4-week increments from 40% to 65% of heart rate reserve for a total of 12 weeks. Clinical and functional measures were completed at baseline and after 12 weeks.

Results: Thirty participants completed baseline measures. Overall, half were female, mean (standard deviation = SD) age 67.7 (7.0) years, A1c = 6.7 (1.3)%, BMI = 35.9 (8.6) kg/m², average daily steps = 4207 (5504). Actual mean heart rate responses during aquatic exercise sessions were at 85%, 90%, and 85% of what was prescribed at weeks 4, 8, and 12, respectively. After 12 weeks, improvements were found for 6-min walking distance (+16.6, SD 43.4 m; p = .05), sit-to-stand repetitions (+1.0, SD 2.0; p = .01), and BMI (?0.2, SD 0.6 kg/m²; p = .04)

Conclusion: This pilot study showed that an aquatic program produced functional improvements among overweight older adults with T2DM and arthritis.     

Effects of Good Life Program on Singaporean Older Adults' Psychological Well-Being

ABSTRACT

Population aging is a demographic trend and a growing concern in Singapore. This article explores through a qualitative research method the psychological well-being of 12 ambulant older adults aged 60 and older, participating in a senior center program. The comparative study examining the effects of the Good Life program on regular and new members has yielded findings in line with activity theory and Ryff's psychological well-being model. Regular members have reported improved psychological well-being after their participation at Good Life as compared to new members. With the increase in life expectancy and better health condition of our older adults, future research on the well-being of older adults in the local context is to be encouraged so that they can be better integrated into society.     

Evaluation of Rewind Yoga on Physical Function Outcomes in Older Adults: A Preliminary Study

Yoga is growing in popularity and has the potential to improve strength, flexibility, mobility, and balance in older adults. However, few yoga programs tailored to the unique needs of older adults exist. Rewind Yoga? was created to address this gap and a pilot study was conducted to evaluate the effectiveness of the program on physical function parameters. Healthy, older adults (n = 16) residing in a retirement community (55 and older) enrolled in a study examining the effect of Rewind Yoga? on strength, flexibility, dynamic balance, and endurance as measured by the Senior Fitness Test. A single group design (n = 14) with three repeated measures (baseline, 6 weeks, and 12 weeks) was used. Results from repeated measures analysis of variance indicated significant (P < 0.05) improvements in all measures of the Senior Fitness Test at 6 and 12 weeks. Rewind Yoga? appears to improve flexibility, strength, dynamic balance, and muscular endurance in older adults.     

Test-Retest Reliability of Yale Physical Activity Survey Among Older Mexican American Adults: A Pilot Investigation

The objective of the work reported in this paper is to assess test-retest reliability of Yale Physical Activity Survey Total Time, Estimated Energy Expenditure, Activity Dimension Indices, and Activities Checklist in older Mexican American men and women. A convenience-based healthy sample of 49 (42 women and 7 men) older Mexican American adults recruited from senior recreation centers aged 68 to 80 years volunteered to participate in this pilot study. Forty-nine older Mexican American adults filled out the Yale Physical Activity Survey for this study. Fifteen (12 women and 3 men) of the 49 volunteers responded twice to the Yale Physical Activity Survey after a 2-week period, and helped assess the test-retest reliability of the Yale Physical Activity Survey. Results indicate that based on a 2-week test-retest administration, the Yale Physical Activity Survey was found to have moderate (ρ_I = .424, p < .05) to good reliability (r_s = .789, p < .01) for physical activity assessment in older Mexican American adults who responded.     

Impact of life stories on college students’ positive and negative attitudes toward older adults

Gerontological educators are increasingly interested in reducing college students’ negative, and promoting their positive, attitudes toward older adults. Over the course of a semester, students from six 4-year institutions viewed three life story videos (documentaries) of older adults and completed pre- and posttest surveys that assessed their positive (Allophilia Scale) and negative (Fraboni Scale of Ageism) attitudes. The authors assessed changes in attitudinal scales between treatment (with videos, n = 80) and control (no video, n = 40) groups. Change score analysis with 95% bias-corrected bootstrap confidence intervals estimated the effects of the documentaries on students’ attitudes. The treatment group showed significant increases in kinship, engagement, and enthusiasm, and decreases in antilocution and avoidance (all ps <.05). There was no significant change in affect, comfort, or discrimination. This study demonstrated how video stories impact students’ attitudes about older adults.     

Individual risk factors of feelings of unsafety in later life

The aim of this contribution is twofold: on one hand to examine the individual risk factors regarding feelings of unsafety among older people and on the other hand to investigate whether they differ between third-age adults (aged 60–79) and fourth-age adults (aged 80+). This study seeks to identify the relationship between demographic variables, lack of economic resources, well-being and perceived ageism on the one side and feelings of unsafety on the other. On the basis of data from the Belgian Ageing Studies (N = 26,116), it was found that fourth-age adults experienced higher levels of feelings of unsafety than third-age adults. Furthermore, hierarchical regression models indicated that gender, number of children and perceived ageism were significantly related to feelings of unsafety across the third and fourth ages. However, several individual characteristics were found to be specific to the different age groups. Conclusively, practical implications and research issues are critically discussed by emphasising the importance of tackling structural inequalities among older persons to reduce their feelings of unsafety.     

The Experience of Older Adults in a Walking Program at Individual,Interpersonal, and Environmental Levels

Walking programs are advocated to mobilize sedentary older adults. Thus, the study of age-specific social ecological walking programs are needed in order to develop interventions that offer best chance for success. The purpose of this study was to analyze the experience of participating in a walking program at individual, interpersonal, and environmental levels in order to identify appropriate strategies for walking interventions to older adults. A 10-month walking program was implemented, three times a week with 19 older adults (mean age = 67,42 ± 2,48). The participants were submitted to a pre and post evaluation of functional fitness, physical activity patterns, and perceptions of their neighborhood environment. After the program, semi-structured interviews were conducted with 12 randomly selected participants. The results highlight the potential of this walking program by enhancing physical and mental health, creating supportive social networks, and a context of walking in nature which was crucial for the promotion of the active lifestyle and functional improvement of older adults participants.     

Attitudes and Experiences With Older Adults: A Case for Service Learning for Undergraduates

The current study examined whether relationship quality with older adults currently and in childhood, as well as experience with older adults, was associated with biases toward older adults and interest in working with older adults as a possible career area. The authors sampled undergraduate students (N = 753, M = 18.97 years, SD = 2.11 years) from a Northern California university. In hierarchical regression analyses, higher perceived quality of relationships with older adult family members, higher perceived social support, and lower perceived conflict from relationships with older adults was significantly associated with positive attitudes toward older adults. Interest in working with older adults was significantly associated with taking courses in aging, providing care to an older adult, and volunteering with older adults. These results suggest that positive relationships with older adults are useful in reducing biases, though student interactions with older adults are key in helping to promote interest in working with older adults.     

Implementing an interdisciplinary intergenerational program using the Cyber Seniors® reverse mentoring model within higher education

ABSTRACT

Intergenerational service-learning in higher education positively affects older adults and students, but little is known about the effectiveness of interdisciplinary, reverse mentoring programs that use technology as the medium of bringing generations together. This study describes an intergenerational service-learning program that utilizes reverse mentoring within higher education, the “Engaging Generations Program,” at a midsized public university in New England where students help older adults learn about technology, and students gain communication and teaching skills. In this article, we outline how the program was implemented, present quantitative data on participation outcomes for students and older adults and qualitative data from older adults, and discuss best practices. Analysis of pre/post surveys found that students’ attitudes toward aging improved (p < 0.01) and older adults interest in technology improved (p < 0.05) after program participation. Best practices identified included: multiple meetings with the same pair to deepen friendships, in-person training for student leaders, student responsibility for scheduling, tailoring sessions to each participant, student documentation of meetings, and active involvement by community partners.     

Moderating Effects of Community Social Capital on Depression in Later Years of Life: A Latent Interaction Model

Objective: This study tested the stress-buffering model and examined the buffering role of community social capital on late-life depression.

Methods: This study used the data from the second wave of National Social Life, Health, and Aging Project (NSHAP, 2010–2012). In the present study, a total of 2,362 older adults aged 65 and older (Mage = 74.5, SD = 6.69) were included. Latent moderated structural equations model was tested by comparing the main effect model and interaction model. Depression, stress, and community social capital were constructed as latent variables for the analyses.

Results: The main effect model was acceptable: χ² (df = 334) = 1596.4, p = .000; RMSEA = .04 (.038 - .042); CFI = .91; and SRMR = .05. And interaction model was significant (D = 35.0, p < .001). The latent constructs of stress (β = . 50, p < .001) and community social capital (β = ?.14, p < .001) not only had a direct effect on depression, but their interaction was also significant (β = ?.21, p < .01).). The group with a high level of social capital presented a relatively stable slope in the prediction of stress on depression, suggesting their resilience, while the group with a low level of community social capital demonstrated a steep slope, indicating heighten vulnerability to depression when faced with stress.

Conclusions: The findings support the hypothesis of stress buffering model and identify the protective effects of community social capital on depression of older adults.

Clinical Implications: Older adults with lower community social capital are particularly vulnerable to depression. The results highlight that practitioners and policymakers should pay more attention to finding ways to enhance community resources to improve older adults’ mental health.