Improving the Quality of Life of Elderly Adults

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Harrison County

Harrison County Assisted Living Facilities: Improving the Quality of Life of Elderly Adults

Table of Contents

Target Population

Harrison County

Target Population Summary

References

Phase 2:  Epidemiological Assessment

Program Goal

Program Objective

Literature Review Summary

References

Phase 3:  Behavioral and Environmental Assessment

Behavioral Assessment

Behavioral targets

Behavioral Objectives

Environmental Assessment

Environmental Target

Environmental Objective

Literature Review Summary

References

Phase 4:  Education and Ecological Assessment

Predisposing Factors

Enabling Factors

Reinforcing Factors

Targeted Factors

Learning Objectives

Resource Objective:

Literature Review Summary

References

Phase 5:  Administrative and Policy Assessment

Resource Assessment

Assessment of Factors Influencing Implementation

Policy Assessment

Transtheoretical Model (TTM)

Marketing

Title of Program: Prevention

Session Number: 1

Title of Program:

Session Number: 2

Title of Program:

Session Number: 3

Title of Program:

Session Number: 4

Title of Program:

Session Number: 5

Phase 6:  Implementation

Session 1

Session 2

Session 3

Session 4

Session 5

Phase 7:  Process Evaluation

Phase 8:  Impact Evaluation

Session 1-5 Pretest/ Post-test

Phase 9 Outcome Evaluation

Appendices

Appendix A

Appendix B

Appendix C

 

Phase 1

Target Population

Target Group:

My target group is male and female residents living in an assisted living facility in Harrison County.

Demographics of facility:

Total number of apartments: 60

Total number of residents:  Approximately 64

Median age for all residents: 82

Males:  33.5%

Females:  66.5%

Independent living:  1%

Assisted living:  99%

Alzheimer’s care:  45%

Other medical care: 54%

Demographics of group:

Number in Group:  12

Age Range:  69-83

Gender:  Female

Racial Composition:  Caucasian

Education level:  High school degree or higher

Harrison County

Harrison County is located along the Gulf Coast of Mississippi.  Gulfport (99% urban, 1% rural), Biloxi (91% urban, 9% rural), Long Beach (100% urban, 0% rural), D’Iberville (97% urban, 3% rural), Pass Christian (100% urban, 0% rural), Saucier (no data), DeLisle (no data), Lyman (no data), and Henderson Point (no data) are located within Harrison County (City-Data, 2016).  The county is 77% urban, 23% rural, with 581 sq. miles of land and 395.2 sq. miles of water (City-Data, 2016).

Population

Per the American Community Survey, Harrison County has an estimated total population of 196,300 with a median age of 35.4 years with an estimated 24% of the population under 18 years of age, 10.5% being 18-24 years of age, 27% being 25-44 years of age, 25% being 45-64 and 13% being 65 years and older (U.S. Census Bureau, 2016). The population race in Harrison County is reported to be 67.2% white, 21.9% black and 10.3% being of another race (City-Data, 2016).

Housing

American Community Survey reports that between 2011 and 2015 Harrison County housing consisted of an estimated 88,800 housing units, of which 15% where estimated to be vacant (U.S. Census Bureau, 2016).

             Total housing units:

  • 65% were in single-unit structures
  • 26% were in multi-unit structures
  • 9% were mobile homes.

Median monthly cost:

  • mortgaged owners $1,213
  • non-mortgaged owners $369
  • renters $837.

Group Housing

In 2010 there was an estimated 5,452 people living in 13 group quarters in Harrison County per City-Data (2016), the breakdown of the population is as follows:

  • 3,272 people in military barracks and dormitories (non-disciplinary)
  • 811 people in local jails and other municipal confinement facilities
  • 660 people in nursing facilities/skilled-nursing facilities
  • 160 people in other non-institutional facilities
  • 159 people in state prisons
  • 85 people in correctional residential facilities
  • 72 people in workers’ group living quarters and job corps centers
  • 67 people in mental (psychiatric) hospitals and psychiatric units in other hospitals
  • 51 people in emergency and transitional shelters (with sleeping facilities)
  • 40 people in group homes intended for adults
  • 32 people in residential treatment centers for adults
  • 28 people in correctional facilities intended for juveniles
  • 15 people in group homes for juveniles (non-correctional)

Assisted Living Facilities

Harrison County has 7 assisted living facilities (“Assisted Living in Mississippi | Caring.com”, 2017).  The number of beds available for use within Harrison County per Harrison County 2007 Health Profiles is 796 (Zhang, Hayes, Kopp, & Dvorak, n.d.).  The median monthly fees according to Assisted Living in Mississippi (2017) for a resident in an assisted living facility is $2,949.25, and the cost rises as the resident requires more skilled care.  As the number of residents age, the need for more assisted living facilities will increase.

Economics

According to the U.S Census Bureau Quick Facts (2016), the median household income is $41,722 in Harrison County which is slightly above average, with the state average being $39,655.  There is an estimated average of 22% of the population in Harrison County living in poverty (U.S. Census Bureau, 2016). The cost of living in 2016 was 88.9, which is below the state average of 100 (City-Data, 2016).  Unemployment rates are 5.4%, right below the state average of 6.3% and slightly higher than the United States average of 4.9% (U.S. Census Bureau, 2016).

Education

In 2015, 85% of people 25 years and over had reported to have at least graduated from high school and 21% had reported a bachelor’s degree or higher with 15% claiming to have not graduate from high school according to the American Community Survey (U.S. Census Bureau, 2016).

Crime

The Harrison County Sheriff’s office has reported the following number of crimes in 2005 per City-data.com (2016):

  • Murders: 8
  • Rapes: 49
  • Robberies: 11
  • Assaults: 43
  • Burglaries: 343
  • Thefts: 979
  • Auto thefts: 129

Concerns for Harrison County:

Unemployment

Poverty

Aging Population

Target Population Summary

My target population for Harrison County is male and female residents in assisted living facilities. To concentrate on what this populations needs are, I have reached out to an assisted living facility in Biloxi, Mississippi.  Multiple informal visits were conducted before any nominal information could be gathered, allowing for both the residents and myself to develop a rapport.  A flyer was designed and approved of by the activities director.  The activities director then distributed the flyer the week before and the week of the meeting.  It was agreed that the first flyer would go out on a Wednesday the week prior with the distribution of the weekly calendar that all residents receive.  Monday the week of the meeting, the same flyer was given to all residents during communal lunch.  If a resident was absent for communal lunch the flyer was attached to the room service tray for that resident.  On Thursday, the day before the meeting, the same flyer was once again distributed to each room via the activities director.  Nominal information was collected using one on one interviews and an informal focus group.  Coffee, tea, donuts, and a variety of muffins and cookies were provided to the participants while one on one interviews were performed.

The one on one interview was used to solely collect non-identifiable, demographic data.  No personally identifiable information (PII) or protected health information (PHI) was collected.  Data collected from the one on one interview questions provided the following demographics of the 12 participants.  The participants were all Caucasian females with varying degrees of medical issues.  The ages of my 12 participants ranged from 69 to 83 with a median age of 72. All participants acknowledge having at least a high school diploma.

An informal focus group was the best form of data collection, as most participants voiced concerns with their vision and writing abilities.  The group was given the following question:

What are you most concerned with?

After much discussion, the following responses were listed in order of importance to them.  After discussing the concerns in which they had, a list of questions was generated to better understand this list.

These questions are as follows along with a summary from their responses:

  1. Loss of independence

What about independence most concerns you? 

The group discussed the struggle of remaining independent while being aware of their dependency brought on by their age and declining health.

  1. Health and social issues with memory loss

We talked about memory and health.  What do you mean when you talk about memory and health?  Some of you have said that health and memory are separate? 

Most prominent in the discussion was the way in which they talked about mental health leading to a chronic illness or resulted from a chronic illness.  Mental health is the main concern among the group followed by chronic diseases.  Another concern with mental health was the social impact it had on them.  The participants are aware of the way in which Alzheimer’s affects not only themselves but their loved ones.  There was some internal discord in wanting to be around family and friends while their memory was declining.

  1. Lack of finances to participate in group outings

We talked about money and how your finances affect your social behaviors, and about not having enough to live past a certain age.  What do you guys mean by that? 

Although money ranked third among the group, it was the subject that generated the most discussion.  Money or lack of was a deciding factor for choosing activities outside the facility.  The group found it more rewarding to participate in group activities outside of the facility, especially when they included those with whom they conversed with daily.  These activities are not utilized by the group as often as they would like, due to financial concerns

  1. Lack of visits from family members

You guys have stated that a lack of visits from family is a concern, what do you mean by this?

Most discussion was focused on wanting to see family and interact with them as it occurred before coming to live in the facility.  A pattern starts to develop between wanting to see the family more, becoming a burden so not wanting them to come around, to feeling like they no longer exist within their family.

  1. Not feeling like part of the community in which they came from

Community seems to be important to you guys.  Why is feeling like part of the community you use to live in such an important concern?

They built their identity within and from the community in which they use to live and no longer living within that community means they no longer have a place in which to identify with.

  1. Not being as active as they once were in the community

You talked about being active in the community, why are you no longer active within the community and why is it a concern?

The activity they described lead them to feeling like they were still contributing to that community.  They acknowledged activities being plentiful within the facility, but likened those too games to pass time and not contribute to the community inside the facility or outside the facility.

Concerns of the group

  • Independence
  • Health and Social issues pertaining to Mental Illness
  • Money
  • Family and community engagement

References

Assisted Living in Mississippi | Caring.com. (2017). Caring.com. Retrieved from https://www.caring.com/local/assisted-living-facilities-in-mississippi

City-Data.com. (2016). Harrison County, Mississippi detailed profile – houses, real estate, cost of living, wages, work, agriculture, ancestries, and more. Retrieved from http://www.city-data.com/county/Harrison_County-MS.html

Harrison County Board of Supervisors. (2017). Harrison County Mississippi: Senior services. Retrieved from http://co.harrison.ms.us/departments/senior%20services/

MDHS. (2016). Services for seniors. Retrieved from http://www.mdhs.state.ms.us/aging-adult-services/programs-daas/services-for-seniors/

U.S. Census Bureau. (2016). American community survey. The Data Web. Retrieved 2017, from http://thedataweb.rm.census.gov/TheDataWeb_HotReport2/profile/2015/5yr/np01.hrml?SUMLEV=50&state=28&county=047

U.S. Census Bureau. (2016). Harrison County Mississippi quickfacts from the US Census Bureau. Retrieved from https://www.census.gov/quickfacts/table/PST045215/28047

Zhang, L., Hayes, S., Kopp, L., & Dvorak, C. Harrison County 2007 Health Profiles. Mississippi State Department of Health. Retrieved from http://msdh.ms.gov/county/harrison.pdf

Phase 2:  Epidemiological Assessment

Program Goal

Improve the physical, social and emotional health of older adults in assisted living facilities using a multi-dimensional program designed.

Program Objective

By 2020, there will be a 10% increase in active participation in social activities among residents in the assisted living facility.

Epidemiological Assessment

According to Bunker, the increase in life expectancy can be contributed to improved medical interventions and advancements in technology (2001).  As mortality rates in infectious and acute diseases declined, the diagnosis of chronic diseases increased (Centers for Disease Control and Prevention, 2013).  Eight of the top ten leading causes of death in the United States are due to a chronic disease (Centers for Disease Control and Prevention, 2017).  Per the Centers for Disease Control and Prevention (2013), the top five leading causes of death among persons 65 years are older are heart disease, cancer, chronic lower respiratory disease, stroke and Alzheimer’s.  Like the rest of the United States, Harrison County has seen an increase in the aging population, and a comparison on QuickFacts shows a 2% increase in the population of those 65 years are older between 2010 and 2015 (U.S. Census, 2016).  This increase is only going to continue to grow as the community ages per Harrison County 2007 Health Profiles, which has projected an estimated 24% increase of those 65 to 74 years of age by 2025 and an estimated 32% increase of the population over the age of 75 (Zhang, Hayes, Kopp, & Dvorak, n.d.).

Literature Review Summary

The Meaning of “Independence” for Older People in Different Residential Settings

To better understand how the elderly perceives their level of independence I turned to a qualitative research study in the Journal of Gerontology.  Sarah Hillcoat-Nalletamby (2014), uses a qualitative technique to gain information on varying views of independence from the elderly living in three different residential settings.  What I learned from this study is that independence is concept unique to each of us and our individual circumstances.  Each phase in our lives contributes to the ever-changing theme of independence gained by our own experiences.  As we age, we often feel as though we are becoming less dependent on those around and free to live with the choice we make.  Independence can thus only be measured by our own definition of the term.  Society has placed such a big emphasis on independence that as we move from one stage to the next we often fail to acknowledge the mutual dependency we have with those around us (Hillcoat-Nalletamby, 2014).  Having placed our importance on independence and failing to recognize the natural mutual dependence we have creates a conundrum as we age and health declines.  The results of the study show that not one definition or explanation can be created to measure a person’s interpretation of independence.  This is seen when Hillcoat-Nalletamby (2014) states, “older people’s understandings of the concept are diverse, with some common to all three settings” (p. 427).  Understanding that mutual dependency is a factor that helps not only in infancy but through all stages of adulthood needs to be recognized by society.  We need to start by de-stigmatizing dependency as a negative connotation and reiterate the positive impact it has on shaping relationships that allows for a healthier quality of life at all stages of life.

Effects of Social Integration on Preserving Memory Function in a Nationally Representative US Elderly Population

The stigma surrounding Alzheimer’s and the physical and emotional impact it has on the individual burden with the disease is astronomical.  The impact could be seen during interviews with the participants when the word was used.  Avoid the word Alzheimer’s by using other words in its place was done frequently.  Words such as memory loss, declining memory, and forgetfulness was preferred.  Most participants attributed their declining memory issues to a chronic health disease and attributed both to their lack of social engagement.  To see if there was any validity to this I turned to a study conducted by Harvard School of Public Health in 2008, were researchers looked at the correlation of social relationships and cognitive decline among the aging population (Ertel, Glymour, & Berkman, 2008).  What they found was that more social integration led to a slower decrease in the cognitive decline, along with a greater sense of purpose among the elderly population (Ertel, Glymour, & Berkman, 2008).  Memory loss effects the quality of life of not only those who are experience it, but also those caring for the individual diagnosed with Alzheimer’s.  Being able to slow the condition using social integration among the community outside an assisted living facility will not only help those with self-esteem issues pertaining to their memory loss but it can also help elevate the feeling of isolation and loss of independence.

Determinants of Quality of Life in Ageing Populations: Results from a Cross-Sectional Study in Finland, Poland and Spain

An observational, cross-sectional study was done to identify modifiable determinants of life among the European population.  The research was also aimed at measuring current perceptions of determinants, finding which determinants had lower quality of life scores and measuring the modifiability of those determinants, the determinants identified as modifiable included health habits, physical activity, and social interactions (Raggi et al., 2016).  We need to identifying modifiable determinants of health as early as possible so that we can plan and implement programs aimed at modifying those determinants in the population as early as possible.  Policies can be created addressing the determinants allowing for a higher rate of quality of life among the elderly.

Quality of Life, Perceptions of Change, and Psychological Well-Being of the Elderly Population in Small Rural Towns in the Midwest

It is well known that the life expectancy of the population has increased and will continue to increase over the next few decades.  As the population ages their physical and cognitive health declines, along with their ability to maintain daily activities of living (ADLs).  With the diminishing independence, aging in place can become overwhelming for both the caregiver and aging adult.  Struggling with the loss of independence and diminishing health, coupled with the fear having to move out their home contributes to negative behaviors leading to a lower quality of life.  A lower quality of life, negative health behaviors and both chronic and cognitive decline leads to premature death and disability (Cantarero, & Potter,2014).  Cantarero and Potter stress how improving and maintain a quality of life that promotes a positive physical and mental environment for the aging population can slow the decline that leads to premature death and disability (2014).  Removing the negative belief and ideas that dependency is a loss of one’s self-worth and promoting activities aimed at variables measuring quality of life can aide in the overall health of the aging population (Cantarero, & Potter,2014).

Aging in Community: Mobilizing a New Paradigm of Older Adults as a Core Social Resource

The loss of independence can happen at any stage of life.  Individuals of all age are at a risk of losing some independence, yet the negative stigma surrounding its loss is mostly associated with the aging population.  Adding to the loss of independence due to physical or mental disability, many elderly individuals turn to assisted living facilities to aide in their everyday activities (Black, Dobbs & Young, 2012).  Although these facilities are aimed at providing some independence to the individual, many still perceive the move negatively and thus associate their worth based on this perception.  To increase the dignity and independence of individuals in community settings Black, Dobbs and Young (2012) found that meaningful involvement within the community, aging in place, social inclusion, staying connected with events and activities, having access to transportation, and staying physically active.  Using this information and finding ways in which to incorporate it into a community facility can impact the way in which facilities engage residents.

References

Black, K., Dobbs, D., & Young, T. L. (2015). Aging in community: Mobilizing a new paradigm of older adults as a core social resource. Journal of Applied Gerontology, 34(2), 219-243. doi:10.1177/0733464812463984

Bunker, J. P. (2001). The role of medical care in contributing to health improvements within societies. International Journal of Epidemiology, 30(6), 1260-1263. doi:10.1093/ije/30.6.1260

Cantarero, R., & Potter, J. (2014). Quality of life, perceptions of change, and psychological well-being of the elderly population in small rural towns in the Midwest. The International Journal of Aging and Human Development, 78(4), 299-322. doi:10.2190/ag.78.4.a

Centers for Disease Control and Prevention. (2013). Mental health. Atlanta, Ga: Centers for Disease Control and Prevention, U.S. Depart. of Health & Human Services.

Centers for Disease Control and Prevention. (2013). The state of aging and health in America 2013. Atlanta, Ga: Centers for Disease Control and Prevention, US Dept. of Health and Human Services.

Centers for Disease Control and Prevention. (2017). National center for health statistics. Atlanta, Ga.: Centers for Disease Control and Prevention, US Dept. of Health and Human Services.

Ertel, K., Glymour, M., & Berkman, L. (2008). Effects of social integration on preserving memory function in a nationally representative US elderly population. American Journal of Public Health, 98(7), 1215-1220. http://dx.doi.org/10.2105/ajph.2007.113654

Hillcoat-Nalletamby, S. (2014). The meaning of “Independence” for older people in different residential settings. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 69(3), 419-430. http://dx.doi.org/10.1093/geronb/gbu008

Raggi, A., Corso, B., Minicuci, N., Quintas, R., Sattin, D., & De Torres, L. et al. (2016). Determinants of quality of life in ageing populations: Results from a cross-sectional study in Finland, Poland and Spain. PLOS ONE, 11(7), e0159293. http://dx.doi.org/10.1371/journal.pone.0159293

U.S. Census Bureau. (2016). American community survey. The Data Web. Retrieved 2017, from http://thedataweb.rm.census.gov/TheDataWeb_HotReport2/profile/2015/5yr/np01.hrml?SUMLEV=50&state=28&county=047

U.S. Census Bureau. (2016). Harrison County Mississippi quickfacts from the US Census Bureau. Retrieved from https://www.census.gov/quickfacts/table/PST045215/28047

Zhang, L., Hayes, S., Kopp, L., & Dvorak, C. Harrison County 2007 health profiles. Mississippi State Department of Health. Retrieved from http://msdh.ms.gov/county/harrison.pdf

Phase 3:  Behavioral and Environmental Assessment

Target population:

Male and female residents in assisted living facilities.

Health problem:

Lack of participation in social and physical activities that leads to lower quality of life thus increasing premature mortality and morbidity among aging adult residents in assisted living facilities.

Program goals:

Improve the physical, social and emotional health of aging adults in assisted living facilities using a multi-dimensional program designed.

Program objectives:

By 2020, there will be a 10% increase in active participation in social and physical activities among aging adults in the assisted living facility.

Behavioral Assessment

Behavioral Risk Factors Non- Behavioral Risk Factors
Cognitive function Genetics
Self-perceived dependency Age
Inactive life style Physical/mental health function
Social disengagement Economic Stability
Negative perception of aging Isolation
Preventable Behavioral Factors Treatment Behavioral Factors
Participate in hobby Build activities around hobbies
Volunteer Volunteer in community
Physical activity Promote physical activity
Intergenerational programs Participation in integrational programs
Social engagement Incorporate social engagement into activities
Important Behavioral Factors Changeable Behavioral Factors
1.  Social disengagement 1.  Social disengagement
2.  Inactive life style 2.  Inactive life style
3.  Self-perceived dependency 3.  Self-perceived dependency
4.  Negative perception of aging 4.  Negative perception of aging
5.  Cognitive function 5.  Cognitive function

Behavioral targets

Social disengagement

Inactive life-style

Self-perceived dependency

 

Behavioral Objectives

  • 15% of the participants will report being actively involved in weekly social activities 3 months after completing the program.
  • 6 months after the program, 10% of the participants will report an increase in light, moderate, or leisure-time physical activities.
  • 1 year after the program 10% of residents who participated in the program will indicate being actively engaged in an intergenerational program.

Environmental Assessment

Nonbehavioral Factors/Causes  
Genetic
Age
Physical/mental health function
Economic Stability
Isolation
Important Nonbehavioral Factors Changeable Nonbehavioral Factors
1.  Physical/mental health function 1.  Family/social support to improve function
2.  Economic Stability 2.  Utilizing limited personal resources
3.  Isolation 3.  Proving privacy where you can
4.  Genetics
5.  Age

Environmental Target

An activity board will be displayed in the common dining room with a list of social events, physical activity goals, community events and locations and times of intergenerational activities; the list will be updated every Sunday by the activity director.

Environmental Objective

  • 100% of participants will receive a sign-up sheet on Sunday for the week’s activities, and will be reminded of the next day’s event during dinner in the common dining room.
  • 100% of the participants will receive a survey at the end of each week where they can rate the activities/location for that week, and write in recommendations for any new activities or social events they would like.

Literature Review Summary

The correlation that both mental health and physical activity plays on one’s well-being regardless of age is well documented.  As one ages the correlation between the two become more apparent.  Studies on quality of life and negative behaviors regarding poor mental and physical health of the aging population have shown an association of higher rates of both mortality and morbidity (Dickens et al., 2011; Fried et al., 2004; and Zhao et al., 2017).  Dickens et al. (2011), references the results of a meta-analysis study that reported, “a 50% reduction in the likelihood of mortality for individuals with strong social relationships”.

Participating in social engagements or purchase fitness memberships can be costly, and many aging adults do not have the financial means for such activities (Rozanova, Keating, & Eales, 2012).  Among financial restrictions, many aging adults feel as though they can no longer participate in certain activities because of their health/mental function, and this perception is only reinforced by the stigma in which society holds on aging (Dickens et al., 2011; Fried et al., 2004; Zhao et al., 2017).  Volunteerism is a great way to get aging adults socializing with the general population, and the added benefits of that volunteerism lends to the community is an added bonus.  Not only do the aging adults benefit from the social engagement, the community gets the knowledge from the aging population as well as years of experience.

Getting adults to participate in activities that can help with and or improve their overall well-being needs to be addressed.  Society in general needs to be engaged in helping to facility a way in which we engage the aging population by removing the stigma that is associated with aging and embracing a population set that has time, knowledge and experience to lend us.  Physical activity and socialization can help in not only reducing the negative behaviors but also reduce some chronic health issues and thus increase the aging population views their well-being.

References

Dickens, A., Richards, S., Greaves, C., & Campbell, J. (2011). Interventions targeting social isolation in older people: a systematic review. BMC Public Health, 11(1). http://dx.doi.org/10.1186/1471-2458-11-647

Fried, L., Carlson, M., Freedman, M., Frick, K., Glass, T., & Hill, J. et al. (2004). A social model for health promotion for an aging population: Initial evidence on the experience corps model. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 81(1), 64-78. doi:10.1093/jurban/jth094

Rozanova, J., Keating, N., & Eales, J. (2012). Unequal Social Engagement for Older Adults: Constraints on Choice. Canadian Journal on Aging / La Revue canadienne du vieillissement, 31(01), 25-36. doi:10.1017/s0714980811000675

Zhao, Y., Sautter, J., Qiu, L., & Gu, D. (2017). Self-perceived uselessness and associated factors among older adults in China. BMC Geriatrics, 17(1). http://dx.doi.org/10.1186/s12877-016-0406-z

Phase 4:  Education and Ecological Assessment

Predisposing Factors

Society itself helps shape the roll in the way we think the elderly should behave (Kane & Kane, 2001).  The behaviors of those with a negative outlook on aging have decreased physical activity and disengage in social activities, leading to poor mental health and physical health, and those already suffering from a physical or mental illness are hit even harder by this negative outlook on aging (Cantarero & Potter).  Aging adults buy into the stigma of aging feel useless not only to themselves but to society, and their community (Zhao, Sautter, Qiu, & Gu, 2017)

Enabling Factors

Chronic diseases and mental illness along with stigma society has placed on aging help to enable this thinking for the aging adults (Cantarero & Potter, 2014; Dickens, A., Richards, S., Greaves, C., & Campbell, J., 2011; and Zhao, Y., Sautter, J. M., Qiu, L., & Gu, D., 2017).  Not being able to do the things they once did because of a decrease in their health.  Even when they can still get up and move around some of them still think that they can’t do it because society says they can’t.  Society plays a big factor in the aging populations view on aging, because they put seniors in a class of their own, making them feel like they are too old to do anything.  Most establishments encourage the elderly to retire by a certain age or restrict them from doing jobs because of their age (Rozanova, Keating, & Eales, 2012).  This thinking enables aging adults in their beliefs that once you are over a certain age you are no longer useful and can no longer do what the general population is engaging in.

Reinforcing Factors

Having family and friends that provide the support an aging adult needs to navigate life can help reduce the stigma surrounding ageism an aging (Cantarero & Potter, 2014).  As the aging adult becomes more dependent on their loved ones, and this dependency becomes too overwhelming for their families, the aging adult is usually placed in the care of a facility that assist with everyday care.  Independence, privacy and the feeling of uselessness becomes an even bigger challenge to overcome in the aging population.  Using the knowledge we have on the aging we can educate society on the benefits of aging, teaching them skills that best utilize their environment and unraveling the stigma surrounding aging.

Data collection from group meeting

An informal focus group was conducted with the group.  Questions were asked about the kinds of activities the group liked doing and what it would take to get them involved.  The group answers follow a pattern, this pattern is that they want to participate in activities that ground them to the community, and allowed for them to participate in activities they enjoyed when they were younger.  When it comes to being involved, activities need be free, and reminding them about these activities at various times makes a big difference.

Targeted Factors

  • Opinions on ageism and addressing the stigma surrounding aging
  • The way in which aging adults engage society and their community
  • Support from family, friends and the community in which they live

Learning Objectives

  • After the sessions, 70% of the participants will verbally recall the importance of engaging in social and physical activities for aging adults.
  • After the sessions, 80% of the participants will be able to verbally list different activities that are engaging and important to their overall wellbeing.

Resource Objective:

  • At the end of program, 90% of the participants will utilize the activity calendar to locate an activity or social engagement in which they are interested in attending.

References

Cantarero, R., & Potter, J. (2014). Quality of life, perceptions of change, and psychological well-being of the elderly population in small rural towns in the Midwest. The International Journal of Aging and Human Development, 78(4), 299-322.

Dickens, A., Richards, S., Greaves, C., & Campbell, J. (2011). Interventions targeting social isolation in older people: a systematic review. BMC Public Health, 11(1). http://dx.doi.org/10.1186/1471-2458-11-647

Kane, R. L., & Kane, R. A. (2001). What older people want from long-term care, and how they can get it. Health Affairs, 20(6), 114-127. doi:10.1377/hlthaff.20.6.114

Rozanova, J., Keating, N., & Eales, J. (2012). Unequal Social Engagement for Older Adults: Constraints on Choice. Canadian Journal on Aging / La Revue canadienne du vieillissement, 31(01), 25-36. doi:10.1017/s0714980811000675

Zhao, Y., Sautter, J. M., Qiu, L., & Gu, D. (2017). Self-perceived uselessness and associated factors among older adults in China. BMC Geriatrics, 17(1). doi:10.1186/s12877-016-0406-z

Phase 5:  Administrative and Policy Assessment

Resource Assessment

Assessment of Proposed Resources

Timeline:

Personnel:

1 Program Director

1 Health Educator

3 Arts and Crafts staff

1 certified exercise instructor

Budget:

Project Director:

Health Educator:

Arts and Crafts Staff:

Refreshments:

Commodities:

Office resources

Total Project cost:

Assessment of Available Resources

Readily available resources:

What personnel are available?

Budgetary constraints?

If resources are not available or affordable, adjustments must be made.

Assessment of Factors Influencing Implementation

Policy Assessment

Assessment of the Organizational Mission, Policies, and Regulations

Assessing Political Forces

Transtheoretical Model (TTM)

Many aging adults see aging in a negative way.  Many of them feel as though they are no longer an asset to the community in which they live.  Others feel as though they no longer can participate in the activities they once enjoyed due to multiple reasons such as mental health and chronic illness.  This is far from the truth, particularly those aging adults that are no longer working.  The contribution to the community through volunteerism and is with the time they have available.  Using their free time to participate in the community are activities can increase their view on aging thus increasing their overall outlook and feelings on life.  I will address the precontemplation stage by interacting with the participants, having them discuss and identify activities they find motivating.  By getting them to identify these activities I can integrate these ideas into the program sessions making them more appealing to the participants thus increasing participation to future program sessions.  During the sessions, the contemplation stage will be addressed when the participants find the activities fun and engaging.  Once the participants become engaged and find participation not only fun but beneficial, they will move into the preparation stage.  The participants will start to consider different activities they can participate in while at the facility.  Those wanting to volunteer in the community will be more likely to providing their time when those occasions arise.  With all the activities provided through the program, participants will be more open to the action stage.  In the action stage the participants will decide on a list of activities that best fits his or her desires.  Engagement in activities will be consistent, and beneficial for their mental and physical well-being.  Having participated in the activities continuously without thinking about it, the termination stage has been reached.  The thought of not being able to participate in activities due to age will no longer be at the fore front of the participant’s minds.

Marketing

Advertisement of the program will be done at the facility.  Flyers will be distributed to all residents along with a signup sheet.  A copy of the activities that will be provided to the participants will be given to the activity director of the facility, schools, churches and other organizations participating in the program.

Title of Program: Prevention

Session Number: 1

Session Objectives

After completing the program, 90% of students will be able to identify at least 3 types of birth control.

Detailed Content Outline

Pass out the pretest on different kinds of birth control.

Introduce myself to the class room.

I know talking about sex can be very uncomfortable.  It’s crazy how we can find it almost everywhere though.  It’s in movies, on television, in songs, on billboards, in magazines and yet when someone says sex it becomes taboo.  Sex comes with a lot of responsibility.  One of the responsibilities is preventing pregnancy until you are ready to have a baby.  And that is where I come in.  Today we are going to talk about contraceptives.

As you can see from both of these maps Mississippi has the highest rate of teen births.   In 2012, the rate of pregnancy for females 10 to 14 was 1.1, and 31.4 for females 15-17.  Every year that rate gets higher.

Play Game

Read the instructions

Have everyone line up

Play game

Hand out post-test

Question and Answers

Learning Activities/Methods Utilized

Power point – Preventing Teen Pregnancy: Contraceptives Session 1

Brochure What Everyone Should Know About Contraceptives.

Contraceptive Handouts

Trifold: Pictures of contraceptives

Bag of Chances Candy Game

Have everyone line up and pull candy from a bag.  Each bag is labeled with a contraceptive.  Each bag contains 30 Kisses.  The Kisses represent either a good or failed contraceptive interaction.  Each time they reach into the bag represents a sexual encounter and if the contraceptive worked or failed.  After the candy is gone we move on to the next bag.

Material and Resources Needed

Evaluation Procedures

Pretest

Post-test will be given at the end of session 1

Title of Program:

Session Number: 2

Session Objectives

After completing the program, 90% of students will be able to identify at least 3 types of birth control.

Detailed Content Outline

Pass out the pretest on different kinds of birth control.

Introduce myself to the class room.

I know talking about sex can be very uncomfortable.  It’s crazy how we can find it almost everywhere though.  It’s in movies, on television, in songs, on billboards, in magazines and yet when someone says sex it becomes taboo.  Sex comes with a lot of responsibility.  One of the responsibilities is preventing pregnancy until you are ready to have a baby.  And that is where I come in.  Today we are going to talk about contraceptives.

As you can see from both of these maps Mississippi has the highest rate of teen births.   In 2012, the rate of pregnancy for females 10 to 14 was 1.1, and 31.4 for females 15-17.  Every year that rate gets higher.

Play Game

Read the instructions

Have everyone line up

Play game

Hand out post-test

Question and Answers

Learning Activities/Methods Utilized

Power point – Preventing Teen Pregnancy: Contraceptives Session 1

Brochure What Everyone Should Know About Contraceptives.

Contraceptive Handouts

Trifold: Pictures of contraceptives

Bag of Chances Candy Game

Have everyone line up and pull candy from a bag.  Each bag is labeled with a contraceptive.  Each bag contains 30 Kisses.  The Kisses represent either a good or failed contraceptive interaction.  Each time they reach into the bag represents a sexual encounter and if the contraceptive worked or failed.  After the candy is gone we move on to the next bag.

Material and Resources Needed

Evaluation Procedures

Pretest

Post-test will be given at the end of session 1

Title of Program:

Session Number: 3

Session Objectives

After completing the program, 90% of students will be able to identify at least 3 types of birth control.

Detailed Content Outline

Pass out the pretest on different kinds of birth control.

Introduce myself to the class room.

I know talking about sex can be very uncomfortable.  It’s crazy how we can find it almost everywhere though.  It’s in movies, on television, in songs, on billboards, in magazines and yet when someone says sex it becomes taboo.  Sex comes with a lot of responsibility.  One of the responsibilities is preventing pregnancy until you are ready to have a baby.  And that is where I come in.  Today we are going to talk about contraceptives.

Play Game

Read the instructions

Have everyone line up

Play game

Hand out post-test

Question and Answers

Learning Activities/Methods Utilized

Power point – Preventing Teen Pregnancy: Contraceptives Session 1

Brochure What Everyone Should Know About Contraceptives.

Contraceptive Handouts

Trifold: Pictures of contraceptives

Bag of Chances Candy Game

Have everyone line up and pull candy from a bag.  Each bag is labeled with a contraceptive.  Each bag contains 30 Kisses.  The Kisses represent either a good or failed contraceptive interaction.  Each time they reach into the bag represents a sexual encounter and if the contraceptive worked or failed.  After the candy is gone we move on to the next bag.

Material and Resources Needed

Evaluation Procedures

Pretest

Post-test will be given at the end of session 1

Title of Program:

Session Number: 4

Session Objectives

After completing the program, 90% of students will be able to identify at least 3 types of birth control.

Detailed Content Outline

Pass out the pretest on different kinds of birth control.

Introduce myself to the class room.

I know talking about sex can be very uncomfortable.  It’s crazy how we can find it almost everywhere though.  It’s in movies, on television, in songs, on billboards, in magazines and yet when someone says sex it becomes taboo.  Sex comes with a lot of responsibility.  One of the responsibilities is preventing pregnancy until you are ready to have a baby.  And that is where I come in.  Today we are going to talk about contraceptives.

Play Game

Read the instructions

Have everyone line up

Play game

Hand out post-test

Question and Answers

Learning Activities/Methods Utilized

Power point – Preventing Teen Pregnancy: Contraceptives Session 1

Brochure  What Everyone Should Know About Contraceptives.

Contraceptive Handouts

Trifold: Pictures of contraceptives

Bag of Chances Candy Game

Have everyone line up and pull candy from a bag.  Each bag is labeled with a contraceptive.  Each bag contains 30 Kisses.  The Kisses represent either a good or failed contraceptive interaction.  Each time they reach into the bag represents a sexual encounter and if the contraceptive worked or failed.  After the candy is gone we move on to the next bag.

Material and Resources Needed

Evaluation Procedures

Pretest

Post-test will be given at the end of session 1

Title of Program:

Session Number: 5

Session Objectives

After completing the program, 90% of students will be able to identify at least 3 types of birth control.

Detailed Content Outline

Pass out the pretest on different kinds of birth control.

Introduce myself to the class room.

I know talking about sex can be very uncomfortable.  It’s crazy how we can find it almost everywhere though.  It’s in movies, on television, in songs, on billboards, in magazines and yet when someone says sex it becomes taboo.  Sex comes with a lot of responsibility.  One of the responsibilities is preventing pregnancy until you are ready to have a baby.  And that is where I come in.  Today we are going to talk about contraceptives.

As you can see from both of these maps Mississippi has the highest rate of teen births.   In 2012, the rate of pregnancy for females 10 to 14 was 1.1, and 31.4 for females 15-17.  Every year that rate gets higher.

Play Game

Read the instructions

Have everyone line up

Play game

Hand out post-test

Question and Answers

Learning Activities/Methods Utilized

Power point – Preventing Teen Pregnancy: Contraceptives Session 1

Brochure  What Everyone Should Know About Contraceptives.

Contraceptive Handouts

Trifold: Pictures of contraceptives

Bag of Chances Candy Game

Have everyone line up and pull candy from a bag.  Each bag is labeled with a contraceptive.  Each bag contains 30 Kisses.  The Kisses represent either a good or failed contraceptive interaction.  Each time they reach into the bag represents a sexual encounter and if the contraceptive worked or failed.  After the candy is gone we move on to the next bag.

Material and Resources Needed

Evaluation Procedures

Pretest

Post-test will be given at the end of session 1

Phase 6:  Implementation

Session 1

Power Point – Preventing Teen Pregnancy: Contraceptives

Brochure: What Everyone Should Know About Contraceptives

Contraceptive Handouts for Session 1 and Session 2

Bag of Chances Candy Game

Trifold:

Pictures of different contraceptives

Session 2

Power Point – Preventing Teen Pregnancy: Ways of Preventing Teen Pregnancy

Brochure: Talking to Adolescent About Sex

Chalkboard Game

Trifold:

Names of different clinics in the area

Ways to start conversations about contraceptive use

Ways to prevent pregnancy

Session 3

Power Point – Preventing Teen Pregnancy:  Consequences of Teen Pregnancy

Brochure:  Teen Pregnancy – Don’t take chances

Chalkboard Game

Poster Boards:

Names of different clinics in the area

Ways to start conversations about contraceptive use

Ways to prevent pregnancy

Session 4

Power Point – Preventing Teen Pregnancy:  Consequences of Teen Pregnancy

Brochure:  Teen Pregnancy – Don’t take chances

Chalkboard Game

Poster Boards:

Names of different clinics in the area

Ways to start conversations about contraceptive use

Ways to prevent pregnancy

Session 5

Power Point – Preventing Teen Pregnancy:  Consequences of Teen Pregnancy

Brochure:  Teen Pregnancy – Don’t take chances

Chalkboard Game

Poster Boards:

Names of different clinics in the area

Ways to start conversations about contraceptive use

Ways to prevent pregnancy

Phase 7:  Process Evaluation

Please read the sentence and circle the response that best fits today’s session.

  1. How do you currently feel?    Yes  No  Neutral
  2. Do you like participating in activities?  Yes No Neutral
  3. I would recommend session to a friend.  Yes No Neutral
  4. I am likely to come back for another session.  Yes  No Neutral

How can we improve the program?

On a scale of 1 – 10, how effective was today’s session?

0                    5                                                                        10

Not             Somewhat              Very

Effective              Effective                                                    Effective

Phase 8:  Impact Evaluation

Session 1-5 Pretest/ Post-test

Session 1 Pretest/Post-test

Contraceptive Pretest

Contraceptive Post-test

Session 2 Pretest/Post-test

Pregnancy Prevention Pretest

Pregnancy Prevention Post-test

Session 3 Pretest/Post-test

Challenges of Teen Pregnancy Pretest

Challenges of Teen Pregnancy Post-test

Session 4 Pretest/ Post test

Contraceptive Pretest

Contraceptive Post-test

Session 5 Pretest/Post-test

Contraceptive Pretest

Contraceptive Post-test

Session 1 Pretest

 

 

 

Session 1 Post-test

On a scale of 1 – 10, how effective was today’s session?

0                    5                                                                         10

Not             Somewhat                        Very

Effective              Effective                                                                  Effective

Session 2 Pretest

Session 2 Post-test

On a scale of 1 – 10, how effective was today’s session?

0                    5                                                                        10

Not             Somewhat                      Very

Effective              Effective                                                                 Effective

Session 3 Pretest

Session 3 Post-test

On a scale of 1 – 10, how effective was today’s session?

0                    5                                                                        10

Not             Somewhat                       Very

Effective              Effective                                                                  Effective

Session 4 Pretest

Session 4 Post-test

On a scale of 1 – 10, how effective was today’s session?

0                    5                                                                        10

Not             Somewhat                       Very

Effective              Effective                                                                 Effective

Session 5 Pretest

Session 5 Post-test

On a scale of 1 – 10, how effective was today’s session?

0                    5                                                                        10

Not             Somewhat                       Very

Effective              Effective                                                                  Effective

Phase 9 Outcome Evaluation

In 3 to 5 years’ data will be collected from local hospitals and health departments to see if there was a change in teen pregnancy rates.

 

 

 

 

Appendices

 

 

 

 

Appendix A

 

 

 

 

Appendix B

 

 

 

 

Appendix C

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