Philadelphia Foundation

Abstract Service organizations for people with intellectual and developmental disabilities (IDD) increasingly use telecare applications to improve their services. This study explored the usefulness of offering the 24/7 online support service DigiContact within a broader mix of professional services for people with IDD living independently. We employed a qualitative multiple case study, in which the cases of nine online support users were reconstructed through semistructured interviews with both support users and their case workers. Thematic analysis showed that online support was used as an addition to regular onsite support to enable a more tailor-made delivery of professional supports. Online support can be valuable for its users by increasing the accessibility of professional support and creating opportunities for more self-direction in support.

Displacement in late life may cause social and health issues. Displaced older adults may experience language and cultural barriers, loss of social networks, difficulties in navigation in new physical and social environments, limited options in transportation and mobility, delayed access to health care, and thus sudden or gradual loss of their autonomy, and increasing dependence on their adult children. These issues are known but not well understood, and effective interventions are yet to do developed. This symposium brings together four studies that address several critical social and health issues among late-life Asian immigrants. Dr. Inoue discusses use of person-centered care to reduce social isolation and loneliness among old and ill Asian immigrants in long term care settings. Ms. Ring examines racial differences in navigation and access to long term aging services and social supports (LTSS), and evaluates the use of Social Interaction Modeling to help connect limited English-speaking minorities in need to the formal LTSS system. Dr. Torres from Sweden provides a systematic review of research into racial/ethnic differences in health and social care, and from an international perspective, advocates a research agenda that is both diversity-astute and injustice-aware. In settings where self-report data are likely unreliable, Dr. Li demonstrates an innovative method for objectively measuring spatiotemporal patterns of physical and social activities and use of neighborhood resources among non-English speaking late-life immigrants. Together these studies demonstrate that existing methods can be adapted and new methods can be created to answer important health and social issues among late-life Asian immigrants.

The often stated goal of empowering older adults to make their own decisions can be very difficult to implement in health care settings. The health of the older adult, including cognitive status, as well as limits placed on choices by diagnosis, available treatments and other factor such as cost often leave few choices in the hands of the patient. Each of the four papers on this panel presents findings from an intervention designed to maximize the opportunities for decision making on the part of the older adult. Stoop will describe comprehensive care programs in Europe that, amongst others, aim to improve involvement of older people and their informal caregivers in decision making and planning their care process. Scott’s paper is on a program that empowers seniors by facilitating their healthcare needs with clear direction, consideration for the wishes and needs of the senior and family/caregiver, and provision of resources through the use of a brief cognitive screen. Hawkley and Huisingh-Scheetz will discuss their use of technology to enhance the decision making opportunities for older adults. Eisenstein will look at research as a way of engaging and empowering older residents in a long term care setting. Abbott will respond to the papers and discuss empowerment as a goal and the challenges to that goal in health care settings. The great diversity among the topics will provide a very comprehensive look at approaches designed to provide older adults and their caregivers with real choices in what can be very difficult circumstances.

Defining the goals of age-friendly interventions is a challenge to both policy and research. Interventions designed to make communities more age-friendly have targeted aspects of transportation, housing, food access, and strengthening social ties among others. Menec et. al. (2011) have suggested that the basic benefit of age-friendly communities is social connectivity, which is associated with these health outcomes. In 2015 a group of researchers came together to discuss and comment on Menec’s framework. This group considered Menec’s framework as it applies to age-friendly efforts, research, and policy. This panel is a follow up to the original discussion. Each presentation represents next steps in considering the implications of the framework for the future of age-friendly efforts. DeLaTorre and Neal, who have been involved with age-friendly efforts for 10 years, compare Menec’s framework to the work being done in Portland Oregon. They consider both similarities and differences in two approaches. Frochen and Pynoos Address housing policy and how housing fits into the age friendly framework. Ring, Glicksman, Kleban and Norstrand present a new methodological approach designed to support Menec’s focus on an ecological framework by using two types of environmental measures – spatial and self-report, to better understand health outcomes. Finally, Lehning and Greenfield will respond by placing the three presentations into a larger policy perspective. Verena Menec et. al.. (2011). Conceptualizing Age-Friendly Communities. Canadian Journal of Aging, 479–493

This article describes an innovative model for integrating research into a policy and planning agenda aimed to help neighborhoods become more supportive of older adults. Philadelphia Corporation for Aging (PCA) established Age-Friendly Philadelphia (AFP) to catalyze efforts to improve the physical and social environments for seniors. The Research Program at PCA became an important part of this effort by providing multiple types of supports to PCA staff and other stakeholders. Most notably, the research program worked with planners to adopt the United States Environmental Protection Agency's Aging Initiative model for Philadelphia. That model focuses on (1) staying active, connected, and engaged; (2) development and housing; (3) transportation and mobility; and (4) staying healthy. Examples of practice efforts actualized using this research are also presented. By developing a new approach to the way research can support practice initiatives, AFP has been able to increase its effectiveness, and researchers have found better ways to work collaboratively with professionals in policy, planning, and practice. The PCA model should be considered as a framework for similar efforts aimed at creating age-friendly communities.

GenPhilly is an innovative, replicable model that was developed in Philadelphia, Pennsylvania, to inspire and engage emerging leaders from a variety of disciplines to promote and sustain an aging-in-community agenda. Administrative support is provided by the Area Agency on Aging, Philadelphia Corporation for Aging, yet it was designed by its members to be peer-led. In this way, young professionals in their 20s and 30s can capitalize on popular culture to create unique professional development opportunities and get younger generations thinking about the type of city in which they themselves want to get older. The group has benefited the field of aging by building awareness of aging services in the wider community; facilitating cross-disciplinary learning and innovation around aging issues; stressing the competitive advantage for emerging leaders from all fields to know about aging issues; strengthening the aging network workforce; breaking down stereotypes about working with older adults; and introducing expertise from outside the aging network to benefit older adults. Encouraging the development of similar groups will not only benefit the field of aging, it will assist the next generation of leaders in many fields to plan better for their communities and for themselves.

The State of Israel provides significant opportunities to study social processes that can enhance our understanding of the aging experience. It has high life expectancy and rapid growth of its older population. With an older cohort that is composed largely of former immigrants and includes a minority Arab population, Israel provides much diversity for gerontological study. Among the unique issues facing older Israelis are the aging of Holocaust survivors, modernization in the Arab sector, and privatization in the kibbutzim. New legislation related to pensions and universal health care is expected to affect aging processes. The development of "supportive communities" offers a new service model. The article notes 2 longitudinal studies of importance-the Israeli component of the Survey of Health, Ageing, and Retirement in Europe and the Jerusalem Longitudinal Cohort Study.