I am a recent graduate of the Wayne State University Department of Psychology’s Ph.D. program in behavioral and cognitive neuroscience, and of the Institute of Gerontology’s pre-doctoral training program. My research has focused on changes in brain structure and cognitive abilities that occur over the adult life span in healthy adults. We measure brain structure using different types of MRI scans, and we assess cognitive abilities using a variety of different tests of memory, attention, or reasoning. We know that some regions in the brain shrink over time, even in healthy people. However, not all parts of the brain show the same vulnerability to atrophy, and some regions seem to shrink more or to start declining earlier in life than others. In addition, this shrinkage appears to be related to changes in attention and memory. We also know that a host of different disorders ranging from increases in blood pressure or blood glucose levels to different genetic markers can exacerbate these declines. The reality is that age-related changes in the brain and mental abilities are very complex. We are currently trying to better understand how genes may interact with health and lifestyle factors to be either protective or to make people more vulnerable to this decline.
As we all get older, we tend to notice certain things – our memory is not as good as it used to be, or we are slower mentally and physically. Awareness of these changes can be alarming, even if it is not an indication of pronounced problems like dementia. In response to this growing awareness, we are willing to try anything that might possibly stop or reverse these declines in advancing age. We have seen a multitude of products that claim to undo the negative effects of aging. These range from ‘brain training’ software and smartphone apps to vitamins and supplements. Unfortunately, these claims are often based on limited research or from findings from studies using mice or rats that are not substantiated in humans.
Most people have heard the expression, “Correlation is not causation.” This simply means that although two things are related, one does not cause the other. For example, just because increases in homelessness are associated with higher crime rates, does not mean that increased crime is because of homeless people – both tend to increase when the economy is poor. Those selling anti-aging products capitalize on our lack of understanding of this very phenomenon. Similarly, the next time you see an ad or hear a friend talk about how taking a supplement of wahoo-berry extract is associated with better memory, it is important to ask “But does it actually cause memory to improve?” Here’s a link to a site with some more great examples of false or “spurious” correlations: http://www.tylervigen.com/.
By now, you may be asking yourself, “If the claims made by all those anti-aging products might be misleading, then is there anything we can do?” Fortunately, there are some things that have been shown to be particularly helpful to limit the effects of age on our brains and cognition. Unfortunately, they actually require effort, and may require some lifestyle changes as well, and many people struggle making such changes. The biggest protective factor is cardiovascular fitness. The brain is packed with blood vessels, and anything that affects the vascular system can affect the brain. There is also some strong evidence that a large part of the effects of Alzheimer’s disease is related to the impact of the disease on the brain’s vascular system. In addition to physical exercise, cognitive and social engagement and learning new skills seem to be more protective than playing brain training games. Learning a new language, or learning how to dance, how to use digital photography or other skills that integrate social, cognitive, and physical systems seem particularly promising approaches in combatting the effects of age.
In addition to these new activities, it is extremely important for those with chronic conditions like high blood pressure and diabetes to closely monitor their health and to take prescribed medications to keep these in check. Stress is another factor that can negatively affect our brains and cognitive abilities. Because of this, activities like yoga, mindfulness and meditation can help to reduce the stress hormones in our bodies and limit the negative effects on our brains.
Before you go out and plunk down your hard-earned money on products claiming to undo the effects of age, go for a walk, visit with friends, learn a new skill – it will serve you far better.
Disclaimer: The opinions expressed here are solely those of the author and do not reflect the views of Wayne State University, the Institute of Gerontology, its employees, directors or programs.
Our spring newsletter has released with a focus on cognitive neuroscience. Our Editor Cheryl Deep, MA shares details from the Paul B. Baltes International Conference on Lifespan Cognitive Neuroscience that resulted in a special journal section of the Neuroscience & Behavioral Reviews journal on neural and cognitive plasticity. The newsletter also highlights the dissertation defense of former IOG student and newly robed Dr. Andrew Bender titled, Changes in Cerebral White Matter, Vascular Risk and Cognition Across the Lifespan. Read on to learn more about awards, events and our partners.
A recent study by researchers at La Trobe University and Monash University in Melbourne, Australia, suggests that working women “need more managerial support [while] going through menopause.” This “Women at Work” study explored the health and wellbeing of working women and women’s satisfaction at work, yet focused on working experiences in or around menopause. The lead researcher, Professor Gavin Jack, reports that “menstrual status did not affect work outcomes” but that “if a woman had one of the major symptoms associated with the menopause — for example weakness or fatigue, disturbed sleep or anxiety, then this did influence how they regarded work.” Jack is further quoted as saying: “What is really important is not the fact of going through the menopause in itself, but the frequency and severity of symptoms which women experience, and how these factors affect their work.”
This study has been described in several news sources over the past few weeks, such as the International Menopause Society, Science Daily, and IrishHealth.com. I have many reactions to this research, both positive and negative.
I’ll present my positive feelings first: I appreciate the fact that researchers are talking about the fact that menopausal women are a large part of the workforce and that menopausal experiences matter for individual women. I also applaud the attention given to the fact that workers are human beings with bodies, and that bodies matter. The idea that employers should recognize that paid workers have bodies and that paid workers may be affected by their bodies is an excellent one. I agree that employers should be educated to be more sensitive to menopause and other bodily experiences that their paid workers might have, and simple adjustments in work policies and work environments can go a long way in making employees happier and more productive (plenty of research has already shown this). Finally, and maybe most importantly, as one article in Science Daily notes, “Not enough attention is paid to the experiences which people go through at different stages of life — the workplace treats this very unevenly.” I couldn’t agree more. Especially when it comes to midlife and aging, we forget that paid workers are still dealing with bodily transitions. We forget the range of chronic illnesses that paid workers might have at midlife and beyond, as well as the many normal health transitions that any midlife or aging individual deals with. Anything from the acquisition of bifocals (and learning to see differently through bifocal lenses) to the hassles of dealing with back pain, neck pain, arthritis, hearing impairments, insomnia, etc., can affect one’s work. Not to mention menopause, prostate conditions, and other aging health concerns that can involve a range of different signs, symptoms, and stages. Starting at midlife, it is also much more common to deal with caregiving for elderly parents, divorces and remarriages, putting kids through college (or putting up with adult kids living at home), deaths of parents and spouses/partners, and other social transitions, and all of these things will impact how a paid worker feels and acts on the job. There is much to pay attention to about paid workers in their 40s, 50s, 60s, and beyond, and I believe that this research is a good start on that. Middle-aged paid workers may be reaching the peaks of their careers and may be excellent at their jobs, but they’re still dealing with a multitude of other life circumstances at the same time. And if they’re not performing well on the job, it may well be because of these very same issues. Paid workers are people, with full lives and physical bodies that they can’t leave at home (no matter how much they try).
I do have to offer my negative reactions to this research as well, however: Whenever I see menopausal women picked out and studied specifically for their difficult symptoms, I worry about how those results will be used by others. Someone skimming the news reports might assume that this research shows that menopausal workers are harder to deal with, or aren’t ideal workers. So, let’s make sure we read this research appropriately: this research does NOT report that the quality of women’s work decreases when they reach perimenopause or menopause. This research only reports that women feel differently about their workplaces and sometimes wish their employers were more supportive of menopausal symptoms. If we don’t read carefully, then we might assume that being menopausal is more deviant than it really is. Working While Menopausal is not typically a negative status, or at least not for most women. Quick news reports also don’t always portray research in full, and I think it’s important to note that women are not always bothered by menopausal signs and symptoms (some are, and some aren’t). This was a study that asked primarily about women’s feelings about their workplaces and how health and wellbeing impacted work satisfaction. It is not a study that can give us comprehensive information about women’s menopause experiences. Finally, let’s remember that menopause is just one of many, many health and illness experiences that can affect how people feel and act on the job. Menopause is not necessarily a reason for employers’ alarm, any more than divorce or elderly caregiving or arthritis or back pain is. Rather, employers should be sensitive to the health and wellbeing of all paid workers across the lifespan and recognize that different groups of workers face different health and wellbeing issues.
I think that the most positive contribution of this research is that it reiterates that paid workers have bodies. Employers need to recognize that paid workers have a variety of bodies and that those bodies represent a variety of life stages. Sure, the ideal worker might not have a body but that ideal worker doesn’t exist. We bring our bodies to work!
This blog entry was originally posted by Heather Dillaway on re:Cycling, the blog for the Society of Menstrual Cycle Research (original post on 5/23/14).
The Detroit River has long been a valued food source for locals, but the fish caught there may not always be safe. Wayne State University researchers Drs. Donna Kashian, Mark Luborsky, and Andrea Sankar started an educational program – Eat Safe Fish — to address the dangers of consuming contaminated fish. Retirees and interns volunteer to increase community awareness by walking the Detroit River and talking to anglers face-to-face.
The Riverwalkers advise anglers about the polychlorinated biphenyls (PCBs), dioxins and mercury found in Michigan fish, which fish are safest to consume, and how to safely prepare the filets. This community educational program hopes to reach 5,000 anglers over two years to improve community health.
To access materials regarding consuming safe fish visit the Michigan Department of Community Health website @ https://www.michigan.gov/mdch/0,4612,7-132-54783_54784_54785—,00.html
To learn more about research conducted at the Institute of Gerontology, please click here.
This program was funded by a grant from the Fred A. and Barbara M. Erb Family Foundation.
Students, researchers, and children will learn about the exciting work that neuroscientists at Wayne State University do when they attend Brain Day at the Michigan Science Center on March 15. Attendees will be able to meet neuroscientists, learn about their labs, and even hold a human brain.
What better time to showcase our neuroscientists and the important research they’re doing at the Institute of Gerontology:
Dr. Naftali Raz is Director of the Lifespan Cognitive Neuroscience Program at the Institute of Gerontology. His Cognitive Neuroscience of Aging Lab focuses on:
-Age-related changes in the brain’s structure and function
-The impact of aging on learning, memory, and reasoning skills
Dr. Raz studies how the brain changes with age and how these changes are related to changes in memory and problem-solving skills in older adults. Since 2001, his lab has been conducting a long-term longitudinal investigation into normal brain aging. Using MRI, his team analyzes changes in brain structure in healthy adult volunteers age 18 to 90. They also study age-related differences in cognitive abilities such as memory, problem solving and spatial navigation. Since 2005, a large portion of Dr. Raz’ work has been funded through a multi-million dollar MERIT (Method to Extend Research in Time) award from the National Institute on Aging.
The award, given only to researchers with consistently high research achievement, allowed Dr. Raz to concentrate on his Neural Correlates and Modifiers of Cognitive Aging project for 10 years without the need to continue to apply for funding. Dozens of research papers have resulted from this investigation, which continues to track the effects of vascular risk factors like hypertension, and genetic modifiers like the ApoE E4 gene variant on changes in the brain and cognition among healthy adults.
Dr. Noa Ofen founded the Ofen Lab which focuses on:
-The development of basic cognitive abilities, learning and memory
-Changes in brain structure and function between childhood and young adulthood
Dr. Ofen studies the neural underpinnings of learning and memory in children, adolescents and adults. Research in her lab combines tests of cognitive abilities with neuroimaging techniques to probe how brain structure and function shape human cognitive functioning across development. In particular, she has worked to explore the structure and function of a small but powerful sliver of brain tissue crucial to memory: the hippocampus. Recent work from the Ofen Lab identified robust differences in the structure of the hippocampus from childhood to adulthood.
Her work to-date, and as a post-doctoral associate at MIT, investigated structural and functional brain development in a wide age range of typically developing children and young adults. At WSU her research is expanding to include the study of atypical brain development which underlies the emergence of many psychiatric disorders. The structure and function of the hippocampus, for instance, is altered in a number of psychiatric disorders with a developmental course, making Dr. Ofen’s research well positioned to address clinically significant questions. She recently received honors from the Society of Biological Psychiatry where she chaired and presented a symposium highlighting the importance of her work to the study of schizophrenia.
Dr. Jessica Damoiseaux is new to the Institute of Gerontology from the Netherlands and founded Connect Lab that focuses on:
-Structural and functional brain changes in healthy older adults
-Early detection of Alzheimer’s Disease
Dr. Damoiseaux came to WSU from Stanford University in April. She arrived with a grant from the Netherlands Organization for Scientific Research to conduct a four-year study into functional and structural brain connectivity changes in healthy older adults (age 55 to 75), some who are complaining of memory problems and some who are not. People who report cognitive problems – despite tests that do not show an obvious cause – are five to six times more likely to develop dementia than people who report no problems. Dr. Damoiseaux wants to understand the correlation. “That initial subjective awareness of cognitive impairment might be our earliest indicator,” she said. If imaging can uncover these precursors, early interventions to slow or stop the dementia might be possible.
Attend Brain Day at the Michigan Science Center on March 15 to learn more about the brain with topics focusing on addiction, development and aging, and head safety.
The event is free with paid general admission to the center, and coincides with the Dana Alliance for Brain Initiatives’ Brain Awareness Week, March 10-16, a global campaign to increase public awareness of the progress and benefits of brain research.
The Michigan Science Center is located at 520 John R Street in Detroit.
What brought Ms. Fritz to the IOG: Heather Fritz completed her PhD from the University of North Carolina at Chapel Hill in March 2013 before joining the IOG in August 2013. Heather is a Post-Doctoral Research fellow working under the mentorship of Drs. Cathy Lysack and Mark Luborsky and was attracted to the IOG because of the culture of autonomy, scholarship, and collaboration. Heather is also an occupational therapist with expertise in adult and geriatric populations. Heather’s work focuses on addressing the challenges of illness self-management and health promotion in low income and minority population. In particular she is interested in how individuals with diabetes become better self-managers through time, and the role of habits, routines, social and cultural context, and daily occupations in the process.
Hobbies: When Heather is not working on her research she enjoys cycling, cooking, and spending time with friends and family. She is also a mother of a very handsome Doberman Pincher.
Interesting Facts: Heather initially attended Ohio State as a veterinary medicine major (with agricultural construction as a minor) and later dropped out of Ohio State and started a small landscape design company which she ran for a few years before moving to NC.
Work: Heather has worked some very interesting jobs including: working on the carnival and in food trucks while in high school, as a bus driver while at Ohio State, and as a parking enforcement office (writing parking tickets) while at UNC.
Travel: Heather lived in Monterrey Mexico in 1999 while studying at ITESM and is still (fairly) fluent in conversational Spanish and enjoys all things Latino and Hispanic especially food, music, and dance. She Recently traveled to Denmark and Sweden where she spent time with faculty and PhD students at University of Southern Denmark and Lund University. We may have lost her in the canal had it not been for this sign!!!
To learn more about Heather visit her profile page @ http://www.iog.wayne.edu/profile/heather.fritz/ or email her @ firstname.lastname@example.org
Reporter Jeanette Brown of ElderBranch interviewed Institute of Gerontology Deputy Director, Dr. Cathy Lysack (pictured), to discuss her paper, “Falls efficacy and self-rated health in older African American adults,” which she wrote along with Dr. Chad Tiernana of Husson University and Dr. Stewart Neufeld, Dr. Allon Goldberg, and Dr. Peter A. Lichtenberg of Wayne State University.
Why did you decide to study falls, falls efficacy, and self-rated health in older African Americans. Why is this important?
Falling in general is really important to older adults because we have a fair bit of evidence now that older adults fall quite a bit. Of community-dwelling adults over the age 65, about one in three falls every year on average. That’s a lot of falling. So it is really a very serious problem. And for a small number of older adults, it’s that step into a downward spiral where the serious fracture means a hospitalization, and then that immobility coupled with maybe a series of other health conditions makes it really difficult to get back out of the hospital and certainly out of the hospital in as independent a mobile state as everyone would like. So it’s a big issue period, and it is understudied – like so many issues – in ethnic minorities.
While it is true that African-Americans who fall are less likely to have a hip fracture compared to their elderly white counterparts, we still don’t know much about the stats and facts of ageing for this group. And, in particular, we know very little about this very interesting dimension of falls efficacy, which is our confidence in our ability not to fall. So it was worthy of study.
Please describe your study. What methods did you use in order to achieve meet your objectives?
We used a telephone survey methodology. Here at our Institute of Gerontology at Wayne State University we have a large number of older African-Americans who are research volunteers that come from the community, so we did a sample from our database of seniors in the Detroit area, and then we had a trained set of older adults themselves conduct the telephone data collection interview.
What were your key findings?
Well, one key finding was that approximately one quarter of our sample reported falling within the past year. That wasn’t very different from the national numbers. It was a bit lower, which is good, since no one wants older people to fall.
That said, our second major finding was how high their confidence was in not falling. That was rather curious. How can you have these two things go together?
What conclusions did you draw from that or what further questions did it raise?
It is known in general that there is an optimism in survey results gathered from older African-Americans. It is not always present, but often compared to white samples there is a stronger sense and stronger reporting from this group that things are “alright.” So at one level it wasn’t really surprising.
What was even more important, though, was to look at the linkages between the self-reported health of the people responding and how that figured into falls efficacy and actual falling. What was surprising to us – you might expect that people who report poor health are the fallers, for example – but that isn’t what we saw.
However, we saw that people who had poor self-rated health also were the folks with the lowest confidence in their ability not to fall. So, in other words, people who were not particularly well physically had low confidence. And that is what you might expect – maybe they know they are a little bit unstable. But this is really important because when people are not well, particularly when they lack confidence in their walking, they tend to do it less. That is a real problem because when you walk less, exercise less, you get less fit. And if you are less fit, you are more likely to fall. There is a spiral effect that we really need to better understand so we can stop it.
Would you make any specific recommendations to nursing homes or others who are working with older African-Americans as result of your findings?
The most important thing I would stress is how important it is to remain as physically strong in your lower extremities as you can for as long as you can. My background is occupational therapy, and I work closely with colleagues in physical therapy. One of the prime therapeutic things that we focus on in those settings is making sure that the ambulation and transfers from bed to chair to toilet to shower, etc. is safe. Again, the stronger, in particular, your quadriceps are – those muscles that you use in squatting down, standing up, squatting down – those muscles are so, so, so important. If individuals need assistance with walking, we need to give it to them. Because lying in bed is really, really bad for you and sitting is bad for you.
Short story: exercise, walking, and maintaining quad strength are incredibly important. When you think of the biomechanics of walking, the first motion is flexing at the hip. So there are tiny little muscles in the groin area that cross the hip bone that begin the step, and that lifts up the knee. But then all of the weight of the motion of walking is shared right across the top of the thigh and over an insertion into the front of the knee. That big, long strap muscle needs to be strong or you see the stumbles and the shuffling and the falling forward, which is the typical injurious fall.
What are the next steps to further your work in this area?
A big question is whether or not we can modify confidence. We have just been talking about modifying physical activity in a positive sense, i.e. doing more exercise and being more fit and strong and having more balance. But an interesting question is what about modifying our confidence not to fall? Could that actually be beneficial?
Could we do something with older adults that would enhance their self-confidence, which in turn would lead to participating more in physical activity and walking. Again, this is because of this fear of falling leading to falling negative spiral that I talked about earlier. We don’t know the answer to that right now, but there is a lot of interest by researchers to see if there can be particular skills training that will boost confidence. Because if you are more confident you’ll go out and walk, and if you’re not confident you may not.
Are there other things that came up in the course of this study that you want to highlight? Things that surprised you or were particularly noteworthy?
Yes, I would say one more thing. There is this question that researchers use all of the time with older adults and other people, this so-called self-rated health question. Basically, it’s where you ask an individual how they would rate their health today and they have five choices: poor, fair, good, very good, and excellent.
We asked that question in our study, like many other researchers have, and it was just a reminder once again how powerful that one single question is and how correlated one’s self-rated health is with other things like depression, physical activity, and even more global questions of life satisfaction and well-being. We talked about it on our research team, and we’ve come to the conclusion that clinicians should really ask this question in practice much more often than they do.
Often you are doing a thorough particular assessment of walking or balance or strength – but even getting an answer from an older adult that falls into one of those categories, we now know from the scientific literature how tightly that answer is related to other important health outcomes. So we would really like to encourage clinicians – whether they are occupational therapists, physical therapists, nurses, physicians – just one quick question can really highlight a group that may be at risk. It is very, very telling when older adults slide down from very good to good and into fair. The curve just dips so, so significantly. So we need to really work at having “excellent” be the response people give when asked to rate their own health.
Cathy Lysack, Ph.D., OT(C), is the deputy director of the Institute of Gerontology and a professor of occupational therapy and gerontology at Wayne State University in Detroit, Michigan. An occupational therapist by profession, she received her Ph.D. from the University of Manitoba, in Winnipeg, Canada, and joined Wayne State as an assistant professor in 1997. Her major research interests include the social and environmental influences on health and understanding how older adults and people with disability redevelop active and meaningful lives in the community after illness and injury. She has studied aging and depression, the independence and safety of older adults who live alone, the impact of spinal cord injury on community participation, mobility loss after hip fracture, and downsizing residential moves in later life.
Questions or comments? Contact Jeanette @ email@example.com or @ (551) 655-3079.
The prevalence of Alzheimer’s disease today is unprecedented in human history. Presently, more than 5 million Americans have a diagnosis. In Michigan alone, roughly 180,000 individuals are living with memory loss. Approximately every 68 seconds, someone develops the disease. By 2050, the numbers are projected to increase to between 11 and 15 million nationwide. Alzheimer’s disease is the 6th leading cause of death in the U.S., and it is the only cause among the top 10 that cannot be prevented, slowed, or cured.
The cost of Alzheimer’s disease is high. This year in the United States, we will spend more than $200 billion caring for people with Alzheimer’s or another dementia. Unfortunately, family caregivers are absorbing a majority of this burden. In fact, in 2012 15.4 million caregivers provided an estimated 17.5 billion hours of unpaid care, valued at more than $216 billion, in the United States.
Family members are often the front line of Alzheimer’s care, but they may lack the appropriate support, resources, or education needed to execute their job effectively. Caregiving can be extremely taxing work, and dementia caregivers are particularly at risk for burnout, distress, and other negative outcomes. Research indicates that dementia caregivers have poorer physical, mental, and financial well-being, than their non-caregiving counterparts. Caregivers are also more likely to experience depression, anxiety, reduced immune function, increased incidence of disease and mortality, as well as disruptions in employment and depleted incomes.
November is “National Alzheimer’s Disease Awareness Month” and “National Caregiver Month”. If you know someone who is a caregiver, show them your support and offer respite. Learn more about this special month and pay tribute to a caregiver here.
If you are a caregiver for someone with Alzheimer’s disease or another dementia, consider following these 10 tips to being a healthier caregiver:
1. Understand what’s going on as early as possible.
Symptoms of Alzheimer’s may appear gradually. It can be easy to explain away changing or unusual behavior when a loved one seems physically healthy. Instead, consult a doctor when you see changes in memory, mood or behavior. Don’t delay; some symptoms are treatable.
2. Know what community resources are available.
Contact your local Alzheimer’s Association office. The staff can help you find Alzheimer’s care resources in your community. Adult day programs, in-home assistance, visiting nurses and meal delivery are just some of the services that can help you manage daily tasks.
3. Become an educated caregiver.
As the disease progresses, new caregiving skills may be necessary. The Alzheimer’s Association offers programs to help you better understand and cope with the behaviors and personality changes that often accompany Alzheimer’s.
4. Get help.
Trying to do everything by yourself will leave you exhausted. Seek the support of family, friends, and community resources. Tell others exactly what they can do to help. The Alzheimer’s Association 24/7 Helpline, online message boards and local support groups are good sources of comfort and reassurance. If stress becomes overwhelming, seek professional help.
5. Take care of yourself.
Watch your diet, exercise and get plenty of rest. Making sure that you stay healthy will help you be a better caregiver.
6. Manage your level of stress.
Stress can cause physical problems (blurred vision, stomach irritation, high blood pressure) and changes in behavior (irritability, lack of concentration, change in appetite). Note your symptoms. Use relaxation techniques that work for you, and talk to your doctor.
7. Accept changes as they occur.
People with Alzheimer’s change and so do their needs. They may require care beyond what you can provide on your own. Becoming aware of community resources — from home care services to residential care — should make the transition easier. So will the support and assistance of those around you.
8. Make legal and financial plans.
Plan ahead. Consult a professional to discuss legal and financial issues including advance directives, wills, estate planning, housing issues and long-term care planning. Involve the person with Alzheimer’s and family members whenever possible.
9. Give yourself credit, not guilt.
Know that the care you provide does make a difference and you are doing the best you can. You may feel guilty because you can’t do more, but individual care needs changes as Alzheimer’s progresses. You can’t promise how care will be delivered, but you can make sure that the person with Alzheimer’s is well cared for and safe.
10. Visit your doctor regularly.
Take time to get regular checkups, and be aware of what your body is telling you. Pay attention to any exhaustion, stress, sleeplessness or changes in appetite or behavior. Ignoring symptoms can cause your physical and mental health to decline.
2013 Alzheimer’s Disease Facts and Figures
Take Care of Yourself Alzheimer’s Association brochure
Why conduct a needs assessment?
Older adults are the fastest growing segment of the population. With mortality rates declining, particularly among the oldest segment, there will be more need for services to help maintain older adults’ well-being and quality of life than ever before. At the same time, funding for aging services remains stagnant at best, whether it comes from Federal or State grants or from local property taxes. A carefully conducted community based needs assessment helps to identify the needs of the older population within a particular place. It provides valid and reliable data to inform and guide the planning, targeting, and delivery of local aging services to help make the expenditure of public funds more effective and efficient.
The IOG has a long track record of conducting older adult needs assessments at the state, county, and city level. Most recently, we reported findings from a needs assessment of older adults in Calhoun County, Michigan. Our report was based on a broad population survey, a stakeholder survey of service providers, leaders, and experts in the local aging network, and several focus groups of aging service clients from around the county. We followed community based participatory research (CBPR) principles and pursued a multi-method data collection strategy, an approach that results in a deeper and richer understanding of the local conditions and unique circumstances and needs faced by the county’s older adults.
What did we learn?
We found that the needs of older adults in Calhoun County vary significantly by health, socioeconomic status, family and living circumstances, and geography. In a broad sense, those who report needing the most supportive services tend to have below-average health, functional or sensory limitations, lower income, lower levels of education, and be single or widowed and living alone in rental housing located in Battle Creek or Albion. However, the older population of Calhoun County is quite diverse, and a great many older Calhoun residents in need do not fit this profile. Plenty of married homeowners in Marshall and Tekonsha and Newton Township also report a need for services to help them maintain their health and independence at home. When it comes to older adults and aging services, one size does not fit all.
The most needed services reported by Calhoun’s older population fall into a few basic categories: Health, independence, and information. Although the vast majority, particularly those age 65 and older, have health insurance, their insurance coverage often does not extend to dental, vision, and hearing services. Those were among the top needed services identified across our three major data collection efforts, in addition to exercise and wellness programs for seniors.
Home repair, chore, and maintenance assistance to help older county residents stay in their homes are the top needed independence services, along with utility assistance for those in financial need and transportation for those who do not drive. In the category of information, stakeholders and focus group participants alike called for more outreach and public awareness efforts, enhanced information and assistance services, and innovative ways of providing access and informing older adults about the options and services that may be available to them.
While rural-dwelling survey respondents were less likely to report living alone and more likely to report having friends and family members they can count on for help, focus group participants from rural areas were more likely to report feeling lonely and isolated. Seniors in sparsely populated areas especially value opportunities to socialize with fellow seniors, so they value the wellness and congregate meal programs not only for their health benefits, but because they facilitate peer interaction as well.
Our focus groups and key stakeholders survey helped us not only to gauge the level of need in the community, but also to gather ideas about ways in which service delivery can be improved. Many participants advocated for greater community partnership, for reaching out beyond the aging network to collaborate with other groups and businesses that have an interest in serving the older population. Churches, service and fraternal clubs, coffee shops and diners, and other locally based organizations may be enlisted to help distribute information, identify seniors in need, and provide an access channel to services. Those already providing aging services can work together more closely to coordinate services, reduce duplication, and close gaps.
What does it matter?
This is just a brief overview of our findings; a copy of our detailed report is available upon request. Of course, the ultimate purpose of a needs assessment is not merely to produce a report, but to inform and guide action. We are pleased that our community needs assessment results have already helped the Calhoun County Office of Senior Services and the Region 3B Area Agency on Aging determine where and how to allocate funding that better responds to the needs of older adults in their county. They have consolidated dispatch and transportation programs to save money and provide better service. They have developed pilot programs for cost-effective chore and home modification services. They have increased funding for dental, vision, and hearing assistance. They have initiated efforts to integrate whole person wellness, health screening, congregate meals, recreational programs, and benefits counseling into combined sessions in rural areas to promote social engagement, reduce isolation, and provide increased access to services. And they are expanding efforts to coordinate services and build relationships with service providers and community organizations. These are just some examples of the ways in which needs assessment research can be used to help strengthen community efforts to support older adults while enhancing effective stewardship of public resources.