The year 2020 brought many challenges to Senior Center Directors and those concerned with senior health and well-being. Restaurant Voucher Programs (RVP) have proven successful in other areas such as Vermont and North Carolina and can be replicated to address nutrition and socialization needs of today’s active senior. The challenges provided by 2020 allowed us to gain new perspectives and inspire new ideas and processes aimed at serving our senior population. RVP services are available to participants 60 years of age or older, or disabled between the ages of 18 - 59. All participants will be required to enroll at our Senior Center and complete the Enrollment Package documents. There is no cost for program participants. Participant donations are elective and are sent to the local Area on Aging. Our Senior Center will fund this program and seek collaborative funding sources who are concerned with senior nutrition and socialization. Participants are required to attend one RVP nutrition meeting per quarter to remain active on the program. RVP meeting location and times will be publicized through social media and print publications. The nutrition meetings are an excellent way to connect with people participating in the program and to learn more about health and nutrition. Voucher meals are for participants only. Participants may not use their vouchers to cover any meal other than their own. Participants are required to present both their identification and voucher at the beginning of each dining experience. Vouchers consist of a two part form which are signed and dated at the time of service. The restaurant site will retain their copy and return that copy to our Senior Center for reimbursement. Our Senior Center will reimburse participating restaurants at a negotiated rate. Vouchers for meals are available for pickup at our Senior Center and other convenient satellite locations (to be determined) on the first three business days of each month. Each voucher contains 12 numbered vouchers and a receipt acknowledgement. The Nutrition Coordinator maintains all administrative functions of the program. Platte Senior Services, in collaboration with our local Area Agency on Aging, is excited to offer the RVP to area seniors and believe it to be sustainable and have a positive outcome for our area Seniors.

Anne Rogers, Executive Director, Platte Senior Services, Inc.

Background: Since 2017, over 500 elderly individuals living at home with chronic health conditions in or near the Orlando metropolitan area have been the recipients of support visits by community paramedics. A non-profit health planning and services organization applied for and obtained $850,000 in pilot funding grants to test using community paramedicine to extend primary care into the home. Unlike the typical Emergency Medical Services (EMS) approach where paramedics working under a medical director triage, treat, and transport patients, this unique program accepts patients referred by their physician for chronic care monitoring and self-care education. The program has transitioned from primarily grant funding to contracts with medical groups, hospitals, employers, and health plans. Staffing has increased from one to ten paramedics. Target Audience: Individuals cared for are primarily over age 65 and live at home with Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, Chronic Kidney Disease, Hypertension, Diabetes, and other chronic health conditions. Goals: National certification and state licensing ensures that paramedics learn a broad scope of treatment interventions. Community paramedics have additional training and experience in patient assessment, mental health, nutrition, pharmacology, and plan of care. Home visits expose them to not only the usual clinical challenges but also to many environmental factors that have the potential to impact health. Paramedics have found squatters, hoarding, food insecurity, insect infestation, clogged air filters, inoperative smoke detectors, and easy access due to broken windows and doors when caring for these individuals. By identifying community-based organizations and vetted businesses that address each of these issues, the paramedics are able to bring short and long term solutions to environmental conditions that aggravate health concerns. While unique in its approach when compared to EMS operated community paramedicine programs, extending primary care into the home this way can be replicated elsewhere. This session will describe the success of the current program and provide insight into how it may be implemented in communities of all sizes.

Kenneth Peach, Executive Director, Health Council of East Central Florida / Care-A-Medix

Older adults are considered to be at a high risk of complications related to COVID-19 and should be socially isolated to reduce their risk. With this recommendation in addition to restrictions against in-person meetings, the delivery of traditional in-person health education programs has been halted. This creates challenges as older adults, who benefit from health education with extended longevity and improved functional status, are largely unable to access health education through conventional channels like in-person lessons at their local senior center. Social distancing guidelines due to the risk of COVID-19 infection have led to other psychological and physical health effects such as social isolation and feelings of loneliness, which can be associated with worsening memory and impaired cognitive function. To combat this problem, a health education program for older adults in northeast Georgia developed multiple innovative strategies to recruit and deliver remote health education services to this population while complying with COVID-19 safety guidelines. At the onset of the pandemic, the health education program was in the process of delivering a general health and wellbeing class which had to be moved from in-person to over the phone, which resulted in a drop in participation. In the summer of 2020, the health education program held farmers’ markets in conjunction with local senior centers and a national partner. The farmers’ markets, which were traditionally held indoors and allowed participants to individually select their produce, shifted to a drive-through format to minimize contact. In the fall, the program developed and scheduled to hold a virtual book club and a walking support group using a teleconferencing platform as a mode of delivery. The program also offered a workshop series on general health and wellbeing which was delivered using a video conferencing platform. Throughout the pandemic, the program used social media, teleconferencing, and videoconferencing platforms to recruit participants and deliver health education content. This included weekly live-streamed nutrition lessons with cooking demonstrations, recorded videos on physical activity and exercises that can be done from home, healthy recipes, and articles pertinent to the target population. There were barriers and challenges experienced in providing remote services to the older adult population during the COVID-19 pandemic. Low recruitment and limited participation of program offerings was evident. Though the general health and wellbeing workshop experienced increased participation compared to the program’s previous attempts at remote education, engagement was still well below what was typical for in-person activities. The goals of this presentation are to discuss the challenges and barriers experienced during the COVID-19 pandemic in providing remote services to older adults in Northeast Georgia. The lessons learned are helpful for providers in adapting to this new remote environment for delivery of services. The target audience for this presentation includes senior center directors and staff and other individuals that provide direct health and wellness services to older adults.

Lesley Clack, Assistant Professor, University of Georgia

Brittani Harmon, Clinical Assistant Professor, University of Georgia

Kyle Hunsinger, Graduate Research Assistant, University of Georgia

The Northern Virginia Falls Prevention Alliance and Marymount University have supported the delivery of the SAIL program over the last 4 years. Due to the emergence of Covid-19, many facilities closed last year, and older adults lost their ability to participate in health promotion and falls prevention activities. SAIL leaders in northern Virginia devised mechanisms to successfully deliver SAIL virtually using Zoom and other online platforms. They also implemented SAIL leader training classes, and provided fitness checks in outdoor venues. To date, 8 SAIL leaders have been trained at an outside venue and over 12 virtual SAIL sessions have been offered. This Ignite session will highlight the lessons they learned so that other facilities and SAIL leaders can successfully transition their SAIL programs ‘outside’ as needed. The target audience for this ignite session includes individuals responsible for coordinating and/or leading health promotion and exercise programs for older adults at community/senior centers and independent living facilities and SAIL program leaders.

Sara Pappa, Assistant Professor, Marymount University

Cathy Elrod, Professor, Marymount University

When someone has been recently diagnosed with a visual impairment, they begin a journey for which they are generally unprepared and may have many questions. More than 25 million Americans report trouble seeing yet few know about or receive the help they need to continue to live independent lives. In fact, less than 3% of individuals who are eligible for vision rehabilitation services receive them due to lack of knowledge of services or inability to access them. Vision loss can have major consequences and entirely disrupt people’s lives. Thus, it is critical for older people with vision loss to find out that help is available. The Getting Started Guide, provided by the American Printing House for the Blind ConnectCenter and Readers Digest Partners for Sight Foundation, can help navigate the journey. It does not provide the answers to all questions, but it does point older people in the direction of finding the tools, information, support systems, and guidance they may seek during this new and challenging time. Additionally, The Guide is filled with evergreen tips and techniques that people can use right away. The APH ConnectCenter recognizes that we live in an ever-changing world and, in a post-COVID-19 reality, we understand that people who are new to vision loss may have to rely more heavily on virtual support systems. To meet that need, The Getting Started Guide is provided in many formats, including print, web, social media, apps, and our toll-free hotline. All of these are provided free of charge. It is important for older people with vision loss to know that they are not alone. Armed with knowledge and support, they can learn the skills and techniques needed to continue to do things they enjoy and live at their maximum independence level. In this session we will discuss several actionable steps and things to consider such as: what to ask during the eye exam, the difference between an eye exam and a low vision evaluation, vision rehabilitation services, access technology, how to locate support and other resources, and transportation. We will also share easy modifications that can make the living environment safer for someone experiencing vision loss.

Melanie Peskoe, Digital Content and Engagement Specialist, American Printing House for the Blind ConnectCenter

There have been long-standing and mutually beneficial partnerships among the NC Division of Public Health Injury and Violence Prevention Branch (IVPB), Healthy Aging NC (HANC), and the NC Falls Prevention Coalition (NCFPC) for over 13 years. These partnerships are supporting data-driven falls prevention work at local and state levels in North Carolina. The goal of this presentation is to share how statewide data sharing and partnerships benefit falls prevention efforts. While unintentional falls continue to be underreported and difficult to count, the NCFPC and HANC have worked closely with the IVPB to better understand and utilize available data. Partnerships with epidemiologists at IVPB are strengthening the work of statewide partners. For example, epidemiologists are educating partners about accessing applicable publicly available data, by helping to review data sources listed on the state falls prevention coalition website and presenting to the coalition. Epidemiologists share strengths and limitations of available surveillance data to ensure that partners are able to make informed data-driven decisions within program planning and evaluation. The NCFPC just completed the 2021-2025 Action Plan. One of the Plan’s guiding principles is to develop and implement data-driven objectives and decisions, which will be supported through this collaboration. The IVPB also provides data to populate the annual Falls Prevention Awareness Week proclamation that is signed by the NC governor and to support successful grant proposals. IVPB develops or populates dissemination products such as the Special Emphasis Report on Fall Injuries to support the work of HANC and NCFPC and seeks feedback from HANC and NCFPC to ensure data dissemination materials are useful and relevant to the work of these organizations. This partnership has also helped HANC and NCFPC members begin to better understand ICD-10-CM coding, which in turn can help partners to create value propositions and educate providers about coding implications for quality falls prevention data. This will help improve the completeness and accuracy of surveillance data. This session will highlight some of these examples through specific success stories and provide ideas for future collaboration. Audiences that may benefit from this presentation include all stakeholders involved in local and state falls prevention coalitions, those working in state divisions of public health and health and human services, and health care organizations.

Ellen Bailey, Falls Prevention Program Manager, North Carolina Center for Health and Wellness

Ingrid Bou-Saada, NC Department of Health and Human Services, 

Shana Geary, Injury Epidemiologist, Division of Public Health, Injury and Violence Prevention Branch NC Department of Health and Human Services

Public libraries frequently offer programming for aging adults. However, Makerspace Librarians are encouraged to market their offerings to youth and to entrepreneurs. After observing how seniors flocked to library crafting programs, one library department decided to find a way to specifically support the aging community through creative classes. After applying for a receiving a grant from the Next 50 organization, a federal agency devoted to funding programs and support systems for adults over 50, librarians worked with local agencies on aging and peer focus groups to create a year long series of classes by and for seniors in their community. Through classes by local artists, photographers, and poets, attendees learned new skills, created beautiful pieces of art, and most of all, forged meaningful friendships. This community of crafters has supported each other through illnesses, deaths of loved ones, and a global pandemic. Public workers who facilitate programming in senior centers, libraries, assisted living facilities, and community centers will learn best practices for seeking funding for creative programs, creating diverse focus groups, identifying key stakeholders and presenters, facilitating group work, and supporting life long learners.

Sharon Rice, Makerspace Librarian, Pueblo City-County Library District

Tai Ji Quan: Moving for Better Balance® (TJQMBB) is a research based twice weekly, twenty-four week balance and strengthening exercise class that reduces the incidence of falls by 58% in individuals 65 and older and by 67% in people with Parkinson’s disease. Additionally, it reduces injurious falls in people 65 and older by 75%. Despite significant falls reduction and functional improvement for older adults, many challenges to program implementation exist, including participant retention, Instructor training, and site support. With previous Administration for Community Living (ACL) funding, The Dartmouth Centers for Health and Aging (DCHA) developed an Implementation Workshop based in implementation science and informed by extensive training experience. Partners who completed the DCHA Implementation Workshop realized a significant increase in TJQMBB participant retention. The global pandemic added an instant challenge to all in-person evidence-based falls prevention programs. Informed by ongoing research, program developer, Dr. Fuzhong Li, was able to offer guidance to allow remote delivery of TJQMBB in the spring of 2020. We have been leading remote TJQMBB community-based classes since April. We have instituted remote Instructor and Implementation Workshop training and are working with partners throughout New England providing technical support to enable remote TJQMBB community-based programs. This session will review updates and tips for remote TJQMBB delivery and new implementation strategies for effective, safe and engaging remote TJQMBB classes for older adults.

Winston Churchill famously said, “Never let a good crisis go to waste,” He was referring to reconstruction and unification after WWII, but this can also be applied to our current situation and COVID-19. What can we learn from the COVID-19 pandemic to strengthen our organizations and work? For Juniper, this pandemic turned our service delivery models upside down. Prior to COVID-19, Juniper offered in-person health promotion and disease prevention classes to Minnesota’s older adults through over 100 provider partners. In March of 2020, COVID-19 forced Juniper to cancel more than 140 in-person classes. Just one month after that Juniper transitioned to virtual classes, and five months after that telephone classes were added. These changes, that would have normally taken us years, took a few weeks or months. In this ignite session we’ll cover lessons that the pandemic has taught us for planning and implementing organizational readiness to carry forward into a post-COVID world. These lessons include: Importance of a strong team. One thing we did not need to worry about in this pandemic was our team. We’ll share the key components of a strong team that have been important and why, including transparent communication, diverse skill sets and perspectives, and mission alignment. Pivoting with mission alignment. Before, during, and after COVID-19 Juniper’s goal remains the same, to enhance the health and wellbeing of Minnesota’s older adults. How we meet that goal has evolved. We'll share the choices we made to pivot our services from in-person classes to virtual and telephone, and the focus it took to get there. Becoming comfortable building as we go. We all want to do an amazing job and deliver a 100% perfect product, during a pandemic when change needs to happen quickly we don’t have the luxury of time for perfection. We’ll share Juniper’s experience of letting go of perfect, focusing on what our community members and provider partners needed, and building as we go. We’ll share the silver lining of this process, building stronger relationships with Juniper providers and quickly connecting to older adults during a time of isolation. Listen to the needs of the community and respond. Especially during COVID-19, it was critically important to listen to what our provider partners and older Minnesotans needed. To ensure we were making the right choices at the right time, Juniper needed to be acutely tuned in to the needs of the community. We’ll share key examples of this work, including the shift to virtual classes, addition of telephone classes, expansion of program offerings, and how connection became as important as content. See the opportunities. During challenging times, it can be hard to see the bright spots, the opportunities for growth and impact. Juniper wasn’t the only organization struggling to find is service-delivery feet and meet the needs of older adults. Other organizations were too. We’ll share how Juniper was able to meet a new need of a current health plan funder to strengthen this relationship and serve older adults.

Rachel Von Ruden, Program Developer, Metropolitan Area Agency on Aging

Jen Rooney, Program Developer, Metropolitan Area Agency on Aging

Harris County Precinct 2 with Commission Adrian Garcia is home to six community centers that host senior sewing classes and groups. Numerous senior citizens came together to teach their peers. Creative sewing projects were initiated for multiple fundraisers and community service programs like lap throws for nursing home residents, quilts, scarf, adult bibs and burial clothing for deceased newborns. Not only were they using their motor skills, but they socialized, left their homes for a few hours, and established a routine with their peers. Research has shown senior citizens who stay connected to their community and are not isolated live longer and healthier lives. On March 20th, 2020, Harris County Precinct 2 temporarily closed their community centers to adhere to CDC guidelines due to COVID-19. This meant the senior sewing classes would not meet and complete their sewing projects. Due to the popularity of our sewing classes and the nationwide shortage of face masks, we received a call from the Harris County Fire Marshall’s office with a unique request. They needed face mask for law enforcement officers who had to be quarantined from their families due to possible COVID exposure sustained in the line of duty. This request sparked the call to action for the Center Managers of these six community centers and the Senior Sewing Bridge was formed. The Senior Sewing Brigade answered the call to service and rapidly developed a safe system, donated their time, skills, and materials to sew masks. The Senior Sewing Brigade members had most of the materials and equipment to begin this project to save lives and reduce the spread of COVID-19. The elastic needed to secure the face mask was the material the members needed the most so the Community Center Managers reached out to community partners, who donated funds to purchase elastic. On April 3rd, less than a month after the community centers' temporary closures, the Senior Sewing Brigade had sewed 245 masks. These masks were immediately distributed to law enforcement, Precinct 2 staff and volunteers at food distributions, testing sites, and other community events. The Senior Sewing Brigade was again using their talents and skills to help save lives by making masks to help reduce the spread of COVID-19 within their community. After Harris County lifted the “stay home, stay safe” order, the Senior Sewing Brigade began to meet in the outdoor covered pavilions located within Precinct 2. To date, the Senior Sewing Brigade has sewn more than 4,000 masks, donating them to law enforcement, Precinct 2 employees and constituents, local nursing homes, fire stations, correctional facilities, and hospitals in New York, Georgia, and Florida. Commissioner Adrian Garcia, with Precinct 2, is dedicated to serving senior citizen constituents by providing safe and secure locations for them to meet, socialize and participate in various activities. The 94 members of the Senior Sewing Brigade were ready to give back the best way they knew, using their skills and talents to sew 4,000 masks and help save lives and reduce the spread of COVID-19.

Chara L. Bowie, LPC-S, Director of Health Services, Harris County, Precinct 2, Commissioner Adrian Garcia

Nineteen percent of older adults (13 million) have incomes below 150% of the Federal Poverty Level, leaving them with limited means to afford basic living expenses. Public benefits can help bridge the gap allowing older adults to better afford food, home utilities, prescription medicines, and healthcare. There are studies demonstrating the positive health outcomes associated with public benefits in older adults. It remains unclear how benefits may also improve subjective measures of well-being in older adults. To examine this question, baseline measures – including the CFPB Financial Well-Being Scale, the SF-36 health survey, and measures of food insecurity – were administered to older adults before they enrolled in benefits and again six months later after they were receiving benefits. Older adults were recruited from NCOA’s Benefits Enrollment Centers (BECs) and participated in phone interviews twice, once at baseline (wave 1) and again six months later (wave 2). Some of the older adults became enrolled in an additional benefit with the assistance of the BEC. Another group of older adults who participated in the study did not become enrolled in an additional benefit and therefore served as a control group. The analyses focused on the differences in measures of well-being, food security, health, and social functioning between wave 1 and wave 2. The control group allowed for comparison between those who did not become enrolled in a new benefit versus those who received the treatment (enrollment in a new benefit). The results suggest that older adults who enrolled in a new benefit such as the Supplemental Nutrition Assistance Program experienced positive changes in a few of the measures included in the study. These findings have implications for the social and behavioral determinants of health in older adults. Goal and Audience: The goal of this presentation is to share findings from a recent study, which will be relevant to audiences who work in public benefits outreach and enrollment.

Lauren Popham, Associate Director, Research and Evaluation, National Council on Aging

Marian Negoita, Senior Associate, SPR

Susan Silberman, Senior Director, National Council on Aging

Goals of Presentation: - Offer new perspective for growth The NCOA data indicates that 70% of senior center participants are female. While men make up a smaller over all percentage of seniors, more than the 30% accounted for as senior center participants need opportunities for socialization, self-efficacy and physical activity. In an effort to attract more socially isolated senior men to our senior centers it would behoove us to examine how we might incorporate more male oriented activities into our programming. In 2018 the Naples Senior Center male to female ratio was meeting the national average of 70% female and 30% male. After instituting one male oriented program, a men’s only coffee hour and discussion group with a male volunteer facilitator, by 2019 the Naples Senior Center ratio was 60 / 40. Men who came for the Guy Time coffee hour began to participate in other activities such as Current Events Group, Book club and Tai Chi. Learning Opportunities: - Deeper understanding of the people it will serve Men and women do not always socialize in the same ways. Gender roles and social constructs under which current senior men lived are strongly ingrained and senior centers need to recognize that some form of “Guy Time” is a possible format to open their doors to more socially isolated senior men. Once they feel established, men are often more open to participating in other senior center classes and programs that are mixed gender. This presentation will provide data and research on male socialization and projects such as Men’s Shed community projects which began in Australia and has spread to 14 countries including Canada and the United States and how local senior centers can adapt the concept for local conditions. This was a catalyst for the development of Naples Senior Center local projects. Local Examples: a. Guy Time coffee hour and discussion group was the NSC first foray into male oriented programs. Given the success of that the senior center manager began to explore other possibilities that would include more self-efficacy. b. Flag Boxes – working with the local Wounded Warrior group a partnership was planned to build flag boxes for the families of veterans who passed away. The Wounded Warrior group would do all of the cutting, screw setting etc. and the men of the Naples Senior Center put the boxes together, stain and polish them. The boxes would then be distributed to local Veteran’s Group upon request. Currently on hold due to COVID. c. Bird Houses – working with the local conservancy group a plan has been developed to build bird houses for local nesting species in South West Florida. Again, all of the prep work for the wood was to be done prior to its arrival at Naples Senior Center at which point the construction and finishing work would be accomplished. Currently on hold due to COVID. d. Other possibility explored was dog houses for the RSPCA. Project did not move forward due to space issues at the senior center.