Social isolation and loneliness (SIL) represent a growing public health and public policy concern, particularly among older adults. Half of older adults over the age of 60 are at risk of social isolation and one-third experience loneliness. SIL is a particular concern for individuals aging-in-place in low-density and rural areas. SIL increases the risk of premature death from all causes in older individuals, and results in $6.7 billion in additional Medicare spending annually. Tennessee is ranked tenth in the nation for risk of social isolation. Strategies to promote social connections are a critical step in designing age-friendly communities. A cross-sectional survey of a convenience sample of older adults (62 years and older) living in affordable housing apartment complexes in Hawkins County, TN was conducted in February and March 2023. Loneliness (UCLA 3-item Loneliness Scale), social isolation (Lubben Social Network Scale 6-item), and sense of community (Brief Sense of Community Scale) were assessed. Data were also gathered on demographic characteristics, health status, social engagement, and strategies to support older adults aging-in-place. Data from 82 participants aged 62 to 95 (73.14 mean age; SD = 7.00) were analyzed. The majority of participants were female (67%), non-Hispanic White (93%), lived alone (90%), and were retired (84%) with an average annual income less than or equal to $14,225 (43%). Nearly half (44%) report their health as fair or poor compared to others their age and 79% of participants have 4 or more chronic conditions. Overall mean loneliness score indicated moderate loneliness (mean = 4.9; SD = 2.08; range 0-9). 48% were at risk of social isolation (mean = 13.35; SD = 6.14; range 0-29). The total mean sense of community score was moderate (mean = 22.9; SD = 1.09; range 0-40). Factors associated with SIL will be analyzed using Pearson’s correlation test. Strategies to promote social engagement will be discussed. Living and growing older in rural communities is considered a primary risk factor for SIL. To support healthy aging, local efforts must include strategies to increase social engagement for rural older adults and their communities. Results from this needs assessment will be used to generate recommendations that can be used to improve social connectedness among older adults living in Hawkins County, TN.

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Activities of daily living (ADLs) are everyday routine tasks which provide insight into the physical and cognitive wellbeing of older adults. ADLs are commonly self-reported to clinicians, which can lead to overestimation and underestimation of a patients’ functional abilities. Remote health monitoring is an emerging field aimed at utilizing technology for monitoring ADLs remotely, improving clinical accuracy and enabling older adults to age safely within their homes. In this dissertation, we report a Smart Home platform and two indoor positioning systems (IPSs) – (i) a hybrid Bluetooth Low Energy (BLE) and radar motion sensor system and (ii) a hybrid radio-frequency identification (RFID) and infrared (IR) range-finding system for tracking occupant mobility, the primary predictor of falls among older adults. For the Smart Home platform, the design methodology and technological features were explained. As for the IPSs’, position accuracy of multiple occupants within multiple rooms of a residential apartment was evaluated. The systems were also evaluated for cost, implementation ease, and scalability, which, upon reviewing literature, were identified as key metrics for developing an IPS for enabling aging in place. Both IPSs enforced a decentralized localization architecture and performed well, achieving high localization accuracy for multiple occupants. / Thesis / Master of Applied Science (MASc) / By 2031, the number of people aged 65 and over is expected to nearly double. This population shift is concerning for healthcare providers as limited resources become increasingly constrained. Resultantly, older adults, the largest consumers of healthcare, face longer wait times and reduced quality of care. Remote health monitoring is an emerging field aimed at utilizing technology for monitoring older adults within their homes. In this thesis, we report a Smart Home platform and two indoor positioning systems (IPSs) for tracking resident mobility, the primary predictor of falls among older adults. For the Smart Home platform, the design methodology and technological features were explained. As for the IPSs’, position accuracy of multiple occupants within multiple rooms of a residential apartment was evaluated. Upon reviewing literature system cost, implementation ease, and scalability, were identified as key metrics for developing an IPS for enabling aging in place. Both IPSs performed well, achieving high localization accuracy for multiple occupants.

The population of adults over age 65 in the United States is expected to reach 89 million by 2050. This population growth will increase demand for aging services at the local and federal levels. Older adults are remaining in their homes in increasing numbers and are part of a paradigm shift that is transferring healthcare services from a centralized institutional model to a decentralized home-based model. However, a majority of homes older adults reside in lack basic accessibility features and are in predominantly suburban locations that have limited transportation options. Villages, a multi-faceted aging support program, were established to address limitations encountered by older adults as they age in their homes and communities. These volunteer-based, membership organizations are becoming a popular and rapidly adopted community-based intervention, but research on Villages has been limited. The purpose of this qualitative case study was to examine how two groups of older adults living in a suburban Naturally Occurring Retirement Community (NORC) aged in community. One group belonged to a Village and the other did not. The theory of residential normalcy provided the theoretical framework for examining how the older adults adapted to their environments through service use and support. Data analysis from interviews revealed four themes: access to information among the Village members and nonmembers; the role of social networks; useful services when aging in community; and the importance of trusted guidance as provided by the Village director. Because Village members have access to additional and consistent support sources, may be better able maintain residential normalcy and therefore age in community longer and more safely than non-members. / Ph. D. / The population of adults over age 65 in the United States is expected to reach 89 million by 2050. This population growth will increase demand for aging services at the local and federal levels. Older adults are remaining in their homes in increasing numbers and are part of a paradigm shift that is transferring healthcare services from a centralized institutional model to a decentralized home-based model. However, a majority of homes older adults reside in lack basic accessibility features and are in predominantly suburban locations that have limited transportation options. Villages, a multi-faceted aging support program, were established to address limitations encountered by older adults as they age in their homes and communities. These volunteer-based, membership organizations are becoming a popular and rapidly adopted community-based intervention, but research on Villages has been limited. The purpose of this qualitative case study was to examine how two groups of older adults living in a suburban Naturally Occurring Retirement Community (NORC) aged in community. One group belonged to a Village and the other did not. The theory of residential normalcy provided the theoretical framework for examining how the older adults adapted to their environments through service use and support. Data analysis from interviews revealed four themes: access to information among the Village members and nonmembers; the role of social networks; useful services when aging in community; and the importance of trusted guidance as provided by the Village director. Because Village members have access to additional and consistent support sources, they may be better able maintain residential normalcy and therefore age in community longer and more safely than non-members.

<p>Dedicated industry professionals from design, construction, and health care are working to provide attractive, constructible, functional and safe home modifications for aging in place. The commitment is to keep senior members of local communities in the homes they love, rather than to segregate them into big box retirement communities. This study explores the confidence level of both individuals interested in aging place for themselves and their friends and family members in aging in place modifications. In additions to those interested in aging in place for themselves and their friends and family members, invested professionals from design, construction and health care are surveyed to measure their confidence in common modifications. A 3d walkthrough is tested to investigate if confidence levels increase with the use of a walkthrough to communicate recommended modifications. <br></p><p> Friends and family members of those intending to age in place were significantly more concerned about the safety of their aging person, than the aging person themselves. Those friends and family members were also more impacted by viewing the video walkthrough than any of the other groups. </p>

Introducing concepts of Craftsman kit construction to the interior, as well as modern technology to lessen the cost of handcrafted details, opens the possibility to new methods of modular design in which interior units are configured around structural skeletons and central base points that provide supply lines to residential units. One example is Dutch design firm Minale-Maeda’s Keystones, a 3D printed connector that holds together any necessary components, like furniture. These keystones can be printed at home and save time and the need to obtain anything but essential components (website). The design firm works to create an “ongoing awareness of the possibilities of both mass-production and skilled craftsmanship” (L’arco Baleno, 2014). Another interesting example is Dutch design brand Fraaiheid’s Minimal Waste Table, which is created from one piece of laminated plywood with a CNC milling machine which makes for extremely minimal waste (Williamson, 2013). These examples of automation require a craftsman’s hand and mind to create the concept but introduce a modern approach to reducing waste, time and cost.

Thesis advisor: Christina Matz-Costa / Given the rising numbers of community-dwelling older adults in the United States (US), understanding the effect of home and community factors on health and well-being is critically important. Although important contributions have been made, most existing studies have used unidimensional measures of neighborhoods, which provide insufficient empirical evidence to develop holistic interventions. Also, despite the prevalence of disability among older adults, only a handful of studies have explored the effect of physical functioning in the relationship between home and neighborhood environments and older adults’ well-being. Finally, the role of the global assessment of community in mediating the effect of home and neighborhood environments on older adults’ well-being has not been explored. To fill these knowledge gaps, this dissertation examined the relationship between home and community environments and well-being (i.e., self-reported health, global assessment of community, and likelihood of aging-in-place) among adults age 65 and older (n=4,066). Based on the press-competence model, differences in hypothesized relationships by respondents’ physical functioning was also examined. Further, this dissertation explored the mediating effect of older adults’ global assessments of their community to see if the effect of home and neighborhood environments on older adults’ likelihood of aging-in-place operates through the global assessment of community. Data were analyzed from the AARP Age-Friendly Communities 2015 survey, which was collected from 14 communities in the US and includes 66 items capturing aspects of home and community environments under eight domains. Results of multi-level regression analyses suggest that both availability of resources and the fit between respondents’ needs and available resources are associated with their health, global assessment of community, and the likelihood of aging-in-place. The impact of home and neighborhood environments was greater among respondents with functional limitations and with low income. Home and neighborhood environments are associated with older adults’ likelihood of aging-in-place through their effect on the global assessment of community. These findings provide a fuller understanding of the impact of surrounding environments on older adults’ well-being, which will inform policy and practice efforts to better serve community-dwelling older adults. / Thesis (PhD) — Boston College, 2017. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

As individuals age, their likelihood of experiencing mental and physical problems increases, as does their risk of developing social isolation. Behavioral, physiological, and/or psychological changes are common manifestations of social isolation. Increased morbidity and mortality are the outcome. Ecological systems theory and social baseline theory provided the framework to explore 10 older individuals' perceptions of risk for social isolation and their perceived barriers to social integration. Data for this interpretive phenomenological study were collected from participant diaries, interviews, the 6-item de Jong Gierveld Loneliness Scale (DJGLS-6), the Lubben Social Network Scale 6 (LSNS-6), a demographic survey, and a social support profile. The Colaizzi method and interpretive phenomenological analysis were used to analyze diaries and interviews. Participant demographics, DJGLS-6, LSNS-6, and social support profile data were used to enrich descriptions of the participants and find other themes. Results indicated that most participants like living alone. However, more than half reported periods of loneliness and 4 reported estrangement from an offspring. Experiences of negative age-related treatment were described by many participants and most reported that transportation and mobility issues were the biggest barriers to social integration. Additionally, many participants reported that access to planned social activities would alleviate social isolation. Implications for positive social change arise from this research in the form of increased awareness of the experiences and perceptions of older individuals at risk for social isolation. Additionally, these findings can inform future research, policy change, and strategies for social isolation interventions and prevention.

Taiwan's population aging rapidly, making many current long-term care institutions, in their business model is extremely different from the past .The purpose of this study is to investigate the market supply and demand for long-term care institutions and the current operating status of the long-term care institutions in Kaohsiung area, thereby identifying the key successful factor of the institutions operating surface. This study adopts case study research of descriptive studies, by the way of in-depth interview to collect information on cases, and adopts Prof. Cher-Min Fong¡¦s ¡]National Sun Yat-sen University¡^the seven dimensions of the business model used, to analysis the competitive advantage of enterprises, as the main analytical tools, including the "product line strategy," "work processes strategy," and " Channel strategy " and "market segmentation strategy," " Services strategy," "strategy focused on the value of activities" and "Technology Strategy"; In addition to Michael Porter¡¦s "five forces anaysis model" and the external environmental factors as a supplementary analysis tools. Through six cases of the in-depth interview, this thesis research found that: The current domestic long-term care market, supply far exceeds the actual demand of about twice.The operating of long-term care institutions of conservation type, failed to actively cooperate with the government planning of aging in place, community service goals, adjusted operating strategies, result in more limited operation. In addition to five forces analysis found that the current operating environment of the existing institutions is adverse, and inter-industry bargain with serious competition, lower quality of care even more serious situation, but also the moral crisis will inevitably trigger controversy. Institutional trading competition, the lack of mutual contacts and exchanges, and their competitiveness also depends on whether the operator has the determination to develop long-term investment. The interview results, the next most important business strategy followed by "expansion of target markets and positioning," "increase services, outreach services," and "innovative services, commodities" and "improving the organizational structure and management system." The future as more competitors access will be serious competition and in the circumstances of difficult to reduce costs, strengthening marketing capabilities, to pursue the differences and decentralization strategy for the industry.

This thesis proposes a strategy to capitalize on the abundance of derelict service stations in Vancouver, BC, as a means to address the current crisis of seniors’ housing and services. Vancouver’s glut of vacant service stations reflects a widespread trend of service station closures across North America. As former service stations, these sites are commonly contaminated and have to undergo remediation before they can be rezoned for other uses. However, this network of sites has great potential for long term development. The goal is to create an alternative to the homogeneous seniors’ home currently available and establish a network of ‘Community Stations’ spread throughout the city. These sites will act as nodes to provide housing and services for seniors in the local community. The design is a phased development which will allow time for the site to remediate as well as, through community involvement, establish value and ownership.