Planning for the Future or Feeling Old - Older People’s Reasons for Moving to Senior Housing in Sweden

Moving accommodation in old age challenges the idea of aging in place. This study describes older people’s (M = 80 years) reasons for moving to senior housing in Sweden and whether different reasons were related to the participants’ background characteristics.

A Critical Examination of Senior Housing: Promoting Equity Through Ensuring Safe Spaces

As affordable senior housing communities aimed to address the health and well-being concerns of residents in the COVID-19 pandemic, special attention to safety during renovation had to be addressed. This paper offers case studies from members of a city-wide advocacy group, Senior Housing Preservation-Detroit. Eighty one percent of covid deaths in the City of Detroit are those 60 and above; 81.2% of deaths have been among African Americans (Detroit Health Department, 2021). With the grief and challenge in a city hit early on in the 2020 pandemic, these case studies will highlight how Covid-19 affected planned projects in senior buildings, how stakeholders such as developers, staff and residents responded and key considerations for future emergencies affecting senior housing communities. This paper offers critical perspectives applicable to many urban landscapes in order to raise awareness to policy makers, and practitioners.

Challenges of Implementing the PRISM 2.0 Trial for Supporting Social Connectivity Through Technology

Following the success of the Personal Reminder Information and Social Management (PRISM) trial, which found that a specially designed computer system for older adults can enhance social connectivity and reduce loneliness among older adults at risk for social isolation, the PRISM 2.0 trial sought to replicate and extend these results to a new technology platform (tablet rather than desktop) with expanded social features and diverse populations of older adults, including older adults living in rural areas, assisted living communities, and senior housing. This symposium discusses the aims of the trial conducted by the Center for Research and Education on Aging and Technology Enhancement (CREATE), challenges encountered (including challenges related to the COVID-19 pandemic), and solutions to those challenges. S. Czaja will begin with an overview of the PRISM 2.0 system and the trial. J. Sharit will discuss challenges encountered working within the context of assisted living facilities and with impaired participants. This will be followed by a discussion of technical challenges encountered during the course of the trial presented by N. Charness. W. Rogers will present training issues involved (both with respect to participants and assessors). Finally, W. Boot will describe challenges encountered with measuring and quantifying technology use during the trial. Lessons learned are applicable to many types of technology interventions administered in diverse contexts. D. Plude, Deputy Director in the Division of Behavioral and Social Research of NIA, will serve as discussant.

Experiencing the COVID-19 Pandemic at Age 85 and Over: An MIT AgeLab Study With the 85+ Lifestyle Leaders Panel

The oldest of older adults remain at the highest risk of developing severe illness, requiring hospitalization, or dying if infected with COVID-19. As a result, the discourse about the COVID-19 pandemic has centered on short-term sacrifices to “protect” older adults. Yet much remains to be known about the prolonged impact of the pandemic on the over-85 age demographic. This symposium shares findings from a longitudinal, mixed methods study with the MIT AgeLab’s 85+ Lifestyle Leaders panel, a panel of octogenarians and nonagenarians convened since 2015. This symposium offers an update to a 2020 GSA session shared regarding the initial, cross-sectional work conducted in March 2020 with this panel. Findings will be drawn from a series of 85 interviews with 15 participants, 14 focus groups (x̅ participants=19.3), and three surveys (March 2020, N=28; August 2020, N=18; November 2020, N=16) conducted with the panel regarding the impact of the pandemic on this group over the past year. The first presentation covers the Lifestyle Leaders’ adoption and use of technology throughout the pandemic, with a focus on telehealth. The second takes an in-depth look at the unique lived experiences of Lifestyle Leaders living in senior housing communities during the pandemic. The third explores the Lifestyle Leaders’ perspectives on cultivating resilience and caring for their mental health while in a pandemic. Finally, the fourth presentation shares the Lifestyle Leaders’ experiences with social isolation and loneliness during the pandemic, with a focus on how family relationships and engagement in intergenerational programming have changed.

Lifestyle Leaders’ Experiences in Senior Housing During the COVID-19 Pandemic

Millions of older adults living in close communal contact in senior housing communities remain vulnerable during the COVID-19 pandemic. Approximately 30% of Lifestyle Leaders currently live in senior housing. This presentation will cover the unique challenges these participants have encountered, including experiences with and the impact of changing norms and pandemic-related policies within communities over time. In March 2020, 75% of Lifestyle Leaders rated the response of their senior housing community to COVID-19 as “Excellent” or “Very Good.” In August 2020, they reported they believed they were less likely to contract COVID-19 living in senior housing compared to people not living in senior housing (80%). Interview data revealed Lifestyle Leaders in these environments held favorable views toward their communities. This presentation will further discuss how the Lifestyle Leaders who do not live in senior housing perceive senior living and how these perceptions have shifted during the pandemic.

Using Smart Speakers in Low-Income Senior Housing to Enhance the Aging in Place Experience: Stakeholder Views

Smart speakers provide a platform that can integrate smart home technology and/or safety devices within the home to enhance quality of life and independent living for older adults. However, few attempts to utilize this technology specifically within low-income senior housing (LISH) residents have been documented. Our purpose was to explore different stakeholder perceptions about the use of smart speakers to support aging in place in older adults living alone in LISH. Smart speakers were deployed in individual LISH apartments, equipped with a voice technology-based aging in place solution for the facility. A qualitative analysis of semi-structured interviews using a constant comparative approach for emerging themes was conducted (n=10: older adult users, n=2: housing staff, n=2: voice technology developers). The three participant groups showed diverging perceptions in terms of benefits, uses, and stakeholder interests. Older adults found smart speakers useful in four main areas: assistance with daily tasks, feeling connected, safety measures, and emotional wellbeing. The two other groups showed a broader interest in the use of the smart speaker device, such as residential management tools and communication channels in addition to its potential use as safety and wellness tools. Older adults experienced significant difficulty setting up desired functions or finding instructions, which restricted utilization of the technology to a limited set of tasks. All stakeholder groups addressed a need for formal training or personalized tech support for older adult users. Findings indicate the importance of developing deployment strategies tailored to the needs and characteristics of the target user group.

PRISM 2.0: A Technology System to Support Resource Access and Social and Cognitive Engagement

Social isolation and lack of engagement are common among older adults and present a risk for emotional, physical and cognitive decline. Technology offers the potential of remediating these risks and enhancing opportunities for connectivity. In this paper we present an overview of the PRISM 2.0 multi-site RCT, which evaluated a simple to use Personalized Reminder Information and Social Management System (PRISM) among a sample of two hundred and forty-eight adults age 65+ in diverse contexts (Rural Locations, Assisted Living Communities and Senior Housing). PRISM 2.0 is a tablet-based system, intended to provide support for access to resources and information, new learning, social and cognitive engagement, and memory. We describe the goals and content of PRISM, the user-centered design process, and measurement strategies. We also discuss the challenges of conducting the trial during the COVID-19 pandemic and the strategies used to adapt the trial protocol within the three contexts.

The Enactment of Care: Lessons Learned From a Multisector Coalition Advocating for Those Living in Senior Housing

This presentation explores how a coalition, Senior Housing Preservation-Detroit, considered and planned for “care” in senior buildings in Detroit, Michigan. Detroit was one of the American cities affected in the early days of the pandemic; the coalition pivoted its work in creative, collaborative ways which included understanding the rapidly changing context for those living in low-income senior buildings. Older minority adults have been shown to be disproportionally affected by COVID-19; the coalition successfully advocated for testing to be brought to senior buildings (and now vaccine distribution) and addressed mask distribution and food insecurity in several senior buildings (see Archambault, Sanford and Perry, 2020). Without the long-established partnerships, “care” could not have been as coordinated, multi-sector and trusted. The presentation will discuss lessons learned that can be applied to future challenges in supporting the well-being of residents as they negotiate their residential spaces.

From Margin to Center: Intersectionality and the Politics of Environmental Gerontology

As the population becomes increasingly older and culturally diverse, so too does the need for critical scholarship that examines the complex lives of differently positioned older adults in relation to their social and physical ecologies. This innovative symposium reflects the importance of putting intersectional frameworks (Collins & Bilge, 2016) in conversation with environmental gerontology to critically examine structures of power in assessing who matters and who benefits from place-based initiatives that intend to support healthy aging (Phillipson, 2004). Perry et al.’s paper addresses the politics of responsibility, asking who is responsible for keeping older people safe in light of Covid-19 though a citywide senior housing coalition in Detroit. The second paper, authored by Johnson, speaks to the politics of access and structural inequalities that create disparities in end-of-life care for unhoused older adults. The third and fourth papers, by Stinchcombe and colleagues and Oswald, critically examine dominant paradigms of age-friendliness in Canada and the United States though a politics of representation that highlights who is (in)visible in these initiatives. The final paper by Reyes, on the civic participation of Latinx and African American older adults, illustrates how structural change cannot happen without engaging these populations in the political process. Together, these papers exemplify the politics of environmental gerontology and demonstrate that without acknowledgment of multi-layered identities and the structures contributing to their inequities, environmental gerontology is inadequate, as it may overlook important social and environmental factors that connect older people to the places where they live and die.

Reinventing Housing Care: Environmental Negotiations Made in Congregate Settings During COVID-19

The COVID-19 pandemic prompted an urgent reconsideration of space and place within congregate housing. Research has only underscored the need for health-promoting physical alterations to residential environments (Peters & Halleran, 2020), but also generated lasting questions about the relationships between congregate environments and their residents, visitors, and workforce —among them, what ways can environments be negotiated to reduce risk (Dosa et al., 2020)? How can environments enact care for formal caregivers (Chen & Chavalier, 2021)? Who might be challenged by this care which may question the dangers associated with proximity (Lynn, 2020)? This symposium focuses on the ways stakeholders within congregate housing observed, related to, and negotiated changes to space and place during the pandemic. Paper 1 presents an organizational case study investigating provider perspectives of how housing and healthcare responses to COVID have shaped palliative care with unhoused patients during the pandemic. Paper 2 highlights the collaborative work of a multi-sector coalition working to address timely needs of residents in low-income senior buildings. Paper 3 reflects on the formation of a cross-national senior housing network and the interdisciplinary exchange of best practices and policy recommendations that emerged. The collective findings of these papers challenge previous notions of care in congregate environments, illuminate how provider networks respond to crises and share emergent knowledge, and consider how institutional decisions about the pandemic have re-placed and re-spaced provider and patient experiences. This symposium offers observations and strategies that may assist in envisioning successful congregate care during COVID-19 and beyond.