Promoting Healthy Aging for Independence
May 2005, Vol. 10, No. 1
ISSN 1540 5273
Kenneth R. Tremblay, Jr., Ph.D., Luann K. Boyer, M.S.
Abstract
Educational efforts by the Colorado State University Cooperative Extension Gerontology Team to promote healthy aging for independence were reviewed in this article. The Gerontology Team was created in 1991 and was aligned with the university’s Gerontology Interdisciplinary Studies Program and its new Center on Aging. The development of a plan of work resulted in a number of programs offered statewide on important issues such as elder fraud, grandparents raising grandchildren, and home modifications. Workshops, fact sheets, monthly columns, and an annual newsletter have been used in these programs with positive evaluations. As the aging population increases in the U.S., demand for educational efforts to assist Americans to age in place will increase.
Purpose
The elderly population is growing faster than any other population segment. As the older population continues to increase, there is a need to provide information that will assist older persons in continuing to live independently in their homes. In 2000 there were 34.8 million Americans aged 65 and older, and this number is projected to reach 70.3 million by 2030 (Administration on Aging 2001). Much of this growth will be fueled by the baby-boom-age cohort, who will begin to turn 60 in 2006. Surveys reveal that approximately 85 percent of older persons want to remain in their homes for as long as possible, although one-half of those homes were built before 1960 (American Association of Retired Persons 2000).
The purpose of this article is to describe the educational efforts by the Colorado State University Cooperative Extension Gerontology Team to enhance independent living. The Gerontology Team was established in 1991 to promote the capacity of older adults to live independently through educational efforts that improve livability of homes and communities, consumer decision-making skills, and lifestyles.
Developing a plan of work
Under the leadership of Dorothy Martin (at that time an Assistant Director of Cooperative Extension), county agents interested in the elderly were identified. These county agents met with Martin during the Cooperative Extension in-service (an annual training session attended by state and county Cooperative Extension faculty at Colorado State University) in 1991. Through roundtable discussions, participants identified important issues to meet the needs of elderly constituents. These issues included housing, grandparents raising grandchildren, nutrition, and consumer fraud. Cooperative Extension specialists with expertise in the aging population were then asked to join the team, representing the fields of housing, nutrition, financial management, and human development and family studies.
Gerontology Team members also aligned themselves with the Gerontology Interdisciplinary Studies Program headed by Clif Barber in the Department of Human Development and Family Studies. This collaboration has been invaluable over the years as outreach efforts have been linked with instructional efforts at Colorado State University. A total of 210 students have completed the Gerontology Interdisciplinary Studies Program (a 21-credit-hour undergraduate curriculum leading to a gerontology certificate) since its inception, with at least two Gerontology Team members serving on its advisory board annually.
The Gerontology Team’s plan of work for 1997-2004 is emphasized here. This plan of work was partially developed based on data reporting the status of Colorado’s elderly population. Approximately 12 percent of Colorado’s population is 65 years of age or older, with the fastest growth rate among those over age 85 (Administration on Aging 2001). Colorado is among the states that have been designated as desirable retirement locations, and the state is likely to attract an increasing number of older persons in the future. About 85 percent of Colorado’s older adults own their homes (U.S. Census Bureau 2000). Most are relatively healthy, active, and self-sufficient (Colorado Department of Human Services 2004). A healthy diet, caregiving skills, financial decision-making skills, and housing modifications can extend the length of independent living.
Creating a team to develop a plan of work also involved consideration of the interests of Gerontology Team members. These members consisted of ten county-based agents (two of whom were county directors) and three university-based faculty housed in the departments of Food Sciences and Human Nutrition, Human Development and Family Studies, and Design and Merchandising. These individuals all volunteered to be members of the team based on their interest in issues of the elderly. All work teams had to fit into one of the core programs of Colorado State University Cooperative Extension, and Enhancing Families and Communities in Transition was selected as the best fit.
During a series of strategic planning meetings, participants determined that the Gerontology Team would produce an annual newsletter to inform county agents of developments in gerontology; write monthly columns on healthy aging practices; revise current fact sheets and determine the need for new ones; and create educational programs on home modifications, grandparents raising grandchildren, caregiving, nutrition, financial education, and elder fraud. Expertise existed with team members on these topics and they were identified as important issues. The educational programs delivered were also influenced by county commissioners and input from the public.
Newsletters, fact sheets, and monthly columns were selected as dissemination methods as they represented the media typically used by Cooperative Extension. Programs involving interactive workshops were conducted throughout the state in almost every county. Resources from Colorado State University Cooperative Extension were obtained to support these educational efforts. The team continues to meet once a year in conjunction with the annual Cooperative Extension Forum held at Colorado State University to review progress and to identify the next year’s activities. In addition, regular contact is maintained through a listserv.
The program
As of fall 2004 there were 78 healthy aging columns available to consumers containing recommendations ranging from lifestyle topics (such as nutrition and exercise), housing (such as home modifications and indoor air quality), and consumer decision-making (such as cyber-shopping and long-term care insurance). All healthy aging columns were mailed to newspapers statewide where they were widely printed and posted on the Cooperative Extension Web site (http://www.ext.colostate.edu/pubs/columnha/hamenu.html). Usage for the 2002-2003 time period ranged from 185 Web hits for “Starting an exercise program” to 4,206 hits for “Non-dairy sources for calcium,” for a total of 62,306 hits. A yearly newsletter was published to update county faculty on research conducted on the elderly around the nation, elderly issues specific to Colorado, and available resources. This newsletter was mailed each year to all 59 county Cooperative Extension offices.
Fourteen fact sheets (ranging in length from 4-6 pages) were updated or written covering housing, caregiving, grandparenting, fraud, long-term health insurance, and health issues. They received an average of over 1,200 hits a year (http://www.ext.colostate.edu/pubs/consumer/pubcons.html#elder). Printed copies of fact sheets were also made available to county offices for distribution at workshops. Examples of a newsletter, monthly column, and fact sheet are shown in Figure 1.
Figure 1. Gerontology publications: newsletter, healthy aging column, and fact sheet.
The elder fraud program received statewide coverage. Project Colorado was launched, consisting of a training video designed to help front-line staff in financial institutions spot and report elder financial fraud. The Gerontology Team was also involved in the Sweepstakes Sweep campaign in which sweepstakes mail was collected around the state to raise legislator awareness of common deceptions used by sweepstakes promoters targeting older persons (Figure 2). Finally, a “Seniors Against Fraud and Abuse” conference was held with a follow-up survey to evaluate changes in participants’ behavior.
Figure 2. Some of the mail that was collected throughout the state, primarily by the Family and Community Education group. This photo shows some of the collaborators representing the attorney general’s office, AARP, Colorado Legislature, Family and Community Education group, and Cooperative Extension.
Based on the 2000 Census, there are more than 2.4 million grandparents whose grandchildren live with them (U.S. Census Bureau 2000). The “Grandparents Raising Grandchildren” educational program was obtained from the American Association of Retired Persons and used at the state level. This effort was paired with a video titled “A Delicate Balance,” created to show the positive aspects of caregiving in rural Colorado. Two fact sheets focusing on grandparenting were also published and distributed at county-based workshops.
A Cooperative Extension educational outreach program was developed on home modifications, defined as adaptations to the home that make it more comfortable, safer, and easier to carry out daily activities (National Research Center on Supportive Housing and Home Modifications 2001). The program included information on demographics, physical changes in aging, significance of housing, and home modifications. Interactive exercises of possible modifications in the kitchen, bathroom, bedroom, and living room were provided. The video “Home Sweet Home,” 38 assistive devices, and illustration boards showed program participants how modifications might look in their homes. A CD-ROM containing these materials was made available to Cooperative Extension educators requesting it. To reach more individuals, selected materials along with signage were displayed at the annual Colorado Garden and Home Show, attracting 80,000 people (Figure 3).
Figure 3. Three boards that displayed assistive devices at Colorado Garden and Home Show.
Evaluation
A variety of tools to measure impact were used, including tracking the number of people reached (all audiences), pre/post instruments for audiences, and follow-up instruments to see what changes were made as a result of attending workshops. For example, results of the follow-up survey to the “Seniors Against Fraud and Abuse” conference showed that 56 percent of respondents learned to check their phone bills to avoid slamming, 38 percent adopted new behaviors to discourage telemarketers, and 31 percent knew to call the attorney general’s office for suspected fraud. Evaluations by consumers at the Colorado Garden and Home Show revealed that knowledge of the assistive devices displayed went from average to high (90 percent) and that their overall rating of the display was excellent (80 percent). A survey of participants who watched the “A Delicate Balance” video found that 97 percent increased their knowledge of the consequences of caregiving stress, 88 percent increased knowledge about caregiving resources, and 86 percent understood the importance of caregivers also meeting their own needs.
During its first year, 14 home modifications programs were conducted at the county level. An evaluation instrument included questions rating knowledge of devices for home modification before and after attending the program, whether enough information was provided, how many of the assistive devices had been seen before, intention to modify homes within the next six months, and whether help was needed to buy or install home modification features. Results showed that there was an increase in knowledge by participants as a result of the program. The average number of assistive devices shown during the program previously seen was 12, meaning that 26 of the devices were new to participants. Participants did express a desire for additional information on costlier forms of home modifications such as converting a main-level living room into a master bedroom and bathroom suite. The program also received positive responses from the county agents who delivered it, particularly in their ability to mix and match different components based on their needs.
Implications
Helping older persons live independently in their homes is important. Providing information to older people on how to live independently in a healthy manner should allow an increasing number of Americans to age in place. This team effort represents an example of how to deliver practical information to older persons using a multifaceted, problem-solving approach. Based on changing needs of the elderly, the Gerontology Team recently joined forces with the Financial Security in Later Life Team in developing a new state plan of work focusing on the national Cooperative Extension initiative “Financial Security in Later Life.” This started as a daylong training session at in-service and lessons have recently been piloted at the local level.
Efforts are now under way to identify other needed educational programs, beginning with a survey of the target audience. Current educational programs described in this article will remain in place. The Gerontology Team also has aligned itself with the newly created Center on Aging at Colorado State University in an effort to incorporate a greater emphasis on research. Three members of the team initially agreed to participate in this endeavor. By focusing on outreach as well as instruction and research, the Gerontology Team is in a strong position to help older Coloradoans to live independently as long as possible.
Authors
Kenneth R. Tremblay, Jr., Ph.D.
Professor and Housing Extension Specialist
Department of Design and Merchandising
150 Aylesworth Hall, SE
Colorado State University
Fort Collins, CO 80523
970- 491-5575 (office)
970-491-4855 (fax)
tremblay@cahs.colostate.edu
Luann K. Boyer, M.S.
Family and Consumer Education Extension Agent
Colorado State University
References
Administration on Aging. 2001. Profile of older Americans. Washington, DC: AOA.
American Association of Retired Persons. 2000. Fixing to stay: A national survey of housing and home modification issues. Washington, DC: AARP.
Colorado Department of Human Services. 2004. Strengths and needs assessment of older adults in the state of Colorado. Denver, CO: CDHS.
National Research Center on Supportive Housing and Home Modifications. 2001. Home modifications resource guide. Washington, DC: NRCSHHM.
U.S. Census Bureau. 2000. Census 2000 summary file 3. http://factfinder.census.gov.
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