Social and Behavioral Sciences Commons^™

Extreme Heat Vulnerability Among Older Adults: A Multi-Level Risk Index For Portland, Oregon, Jacklyn N. Kohon, Katsuya Tanaka, Dani Himes, Paula Carder, Eiji Toda, Bryant Carlson

Institute on Aging Publications

Background and Objectives

Extreme heat is an environmental health equity concern disproportionately impacting low-income older adults and people of color. Exposure factors, such as living in rental housing and lack of air conditioning, and sensitivity factors, such as chronic disease and social isolation, increase mortality risk among older adults. Older persons face multiple barriers to adaptive heat mitigation, particularly for those living in historically temperate climates. This study measures two heat vulnerability indices to identify areas and individuals most vulnerable to extreme heat and discusses opportunities to mitigate vulnerability among older adults.

Research Design and Methods

We constructed two heat …

Climate Change Policies And Older Adults: An Analysis Of States’ Climate Adaptation Plans, Bryant Carlson, Jacklyn N. Kohon, Paula Carder, Dani Himes, Eiji Toda, Katsuya Tanaka

Institute on Aging Publications

Background and Objectives

As climate change drives more frequent and intense weather events, older adults face disproportionate impacts, including having the highest mortality rates from storms, wildfires, flooding, and heat waves. State governments are critical in deploying local resources to help address climate change impacts. This policy study analyzes states’ climate adaptation plans to assess the methods through which they address the impact of climate change on older adults.

Research Design and Methods

This study uses content analysis to analyze available climate change adaptation plans for all U.S. states for strategies designed to increase resilience of older adults to impacts …

2022 Community-Based Care: Resident And Community Characteristics Report On Assisted Living, Residential Care, And Memory Care Communities, Ozcan Tunalilar, Paula Carder, Jaclyn Winfree, Sheryl Elliott, Minju Kim, Diana Jacoby, Wafi Albalawi, Portland State University Institute On Aging

Institute on Aging Publications

This report summarizes findings from the 8th annual study of Oregon community-based care settings, including assisted living and residential care facilities, and memory care communities. This study was conducted during fall 2021 and winter 2022.

2022 Adult Foster Home Resident And Community Characteristics Report On Adult Foster Homes, Ozcan Tunalilar, Paula C. Carder, Jaclyn Winfree, Sheryl Elliott, Minju Kim, Diana Jacoby, Wafi Albalawi

Institute on Aging Publications

This report describes results from a study of Oregon adult foster homes (AFH), including home and owner characteristics; monthly charges and payment sources; resident characteristics, personal and health-related needs; and owners’ experiences with supports and challenges due to the COVID-19 pandemic. The study’s purpose was to collect and report data that can inform and advise policymakers, state and county agency staff, aging advocates and AFH owners about the status of AFHs in Oregon. The report includes information collected between December 2021 and March 2022 and, where possible, compares it to findings from prior years of this study and to other …

2021 Adult Foster Home Resident And Community Characteristics Report On Adult Foster Homes, Paula Carder, Jason Z. Kyler-Yano, Ozcan Tunalilar, Sarah Dys, Sheryl Elliott, Ellis Jourdan Hews, Minju Kim

Institute on Aging Publications

This report describes results from an annual study of Oregon adult foster homes (AFH). Data contained in this report include home and owner characteristics; monthly charges and payment sources; and resident characteristics, personal and health-related needs. The study’s purpose was to collect and report data that can inform and advise policymakers, state and county agency staff, aging advocates and AFH owners about the status of AFHs in Oregon. These data were collected between December 2020 and February 2021. This report constitutes the first year during the COVID-19 pandemic that these annual data were collected.

2020 Community-Based Care Resident And Community Characteristics Report On Assisted Living, Residential Care, And Memory Care Communities, Paula Carder, Ozcan Tunalilar, Sheryl Elliott, Sarah Dys, Portland State University Institute On Aging

Institute on Aging Publications

This report summarizes findings from the 6th annual study of Oregon community-based care settings, including assisted living and residential care facilities, and memory care communities. This study was conducted during fall 2019 and winter 2020.

2020 Adult Foster Home Resident And Community Characteristics Report On Adult Foster Homes, Paula Carder, Sheryl Elliott, Ozcan Tunalilar, Sarah Dys, Portland State University Institute On Aging

Institute on Aging Publications

This report is the sixth in a series prepared by the Institute on Aging at Portland State University for Oregon’s Department of Human Services (ODHS) and examines a sample of Adult Foster Homes (AFHs) throughout the state. This study has four objectives: 1. Describe AFH characteristics, including staffing types, policies and monthly charges and fees. 2. Describe current residents’ health-related needs, service use and demographic characteristics. 3. Compare current results with prior Oregon surveys to identify changes and current trends. 4. Describe characteristics that might affect access, quality, or cost. Oregon has licensed adult foster homes (AFHs) as a type …

The Resident View In Nursing Homes, Diana L. White, Ozcan Tunalilar, Serena Hasworth, Jaclyn Winfree

Institute on Aging Publications

This article presents the Resident VIEW (Voicing Importance, Experience, and Well-Being), a measure designed to learn directly from long-term care residents the extent to which they experience support that matters most to them. The Resident VIEW contains 63 items across eight domains developed through cognitive interviews with residents in different types of residential settings (e.g., nursing homes, assisted living, and adult foster care). Residents rate items on both importance and their experience. In total, 258 nursing home residents living in 32 Oregon nursing homes were selected through a two-stage random sampling design and participated in the study. Results demonstrate that …

Consumer Satisfaction With Aging & Disability Resource Connection Of Oregon: Round 6, Diana L. White, Allyson Stodola

Institute on Aging Publications

This report describes findings from the sixth consumer satisfaction survey conducted with consumers or family members who are served by the Aging and Disability Resource Connection (ADRC) of Oregon, focusing on Call Center staff (or Information, Referral and Assistance; IR&A) and recipients of options counseling services. The Institute on Aging at Portland State University directed the project, partnering with Washington State University Social & Economic Research Center, who conducted the telephone survey between February 27 and April 5, 2019.

2018 Adult Foster Home: Resident And Community Characteristics Report On Adult Foster Homes, Paula C. Carder, Sheryl Dejoy Elliott, Ozcan Tunalilar

Institute on Aging Publications

Adult foster homes (AFH) are small, residential settings that are licensed to provide assistance to older persons or adults with disabilities. These settings may offer a home-like setting in which residents’ independence, personal choice, and decision-making are promoted. Homes may be licensed for one to five residents and must be staffed 24-hours daily to respond to residents’ scheduled and unscheduled needs or requests. Adult foster homes offer a variety of services, including daily meals, housekeeping and laundry, assistance with personal care needs, medication administration, monitoring of health conditions, communication with residents’ health care providers, and social and recreational activities.

This …

2018 Community-Based Care: Resident And Community Characteristics Report On Assisted Living, Residential Care, Memory Care, Paula C. Carder, Ozcan Tunalilar, Sheryl Dejoy Elliott, Sarah Dys

Institute on Aging Publications

This report is the fourth in a series prepared by the Institute on Aging to describe Oregon’s assisted living, residential care and memory care service sectors which are referred to by Oregon Department of Human Services as community-based care (CBC) settings. These settings may also be referred to as Home and Community Based Services (HCBS).

Community-based care settings provide a variety of services, including daily meals, housekeeping and laundry, assistance with personal care needs, medication administration, evaluation, coordination, and monitoring of health conditions, communication with residents’ health care providers, and social and recreational activities. As the population of Oregonians aged …

Two Forecasting Models For Portland, Oregon: Hamilton –Perry Vs Metroscope, Richard Lycan

Institute on Aging Publications

Presentation focuses on population forecasting models and compares the Metroscope Forecasting Model and the Hamilton-Perry Model.

Differential Health And Social Needs Of Older Adults Waitlisted For Public Housing Or Housing Choice Vouchers, Paula C. Carder, Gretchen Luhr, Jacklyn Nicole Kohon

Institute on Aging Publications

Affordable housing is an important form of income security for low-income older persons. This article describes characteristics of older persons waitlisted for either public housing or a housing choice voucher (HCV) (previously Section 8) in Portland, Oregon. 358 persons (32% response rate) completed a mailed survey with questions about demographics, health and housing status, food insecurity, and preference for housing with services. Findings indicate that many waitlisted older persons experienced homelessness or housing instability, poor health, high hospital use, and food insecurity. Public housing applicants were significantly more likely to report lower incomes, homelessness, and food insecurity than HCV applicants. …

The Case For Age-Friendly Communities, Margaret Neal, Alan Kenneth Delatorre

Institute on Aging Publications

The report was funded by Grantmakers In Aging, an organization dedicated to promoting and strengthening grantmaking for an aging society. The movement toward age-friendly communities is growing, with the key impetus being population aging. Beyond what individuals themselves can do to age optimally, the movement to create communities that are age friendly focuses on how the economic, physical, and social environments can be improved to address not only the needs but also maximize the assets of an aging population, for the benefit of all.

Building A State For All Ages: Tapping The Potential Of Older Oregonians, Stephen Percy, Judith A. Ramaley, John Tapogna, Margaret B. Neal, Jay Bloom, Alexandra Reece

Institute on Aging Publications

This report explores how the aging population—including native Oregonians and senior adults moving to the state—represent an asset to Oregon. Aging in America has often been viewed from a perspective of deficit and decline. We wholeheartedly challenge this perspective. This report identifies how older adults can play vital roles in the workforce, entrepreneurship and innovation, and supporting community revitalization through volunteering of time and talent.

Consumer Satisfaction With Aging & Disability Resource Connection Of Oregon: Round 4, Diana White, Sheryl Dejoy Elliott

Institute on Aging Publications

The report describes the fourth round of consumer satisfaction surveys that were conducted with people who had been in contact with the Information & Referral/Assistance (I&R/A) Call Center or received Options Counseling (OC) services of Aging and Disabilities Resource Connection (ADRC) of Oregon. Data for this survey were collected in November 2014. This Executive Report summarizes and presents data on overall satisfaction, conclusions, and recommendations for the ADRC program.

Evaluating Your Age-Friendly Community Program: A Step-By-Step Guide, Margaret B. Neal, Iris Wernher

Institute on Aging Publications

This guidebook was developed to help you document and evaluate your community’s progress in becoming more age friendly. Although this task may sound intimidating, with a small dose of courage and by understanding a few key terms, the building blocks of evaluation can come alive and help guide your work.

Collaborative Treatment Of Late-Life Depression In Primary Care (Germanimpact): Study Protocol Of A Cluster-Randomized Controlled Trial, Iris Wernher, Frederike Bjerregaard, Iris Tinsel, Christiane Bleich, Sigrid Boczor, Thomas Kloppe, Martin Scherer, Martin Härter, Wilhelm Niebling, Hans-Helmut König, Michael Hüll

Institute on Aging Publications

Background: Depression is not a normal side effect of aging, however it is one of the most prevalent mental health issues in later life, imposing a tremendous burden on patients, their families, and the healthcare system. We describe the experimental implementation of a collaborative, stepped-care model for the treatment of late-life depression (GermanIMPACT trial) in the German primary care context. GermanIMPACT was developed as an adaptation of a successful and widely used American model. The aim of the study is to evaluate the model’s applicability to the German primary care setting and its cost-effectiveness.

Methods/Design: The study will be conducted …

Forcasting Senior Populations, Richard Lycan

Institute on Aging Publications

This project seeks to: Improve population forecasts for senior populations; Increase awareness of issues related to forecasting senior populations; Provide support to corecasters

Consumer Satisfaction With Aging & Disability Resource Connection: Round 3, Diana White, Serena Worthington

Institute on Aging Publications

This report describes the third round of consumer satisfaction surveys conducted with users of Aging and Disabilities Resource Connections (ADRC) of Oregon. The telephone survey was conducted between October 18 and November 2, 2013 and focused on three of the core ADRC functions: 1) information, referral, and awareness; 2) options counseling (OC); and 3) streamlined eligibility determination for public programs. The ADRC Advisory Committee had previously established benchmarks to be used in determining success for many aspects of the program described in this report.

Aging And Equity In The Greater Portland Metropolitan Region, Alan Kenneth Delatorre, Margaret B. Neal

Institute on Aging Publications

Aging and Equity in the Greater Portland Metropolitan Region discusses the opportunities and needs created by the increase in older adults in the region. The 65 and older population is expected to more than double over the next two decades, to over half a million people. Planning for the inevitable and unprecedented aging of our population provides an opportunity to improve our environments while becoming a leader in the push to create sustainable, equitable, and age-friendly communities.

Resident And Community Characteristics Report 2014: Assisted Living, Residential Care, Memory Care, Paula C. Carder, Jacklyn Nicole Kohon, Aubrey Limburg, Maximilian West, Amanuel Zimam, Kenneth Gordon Neal

Institute on Aging Publications

This report provides an overview of community-based care settings in Oregon. The results presented here are derived from surveys completed by 243 facilities serving 9,485 residents. Key changes between the 2008 OOHPR survey and 2014 include:

• Compared to 2008, the number of facilities increased by 13%, with the largest growth in MCCs (41%).
• The proportion of for-profit facilities and facilities managed by a third party increased from 2008 by 8%.
• The acuity level of residents increased on most measures compared to 2008.
• Compared to 2008, residents across all three community types required more assistance with ADLs and used more health …

Medication Management Services Offered In U.S. Residential Care Communities, Lisa L. Dwyer, Paula C. Carder, Lauren D. Harris-Kojetin

Institute on Aging Publications

Using data from the 2010 National Survey of Residential Care Facilities, this study estimated the percentage of U.S. residential care communities (RCCs) offering selected medication management services (MMS) and examined differences in prevalence by community characteristics. The most common services were central storage for medications and cueing residents, while the least common were administering injections and intravenous medications. Medication reminders, helping residents take medications, and administering drops/topical ointments and injections varied by RCC characteristics. Characteristics most commonly associated with these differences are size, purposefully built status, nursing hours, and availability of a physician or pharmacist to review medication appropriateness. Understanding …

Action Plan For An Age-Friendly Portland, The Age-Friendly Portland Advisory Council

Institute on Aging Publications

The goal of this Action Plan is to enhance Portland, Oregon’s age friendliness. As defined by the World Health Organization (WHO), an "age friendly" city:

• has structures and services that are accessible and inclusive of older people with varying needs and capacities
• emphasizes enablement rather than disablement, and
• is friendly for people of all ages and abilities

The action steps that comprise this plan are intended to move Portland toward future development and activities that foster not only physical environments but also social and service environments that meet these criteria, making Portland a community for all ages.

Consumer Satisfaction With Aging & Disability Resource Connection (Adrc) Services: Round 2, Diana L. White, Sheryl Elliott

Institute on Aging Publications

Aging and Disabilities Resource Centers (ADRC) are a program of the Administration for Community Living (ACL), the Centers for Medicare and Medicaid (CMS), and the Veterans Health Administration. They serve as a single entry point into the long-term services and supports systems for older adults and those with disabilities. The goal is to provide a coordinated system of information and access to those seeking long-term services and support, thereby minimizing confusion, enhancing individual choice, and supporting informed decision-making.

Home Forward’S Aging In Place Initiative: Planning For Current And Future Residents, Paula C. Carder, Jenny Weinstein, Jacklyn Nicole Kohon

Institute on Aging Publications

This report was prepared on behalf of the Aging in Place Initiative of Home Forward. The Initiative sought to gather information about older persons currently residing in Home Forward’s public housing properties, from persons age 55 and older on the waitlist for housing, and from older adults in the Portland area. While local data were unavailable at the time of this report, we know that nationally, more than one-third (37 percent) of the approximately 5 million households receiving housing assistance from HUD are headed by persons age 62 and older. With this in mind, Home Forward must make decisions now …

The Health And Housing Specialist: An Emerging Job Classification To Support Aging In Place In Subsidized Housing, Paula C. Carder, Jenny Weinstein, Jacklyn Nicole Kohon

Institute on Aging Publications

As the U.S. population ages, the availability of workers with a basic understanding of aging and health-related services has not kept pace. This is true in traditional health care organizations such as hospitals and primary care clinics as well as in long-term care settings and senior housing, including subsidized housing, the focus of this report. Nearly 1.8 million older persons receive some form of publicly-subsidized rental assistance. Some subsidized housing providers, including those that operate buildings designated for older persons, are developing new systems of service delivery that would either coordinate or provide health screenings, physical activity programs, nutrition programs, …

Lane Transit District Integrated Functional Transportation Assessment Project: Findings From A Case Study And Developmental Evaluation, Margaret B. Neal, Susan Eliot, Mark Person, Jost Lottes

Institute on Aging Publications

This report describes the results of a case study and developmental evaluation of Lane Transit District's innovative project to develop an integrated functional assessment for transportation services, referred to here simply as the Transportation Assessment Project (TAP).

The TAP is unique in that it is a collaborative effort between a public transit agency and local human service agencies to blend traditionally separate assessments for eligibility for transportation services. Specifically, in the TAP, Lane Transit District subcontracts with human services agencies to conduct personalized in-home assessments with individuals with special transportation needs and who are requesting paratransit rides. While in the …

State Experiences With Affordable Housing Plus Services: Report To Seniors And Persons With Disabilities, On The Move, Paula C. Carder, Erika Zoller

Institute on Aging Publications

Housing developers, providers, policy makers, and advocates, increasingly recognize that for some groups of individuals, access to affordable housing alone is "not enough." That is, some individuals require more than shelter. Examples include individuals who have chronic health conditions (e.g., HIV/AIDS), those with physical or cognitive limitations (e.g., persons with developmental disabilities, adults with physical disabilities), and those who have a combination of health conditions or who cannot thrive in traditional housing (e.g., persons who have been homeless, individuals with chronic mental illness). Increasingly, housing providers, social service agencies, advocates, states, and federal agencies have recognized the need to combine …

The Older Driver In Oregon: A Survey Of Driving Behavior And Cessation, Margaret B. Neal, Sharon Baggett, Kathleen A. Sullivan, Tyrae Mahan

Institute on Aging Publications

In a study of older adults and their travel patterns in Oregon, a statewide mail survey and telephone interviews were conducted with older drivers and older adults who had voluntarily chosen to stop driving. The purpose of the study was to determine: (1) the factors that influence driving cessation; (2) the physical and emotional barriers that delay driving cessation; (3) what opportunities exist for alternative transportation after driving cessation; (4) whether drivers make relocation decisions on the basis of driving cessation; (5) the warning signs that make a driver stop driving; and (6) whether a crisis situation generally forces a …