Benevolent communities

Develop a “Benevolent Community” to identify and integrate older adults in situations of isolation and vulnerability: a partnership between research, a community organization, and a CIUSSS.

Introduction

To support older adults to age in place, and to promote their health, and quality of life, older adults' social participation, i.e., their involvement in activities that provide them with interactions with others in the community1 is important. Despite their recognized impacts, interventions aimed at promoting social participation offered to older adults remain rare, discontinuous, and poorly adapted to their needs.2–3. Action research offers tools to promote the development of communities and the implementation of a continuum of actions adapted to the needs of older adults, likely to encourage their social participation. This continuum must also be supported by both the health network and the community.

What actions are being taken in your region to identify and integrate seniors in situations of isolation and vulnerability?

Procedure

Resulting from the consultation and exceptional collaboration between the actors of a rural Regional County Municipality (MRC) and researchers, this action research project aims to identify and implement initiatives to promote older adults' social participation. This action research involves the commitment of the main concerned actors, the planning for a change in practices to stimulate social change, and the need to follow an iterative development, validation, and implementation process.4. Thus, from January 2015 to today, meetings with various community stakeholders have taken place to: 1) identify the needs, facilitators, and obstacles to older adults' social participation; 2) prioritize the identified needs; and 3) target, based on scientific writings and community opportunities, the initiatives likely to improve social participation to be implemented. A total of 19 discussion groups, two individual interviews, and 21 forums with key informants were organized, making it possible to meet older adults, caregivers, stakeholders, and managers (n = 166).

What priority needs are identified by older adults, caregivers, social workers, community organizations, and the CIUSSS?

Impacts

Participants identified three needs deemed priorities: i) to be informed about the activities and services offered to seniors; ii) be accompanied by a person to initiate or carry out an activity; and iii) have activities adapted to their needs. Thus, the initiative Benevolent community, combining a Network of scouts5 and Personalized support6–7, aims to help identify vulnerable older adults and offer them personalized support based on their life plan. Other initiatives concern creating a website on opportunities for social participation (activities and services available) and transportation options for older adults. The implementation of these initiatives is underway and targets the entire MRC, i.e., 12 municipalities. This project demonstrates that a partnership between research, a community organization, and a CIUSSS can promote the development of communities and the social participation of older adults.

Partnership offers

Pre Levasseur's research program offers many research opportunities with community organizations and CISSS/CIUSSS. For example, in the coming weeks, CISSS/CIUSSS in Montreal and Quebec will be asked to support a community organization in their region in the implementation of Personalized Support for Community Integration (APIC). Offered to help older adults carry out social and leisure activities that are important to them, the APIC allows the pairing of older adults who lose their autonomy and live in the community with a volunteer guide.

In addition, the CISSS/CIUSSS are also invited to indicate their interest in collaborating in the evaluation of the Lifestyle Redesign®, an innovative health-promoting occupational therapy intervention developed in California. Promoting the development of a healthy and personally meaningful lifestyle among community-dwelling older adults8, the Lifestyle Redesign®is carried out by an occupational therapist over six to nine months, including weekly group meetings and monthly individual meetings. According to a systematic literature review9, studies have demonstrated the effectiveness of the original intervention in improving older adults' physical and mental health, as well as its efficiency. The Lifestyle Redesign® was recently translated and adapted to the Quebec context and successfully tested by our research team.

For more details on partnership offers, contact Joanie Lacasse-Bedard (819-780-2220 ext. 45690; preferable by email during telework).

References

1. Levasseur M, Richard L, Gauvin L and Raymond E. (2010). Inventory and analysis of definitions of social participation found in the aging literature: proposed taxonomy of social activities. Social science & medicine 71:2141-9.

2. Levasseur M, Larivière N, Royer N, Desrosiers J, Landreville P, Voyer P, Champoux N, Carbonneau H and Sévigny A (2014). Match between needs and services for participation of older adults receiving home care: appraisals and challenges. Leadership in Health Care 27(3): 204-223.

3. Turcotte, P.-L., Larivière N, Desrosiers J, Voyer P, Champoux N, Carbonneau H, Carrier A, Levasseur M. (2015). Participation needs of older adults having disabilities and receiving home care: met needs concern mainly daily activities, while unmet needs mostly involve social activities. BMC Geriatrics 15(95): 1-14.

4. Dolbec A and Prud’homme L. Action research. In Gauthier, B (Dir) Social research: From the problem to data collection. Sainte-Foy: Presses de l’Université du Québec. 2009:531-570.

5. Meloche, B. (2007). People with loss of autonomy Network of scouts and watchers for seniors (REVA). In https://www.moncsss.com/soins-et-services/personnes-en-perte-dautonomie/formation-reva.html

6. Levasseur, M., Lefebvre, H., Levert, M.-J., Lacasse-Bédard, J., Desrosiers, J., Therriault, P.-Y., et al. (2016). Personalized citizen assistance for social participation (APIC): A promising intervention for increasing mobility, accomplishment of social activities and frequency of leisure activities in older adults having disabilities. Archives of Gerontology and Geriatrics, 64, 96–102.

7. Lefebvre, H., Levert, M.-J., Le Dorze, G., Croteau, C., Gélinas, I., Therriault, P.-Y., et al. (2013). Personalized citizen accompaniment to support the community integration of people who have suffered a traumatic brain injury: towards resilience? Nursing Research, 115, 107-132.

8. Clark, F., Jackson, J., Carlson, M., Chou, C., Cherry, B., Jordan-Marsh, M. et al. (2012). Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: results of the Well Elderly 2 Randomized Controlled Trial. Journal of Epidemiology and Community Health, 66(9), 782-790.

9. Lévesque, M.-H., Sirois, M.-J., Trépanier, J., and Levasseur, M. (submitted 12/2016). Effects and applicability in the Quebec context of Lifestyle Redesign® among seniors. Canadian Journal of Occupational Therapy.