Curry Senior Center

1. As the population of isolated older adults rises, so does the demand for an adequate health care system that can meet the physical and mental health needs of this population. Caretakers and health and social service providers are responsible for preventing older homebound adults from early institutionalization, over utilization of emergency rooms, and premature death. However, access to primary and psychiatric care is limited and costly—and is becoming an epidemic problem with the growth in this segment of the population (Etters & Harrison, 2008; Zeltzer & Kohn 2006). Making services available to this population of homebound older adults is a responsibility the health care system will have to face. Aging affects everyone and the problem of limited resources to isolated older adults will soon be impossible to ignore. The Uncertainty of Aging: The Physical and Mental Health Needs of Homebound Seniors Living in the Tenderloin • Community health assessment purpose • To explore the physical and mental health needs of homebound seniors 85 years and older living in • San Francisco’s Tenderloin district. Image placeholder Image placeholder • Key questions to tackle • For homebound seniors 85 years and older living in the Tenderloin: • What are the priority mental health needs • What are the priority physical health needs • What services are utilized • What are some services not utilized • What are the gaps in mental and physical health services that need to be addressed • How can providers and gatekeepers address these gaps in services Image placeholder Image placeholder Community members that participated in this assessment Homebound seniors over 85 years old living in the Tenderloin and providers that care for this population. • How did we conduct this assessment? • Between June-July 2011, SFSU graduate students conducted in-depth and key informant interviews • 12 informant interviews with providers that care for homebound seniors. • Nine in-depth interviews with homebound seniors 85 years and older living in the Tenderloin neighborhood of San Francisco. • From August-September 2011, data was compiled and analyzed. Community Partners San Francisco State University (SFSU) ,Department of Health Education, Masters in Public Health (MPH) program The SFSU MPH program in health education promotes social justice and develops competent leaders in public health. This is accomplished through rigorous course work & a team practice experience with a community based organization. San Francisco State University Assessment Team: Alexandra Geary-Stock, Liseli Mulala-Simpson, Kathleen Gali Curry Senior Center The Curry Senior Center, located in San Francisco’s Tenderloin neighborhood, is a non-profit organization that provides comprehensive services to approximately 2,600 seniors annually. Operating since 1972, this center serves independent, low-income seniors living within the Tenderloin & South of Market neighborhoods of San Francisco. Curry Senior Center Community Adjunct Faculty: David Knego, Executive Director

2. What did seniors and providers have to say about homebound • senior’s health needs? • Homebound seniors want: • More opportunities for social engagement that values autonomy and independence. • More vigor and variety in current exercise programs. • Better transportation to access activities for social engagement • Homebound Seniors expressed: • being unfamiliar with mental health services or that these services are not needed • a lack of self worth by devaluing their own perspective and contribution to society • Providers expressed: • An increase in social engagement is a great way to combat the isolation and depression increasing in this population • An increase in transportation is imperative for seniors to access more services. • A need to increase in-home visiting services and in-home support that addresses mobility and fall prevention.  • how a decrease in funding to utilized services such as adult day health, home visiting services and dental services is detrimental to • the health of an ever-growing population of seniors. • Recommendations • Develop an intergenerational support program for seniors that incorporates elementary, high school and college students visiting, interacting, and providing home-based services (ie. delivering meals, educating seniors on new technology) to homebound seniors. • Implement new technology (like computers, smart technology, and WII consuls) for social engagement purposes and to provide an opportunity to increase the variety of exercise options in senior centers and in homebound senior’s place of residence. • Increase advocacy and disseminate research about this population among community members, health care agencies, policy makers and the general public. • Diversify services to include meditation and guided visualization training during group sessions or home-visits to help seniors increase self esteem and reduce stress. • Education on aging through development of cultural humility trainings about ageism to all staff in related agencies and healthcare settings. • In-home mental health screening and education by service providers currently visiting seniors in their homes. • Fall prevention and screening inventory by service providers who can assess fall risk by following standardized fall prevention inventory. • Increase in and evaluation of para-transit to make more convenient services and increase the understanding of current para-transit system. Acknowledgements We would like to thank Curry Senior Center, David Knego, MSW * Jessica Wolin, MPH * Judith Ottoson, PhD * Paul Rueckhaus, MPH * and all the key informants and senior participants who shared their perspectives in this assessment.