Seniors CAN: Enhancing Independence for Older Adults

Introduction

One of the most important demographic shifts in southern Nevada is the growth of its aging population. This exceeds the national "graying of America" because of a large retiree in-migration. More than 25% of the 85,000 who moved to Clark County, Nevada in 2000 cited retirement as the main reason for their move. Most of these mobile retirees are leaving communities where they worked and raised families, places where they built social networks and support structures over time.

Meeting the needs of this rapidly growing population is a priority in Nevada. In 1998, Cooperative Extension initiated a 16-week wellness educational program named "Seniors CAN" in low-income housing developments in urban Las Vegas. Since then, through community collaboration, the program has expanded to senior centers across urban and rural Clark County, and train-the-trainer workshops are expanding program delivery into northern Nevada and to several other states.

Program Design and Delivery

Seniors CAN not only provides education in an interactive setting, it also encourages older adults to try something new they learn in each lesson. The program's main purpose is to enhance older adults' independent living skills by increasing their ability to decipher the overwhelming body of information on health and wellness, and increasing their sense of control over their lives. The information is valuable for all older adults and appeals to lifelong learners who want to take an active role in life decisions.

The theoretical basis of the Seniors CAN program lies in research demonstrating the importance of lifelong mental activity and its positive role in successful aging. Continued education helps maintain mental acuity and can restore or improve both self-esteem and mastery. A sense of control, enhanced by continuing education, can then lead to improved health and a better quality of life.

The workshop series includes 15 sessions during which seniors:

• Discuss and learn basic nutrition techniques, including reading food labels;
• Sample healthy food products such as fruit smoothies in the hydration lesson;
• Experience a guided tour of their local grocery store to apply their new skills;
• Participate in a hand-washing demonstration to illuminate "hidden germs";
• Practice hands-on use of fall-prevention tools such as reach extenders;
• Practice role playing in which they successfully terminate telephone conversations with telemarketers; and
• Receive free materials such as meat thermometers and refrigerator temperature gauges to extend the learning process into behavior change at home.

One secret of the project's success is that the older adults incorporate the information into their lives on an every-day basis. Class size is limited to no more than 20 so that each student can ask questions that make the material relevant to their individual situation. Once they start exchanging ideas related to the lesson materials, a process of peer-education takes over. For example, in the class on dehydration, usually at least one person has been hospitalized for dehydration and can tell a story that gives life to an abstract concept.

Since the program began, more than 20 workshop series have been conducted at sites across Nevada, with more than 100 seniors completing the entire 16-week program, including pre- and post-testing. Hundreds of other seniors have taken from one to 12 sessions. The program appeals to seniors from a wide variety of cultural and ethnic backgrounds and from varying educational and income levels.

To help deliver the program, University of Nevada Las Vegas graduate students, senior center staff, and rural University of Nevada Cooperative Extension (UNCE) staff have been trained. Cooperative Extension provided start-up funding to develop, deliver, and evaluate the program.

Accomplishments and Impacts

We have had tremendous response from older adults, senior center directors, and senior service providers. Comments from senior program completers confirm their acquisition of life skills and behavior changes.

• "I'm trying new foods. I now look for foods rich in calcium and can't believe I loved the tofu cheesecake."
• "I drink lots more water now so I won't get dehydrated."
• "I always learn something new every time I go."
• "I feel like I have more control of my life."
• "Since the hand washing germ demonstration I wash my hands more and purchased a nail brush."
• "Last week I didn't know what tofu was. Today for breakfast I mixed tofu, onions and eggs."
• "I learn various things that help day to day. You'd think at my age I'd know more!"

Program instructors and senior center directors report they have had difficulties getting significant numbers of older adults to participate in long-term wellness programs, despite the recognized need for such information. This was not the case with Seniors CAN, which they found easy to replicate.

• "Our seniors thoroughly enjoyed the program and we have many requests to 'do the program again.' They loved the social interaction with their peers and found the program 'fun' and  'interesting.'"
• "The curriculum is fabulous and was easy for our activity coordinator to follow and facilitate, even without prior experience."
• "The Center thoroughly enjoyed the opportunity to offer such a beneficial program to our senior citizens."

To assess the overall impact of Seniors CAN, a pre/post-test design was employed using the UCLA Loneliness Scale (Pearlin & Schooler, 1978) and the Mastery Scale (Russell, Peplau, & Cutrona, 1980) and a newly developed instrument to assess knowledge gain on nutrition, safety, and wellness information presented during the lessons. The results showed significantly decreased loneliness, increased mastery, and knowledge gain from pre- to post-test on each assessment instrument (p< .05).

As word about the program has spread, several agencies in Nevada and other states have requested help in conducting the program with their older adults. The Seniors CAN program provides a model for other communities that independent seniors can increase their chances of maintaining that status by improving their sense of mastery and quality of life.

References

Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2-21.

Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA loneliness scale: Concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39, 472-480.