EVALUATION OF VIBRANT AGING SOLUTIONS

Human Services Evaluation of the Vibrant Aging Solutions Association (VASA) Sarah Summer Jackson October 24, 2012 HN410 Professor Katrina Taylor Kaplan University

EVALUATION OF VIBRANT AGING SOLUTIONS

Introduction Three hundred thousand baby boomers are turning 65 every month in the United States and there simply are not enough in-home care providers, assisted living or skilled nursing facilities to handle this massive surge in the aging population. At the same time and in direct opposition to what should be happening, government funded programs are receiving cut-backs in the amount of grant monies they receive to service these consumers, and private programs are having to raise the amount they charge to between $19 and $25 per hour in most cases, to be able to stay afloat. As if this were not bad enough, there is no assurance that the people working for these in-home care programs have even been trained, and in most cases there are no human services professionals who can provide case management so as to make sure that a consumers needs are actually being met, and to help them in taking preventive action when appropriate. The boomer generation that has seen all kinds of products and services developed and re-defined as it has moved through time, will expect to have access to a program that fits their needs more specifically. The Vibrant Aging Solutions model combines the best qualities of programs in both the public and private sectors, and it is a member driven association with a free consumer membership that offers trained and vetted service providers, making it the vehicle by which the baby boomer generation will re-define aging as we know it. Practice Setting The practice setting for this evaluation is the network of trained and vetted Life Service Providers of Vibrant Aging Solutions (VASA), a 501 c3 Non-profit Association located in Northern California. The purpose of this network is to provide respite and in-home care services

EVALUATION OF VIBRANT AGING SOLUTIONS

both personal and social, transportation, referrals to appropriate professionals in the community, and case management to members who are 65+ years of age and/or disabled. Outcomes expected are maintained and increased mobility, crisis avoidance and management and an increased ability to age in ones own home due the programs provider services, referrals, case management, and assistance with avoiding some of the potential risks associated with aging; resulting in a proposed healthier overall quality of life for association members. Human services programs must be evaluated to determine their overall effectiveness in actually accomplishing what they set out to do, for the sake of both consumers and the providers. In this case, the ultimate goal of this evaluation is to put Vibrant Aging Solutions under the evaluation microscope to determine if it will pass the test. Target Behavior Target behaviors that are being addressed in this evaluation are declining mobility and helplessness. The cause of declining mobility is multi-faceted and really quite complex. Lack of knowledge about how to prevent some of the mental and physical issues people face in aging, waiting until it is too late to make use of the products and services that help to improve mental and physical capabilities, and not having access to service providers who can do some of the things that will allow consumers to function on higher levels in their daily life are only a few of the causes of declining mobility. People with declining mobility need the help of trained and vetted service providers to assist them with cooking, cleaning, personal hygiene, medications, social activities and transportation to name a few. Declining mobility is best addressed with information and education about new mobility products, equipment, appliances, remodeling options for the home, and access to trained service providers.

EVALUATION OF VIBRANT AGING SOLUTIONS

Helplessness is feeling 1. unable to help oneself; powerless or incompetent and/or, 2. lacking support or protection (Free Dictionary, n.d.). The cause of helplessness is also multifaceted and complex. When a person is feeling as if he or she has run out of options or has no options available to help deal with life crisis and the transitions that occur with aging, and/or when he or she is unable to perform the activities of daily living without help, strong feelings of helplessness can occur that can then lead to all kinds of mental and physical problems including depression. A person who is feeling helpless needs to have information, support and guidance that is provided by a qualified human services professional, in this case the Adult Life Guide, as well as referrals to vetted and trained professionals and service providers, to turn these feelings around. Interventions The intervention or program is the process used to bring about the desired change in target behavior (York, 2009). The interventions that address the above target behaviors include a network of trained and vetted Life Service Providers and the VASA Adult Life Guide who is the programs case manager and refers members to community resources. The goal of the VASA Life Service Provider network intervention is to prevent members from ending up in a skilled living facility. Objectives of this intervention include (a) help members to maintain their mobility by providing in-home and personal services including cooking, cleaning and personal care that can keep them living a more active life, while aging in the comfort of their own home, (b) assist in improving members ability to perform the activities of daily living and learning creative ways to do more of these activities and, (c) perform in-home assessments and education about mobility products and resources.

EVALUATION OF VIBRANT AGING SOLUTIONS

The structure and intensity of this intervention is in-home, personal care and transportation services offered on both a part-time and full time basis (intensity), with a minimum of 20 hours per week, to consumers of California In-Home supportive services, family caregivers and to local community private-pay consumers as well. Personnel for the VASA Life Service Provider intervention are the 20,000 trained and vetted California United Homecare Workers (CUHW), Union Members in 25 counties in Northern California, who currently service the needs of approximately 15,000 consumers. The goal of the VASA Adult Life Guide intervention is to help members to avoid living life in crisis mode that can promote helplessness. Objectives of this intervention include (a) perform an assessment to determine how best to serve each client whether it be to assist in avoiding crisis mode or helping a member to move through a crisis on to a better quality of living, (b) referral of members to appropriate trained service providers in the VASA Life Service Provider Network, (c) educate members about aging in place and how to continue to live in ones own home with the use of mobility equipment, new technologies, appliances and aging in place design principles and, (d) provide referrals to the many local community professionals who can help with financial, insurance, real estate, contractor and complimentary medical needs, to name a few. The structure and model of this intervention is individual, as well as family meetings with the VASA Adult Life Guide who will be provide the information, resources and support necessary for members to meet the challenges of aging head on. The intensity is one two hour meeting for assessment, followed by one hour meetings weekly with the Adult Life Guide until all education, referrals and case management services have been provided and all parties are satisfied and agree to termination. One hour follow up appointments with the Adult Life Guide on a quarterly basis for maintenance are highly recommended. Personnel for the VASA Adult
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EVALUATION OF VIBRANT AGING SOLUTIONS

Life Guide intervention are professionals who have a minimum of a B.S in Human Services with an emphasis in gerontology. Study Sample The study sample for the purpose of this evaluation is a random probability sample of 15 people chosen from the 1,042 study population of people age 75 to 84 years of age, who reside in Sacramento, California where the model will be launched. Any generalizations that are made based on this study sample will be considered to be safe generalizations, because there is no reason to believe that there will be any significant differences between the study sample and the sample population (York, 2009). Ethical Considerations One of the biggest ethical considerations that should be considered in this evaluation is what form of measurement tool to use given the fact that participants may have some level of dementia that would preclude them from fully comprehending the questions being asked. Confidentiality is also a main concern especially when trying to ascertain issues about mobility and personal care. Because of this, all survey information should be kept totally confidential. Great care should also be given to making sure that questions are culturally sensitive and that they are written in a language that the participant thoroughly understands. All communication with members should also be well thought out in terms of its cultural context, and staff should be trained as well. A full assessment and informed consent process is the best way for new members to be made aware of the services offered to them through VASA and any cost associated with them.

EVALUATION OF VIBRANT AGING SOLUTIONS

Measurement of Client Progress For the purpose of this evaluation, the outcome objective that will be measured is: help members to maintain their mobility by providing in-home and personal services including cooking, cleaning and personal care that can keep them living a more active life, while aging in the comfort of their own home. Study sample participants will be tested in two baseline periods and two treatment periods over a two year period of time. The target behavior in this case is declining mobility, and because it is not of the common variety, and there is a question that all participants will have adequate verbal skills to respond to a standard scale, the best measurement tool will be the individualized measurement tool and the ABAB design. This tool will be customized so that there are three tools that speak to the special needs of people who fit some where into the three levels of dementia as diagnosed by the American Psychological Association DSM IV. Threats to Validity There may be a slight possibility that maturation, normal growth and development of some kind (as a result of exercise and eating right for example), may cause a bit of an improvement in a persons abilities when it comes to increased mobility, and there is a possibility that history, a change in the members environment, independent of treatment, might also explain a members change in development. This being said, neither of these threats to validity are of particular concern. When asking the question which alternative explanations should we be especially concerned with in this study sample as a group? It is appropriate to conclude that while there might be some remote possibility of maturation that can be given, it is highly unlikely for more than a minor part of the sample. When speaking of history, it is also not possible to claim that it is probable that the environment in these members lives will change
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significantly irrespective of the interventions in the VASA program on any significant level (York, 2009). Use of Data While it may appear that this evaluation should be making use of a group research design, a single system design that is customized to the three levels of dementia as per the DSM IV has been used. All data collected in this evaluation will be compiled for the purpose of determining the validity of the VASA network of Life Service Providers as an intervention for decreased mobility, and for helping association members to remain in their own homes as they age, as compared to a skilled nursing facility. We have used quantitative data to determine the statistical significance of any improvement in the ability for VASA members to maintain and/or increase their mobility (York, 2009). Summary and Conclusion Through this evaluation we have made the hypothesis and concluded that the trained and vetted network of VASA Life Service Providers will definitely provide the member/consumer with all of the services they need to age in their own home, as the majority of the boomer generation desires to do. It is important for those who will read about this evaluation to understand that aging is not something that can be stopped, but this does not mean that prevention does not apply and that skills cannot be improved. Much has been learned in terms of defining the target behavior and interventions, defining the study sample, ethical considerations, threats to validity and measuring client progress. The Vibrant Aging Solutions model combines the best qualities of programs in both the public and private sectors, and it is a member driven

EVALUATION OF VIBRANT AGING SOLUTIONS

association with a free consumer membership that offers trained and vetted service providers, making it the vehicle by which the baby boomer generation will re-define aging as we know it.

EVALUATION OF VIBRANT AGING SOLUTIONS

References CLResearch. (n.d.). 2010 Population by Age in Sacramento, CA 95938. Retrieved from http://www.clrsearch.com/Sacramento_Demographics/CA/95838/Population-by-Age The Free Dictionary. (n.d.). Definition of Helplessness. Retrieved from http://www.thefreedictionary.com/helplessness. York, O. (2009). Evaluating Human Services: A Practical Approach for the Human Services Professional. Pearson Education.

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