Program involving community volunteers shows promise for reducing health care use by seniors

by Canadian Medical Association Journal

Credit: CC0 Public Domain

Incorporating community volunteers into the health care system shows promise in reducing health care usage by older adults and shifting health care from hospitals to primary care, according to new research in CMAJ (Canadian Medical Association Journal).

13 may 2019--"We found that older adults who took part in the Health TAPESTRY program changed the way in which they used health care services," says lead author Dr. Lisa Dolovich, Department of Family Medicine, McMaster University, Hamilton, Ontario. "Encouragingly, participants had more visits to primary care with fewer [emergency department] and hospital admissions compared to those not in the program."

The Health TAPESTRY (Health Teams Advancing Patient Experience: Strengthening Quality) project combines new elements, such as using trained volunteers and electronic software, with the current health system, to support optimal aging in adults aged 70 years or older. While results from the randomized controlled trial did not affect the primary goal of the study, which was to help older adults to reach their health goals, there were other positive effects between the intervention and control groups. For example, there was an increase of 81 minutes of weekly walking time in the intervention group compared with a 120-minute decrease in the control group, and the intervention group reported higher overall levels of physical activity. The volunteers gave primary health care teams information that the health providers might not have otherwise known.

"These findings suggest that Health TAPESTRY has the potential to improve the way primary care is delivered in Canada by shifting care of individuals away from hospitals to the community and to a more proactive and preventative team-based model of care," says coauthor Dr. David Price, chair, Department of Family Medicine, McMaster University.

In a related commentary, Dr. Susan Smith, Royal College of Surgeons in Ireland, Dublin, Ireland, writes, "The results of this study suggest that the Health TAPESTRY intervention may contribute to improvements in patient care for older, community-dwelling adults. Further exploration of this model of care is warranted given the challenge for all health systems in shifting from single-condition care pathways to approaches that seek to address multimorbidity."

More information: CMAJ (2019). www.cmaj.ca/lookup/doi/10.1503/cmaj.181173

Journal information: Canadian Medical Association Journal 

Provided by Canadian Medical Association Journal 

Older women find health benefits through volunteer program

01 mar 2009--A new article in The Journal of Gerontology: Social Sciences reveals that African American women aged 60 and older who volunteer in elementary schools are not only more physically active than their non-volunteering counterparts, but seem to sustain this physical activity over time. Specifically, those who volunteered burned twice as many calories as those who did not.

This study, led by Erwin Tan, PhD, of the Johns Hopkins University, suggests that the country's investment in national and community service programs can simultaneously be an investment in public health.

"For our volunteers," Tan said, "volunteering with children may be as good for their health as a gym membership. For our children, the wisdom that our older adults have is priceless." He added that, due to their enjoyment of working with children, the volunteers may be more willing to keep up with this approach in the long term, compared with traditional exercise programs.

Tan also explained that the focus on African American women was due to their prevalence in the two community groups from which the study participants were recruited, but he said the results are likely the same for all older people.

The data was gathered from participants in the Experience Corps (EC) program, a community-based initiative that places older adults as volunteers in public elementary schools. This information was then compared to surveys of non-volunteers enrolled in the Baltimore Women's Health and Aging Studies.

Tan's research builds on the results of a 2006 study of the EC program, which showed that 15 hours of volunteer work per week at an elementary school nearly doubled a sedentary older adult's activity level. The new study demonstrates that the increased activity can remain high for at least three years.

Another Johns Hopkins-based investigation of the EC program was published in the December 2008 issue of The Gerontologist. A research team led by Michelle Carlson, PhD, reported similar findings about EC's potential cognitive benefits for participants.

She and her colleagues found that EC volunteers showed greater improvements in memory and executive function than those who did not participate in the program. In fact, the older adults with the lowest baseline performance in these areas — those most at risk for health disparities — demonstrated the most significant gains.

Both studies highlighted above show that everyday activity interventions (e.g., EC) can appeal to older adults' desires to remain socially engaged and productive in their post-retirement years. Simultaneously, these activities provide measurable physical and cognitive health benefits.

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The Journal of Gerontology: Social Sciences and The Gerontologist are refereed publications of The Gerontological Society of America (GSA), the nation's oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging. The principal mission of the Society — and its 5,000+ members — is to advance the study of aging and disseminate information among scientists, decision makers, and the general public. GSA's structure also includes a policy institute, the National Academy on an Aging Society, and an educational branch, the Association of Gerontology in Higher Education.