Senior Centers

Significance of Senior Centers

The Older Americans Act (OAA) of 1965 was the catalyst for the growth and spread of senior centers nationwide. One of the chief goals of OAA was to enhance the well-being of community-dwelling older adults and delay or prevent institutionalization. To this day, the OAA is the largest funding source for senior centers, and its allocations are supplemented at the local level by state, county, and municipal governments. In addition, many senior center budgets are supported and/or supplemented by private sources of funding. The OAA inspired the creation of multipurpose senior centers that were designed to offer a broad spectrum of services (recreational, health, nutritional, and social services). According to the OAA, senior centers are to be considered as “focal points” in the delivery of services to the elderly, thus, emphasizing the need for coordinated and comprehensive service-delivery models. Although all individuals above the age of 60 are eligible for senior center programs (there is no means-testing), the recent amendments call for an increased focus on addressing the needs of the most vulnerable constituents of their communities, that is, individuals with low incomes, multiple needs, and limited resources (National Council on the Aging [NCOA], 2007).

The Expansion and Growth of Senior Centers

Programming in senior centers has gradually evolved in relation to changing needs and user characteristics (Calsyn & Winter, 1999; Demko, 1979; Harris & Associates, 1975; Lun, 2004; Miller, Campbell, Davis, Furner, & Giachello, 1996; Mitchell, 1995; Netzer et al., 1997; Ralston, 1982, 1983, 1984, 1991; Tuckman, 1967). The major reason that senior centers are so diverse in their operating profiles is that they have proven to be quite responsive to the needs of their constituents. Senior centers, depending on their size, budget, and programmatic focus, may range in design from recreational clubs or nutrition sites to traditional community-based senior centers and large, multipurpose senior centers (Krout, 1985; Leanse & Wagener, 1975; Ralston, 1983; Taietz, 1976). Taietz (1976) identified two basic types of senior center models: (a) the social agency model that primarily serves the poor and disengaged populations are in need of services to meet their basic survival needs and (b) the voluntary organization model that tends to attract relatively affluent, better educated, and socially active elders. The five most common categories of senior center programs are nutrition, health and fitness, recreation, volunteer opportunities, and social services (Aday, 2003; Eaton & Salari, 2005; Gavin & Myers, 2003; Gelfand, Bechil, & Chester, 1991; Krout, 1985; Leanse & Wagener, 1975; Pardasani, 2004a; Skarupski & Pelkowski, 2003). Regardless of the individual program designs, meal programs form the core service for the majority of senior centers (Krout, 1998).

So Who Participates in Senior Centers?

Krout, a leading researcher of senior centers, has systematically demonstrated the “graying” of the senior center participant pool from the 1960s to the 1990s (Krout, 1982, 1985, 1986, 1988, 1994, 1998). Longitudinal studies lend credence to the belief among senior center administrators that their participants are “aging in place” and are not being replaced by their younger cohorts (Aday, 2003; Krout, 1988, 1994; Turner, 2004; Walker, Bisbee, Porter, & Flanders, 2004). Researchers have documented that senior center participants are most likely White, single or widowed, older women with medium to low incomes and minimal physical disabilities (Calsyn et al., 1996; Calsyn & Winter, 1999, Krout, Cutler, & Coward, 1990; Pardasani, 2004b; Ralston & Griggs, 1985; Turner, 2004). Participation trends resemble a bell curve. In other words, participation peaks among those in the 75 to 84 age category and then declines as the participants grow increasingly frail or develop limitations.

Rationale for Participation

Reasons offered generally for participation center around the theme of social interaction and companionship, whereby an increase in participation is linked to a greater need for companionship and enhanced quality of programs (Eaton & Salari, 2005; Gitelson, McCabe, Fitzpatrick, & Case, 2005; Krout, 1988; Pardasani, 2004c; Turner, 2004; Walker et al., 2004). Decreased involvement was found to be linked to health problems and lack of transportation to sites (Aday, 2003; New York City Department for the Aging, 2002; Pardasani, 2004c; Strain, 2001; Walker et al., 2004). Men, older adults with higher levels of income and/or education, and those with an extensive social circle were found least likely to participate (Krout, 1988; Lun, 2004; Walker et al., 2004).

Benefits of Participation in Senior Centers

Some studies have found that senior center participants have better psychological well-being across several measures than nonparticipants, including perceived social and health benefits (Gitelson et al., 2005), depression (Choi & McDougall, 2007), friendships (Aday, Kehoe, & Farney, 2006), and stress levels (Farone, Fitzpatrick, & Tran, 2005; Maton, 2002). Aday et al. (2006) found that women who lived alone were most likely to participate in senior centers, develop friendships, and expand their social networks outside of the senior center. Support received through advice from friends and staff at a senior center was directly linked to positive perceptions of health among participants (Fitzpatrick et al., 2005). Skarupski and Pelkowski (2003) found that structured health and nursing programs offered at senior centers increased social support, improved diet and nutrition as well as enhanced the perception of general health. Maton (2002) reported that senior center participation contributed to a heightened perception of general well-being. Meis (2005) and Carey (2004) found that senior centers members felt less isolated and experienced a greater level of social support than their nonparticipating counterparts. Aday (2003) conducted a survey of 734 senior center participants from five states and reported that 90% of the participants felt that their health was better since attending a senior center, and 75% of them reported that the senior center was allowing them to stay independent. Eaton and Salari (2005), Perkinson (1992), and Williams, Haber, Weaver, and Freeman (1998) found that volunteering at a senior center or in activities that benefited the community increased life satisfaction among the members.

Health and wellness programs are at the core of many large, multipurpose senior centers (Beisgen & Kraitchman, 2003; Hayunga, 2004; NCOA, 2001; Pardasani, Sporre, & Thomspon, 2008; Ryzin, 2005). A recent nationwide study of emerging senior center models highlighted the “health and wellness” model as a popular and critical trend (Pardasani et al., 2008). Most recent studies have focused on prevention of falls and minimization of injury risks among older adults (Baker, Gottschalk, & Bianco, 2007; Li et al., 2008; Reinsch, MacRae, Lachenbruch, & Tobis, 1992). Other studies have evaluated the impact of specific health programs offered in senior centers on participants’ physical activity and functioning, including Tai Chi (Li et al., 2008), physical activity and exercise (Fitzpatrick et al., 2005; Wallace et al., 1998), nurse-managed wellness program (Campbell & Aday, 2001), falls and injury prevention (Reinsch et al., 1992), walking (Sarkisian, Prohaska, Davis, & Weiner, 2007), resistance training (Manini et al., 2007), line dancing (Hayes, 2006), increasing healthy eating habits (Hendrix et al., 2008b), and diabetes self-management (Hendrix et al., 2008a). All the studies listed above have demonstrated a positive impact on the health and well-being of their respective participants.

Need for Innovation and Change

Researchers (Calsyn & Winter, 1999; Krout, 1998, Pardasani, 2004c, Turner, 2004, Young, 2006) have summarized the following challenges for the continued relevance and existence of senior centers: (a) continue to serve the current participants effectively while trying to engage nonparticipating older adults, especially the “baby boomers”; (b) people in their 60s are different in their educational and work histories, political attitudes, and recreational/social needs than their older counterparts; (c) reconceptualization of retirement in our society with many older adults preferring or needing to work and many preferring to volunteer and engage creatively with their communities; (d) reconceptualize participation in the new era of increased consumer choices; (e) reduce the negative stigma associated with participation in senior centers (such as only vulnerable seniors need or attend senior centers) and reinvent their image; (f) redesign and rebuild modern facilities; (g) decrease reliance on shrinking public funding sources and explore private resource alternatives; and (h) attract new sources of potential funders—individual and foundations—to expand and innovate.

The NMTF

A taskforce comprised of 21 senior center directors and administrators from around the country was established in 2007 by the NISC, the nation’s premier advocacy and membership organization for senior centers. Eight members of the taskforce also served on the Delegate Council of NISC, while other taskforce members were recruited nationally by the chair of the taskforce, Peter Thompson. The non-NISC members of the taskforce comprised administrators of private and public, not-for-profit senior centers from around the country. The primary author of this study was invited to lead the research efforts of the taskforce. The taskforce was charged with identifying and defining the new, emerging models of senior centers in the country.

Study Questionnaires

An initial 14-item questionnaire was developed by the taskforce. This questionnaire asked respondents to provide information on the demographic characteristics of participants, funding size and sources, and the philosophical mission of their senior centers, as well as to describe the process and product of innovation that they had undertaken. Additional questions attempted to assess the reaction to the innovation from funders, staff, and participants (stakeholders); the involvement of the stakeholders in the process; the resources utilized for the project; the potential for sustainability and replication; and the outcomes of its implementation.

A second questionnaire comprising 10 items was developed as a follow-up to the first questionnaire. Evaluating the responses to the first questionnaire, the members of the taskforce worked collaboratively to identify senior centers with the most impactful and sustainable innovations. Members of the taskforce then conducted phone interviews with the selected respondents. The second questionnaire was utilized for this follow-up interview. This questionnaire allowed for a more in-depth assessment of the innovative model, including the delineation of its chief characteristics, its overall impact, and implications for practice.

Sampling

The first questionnaire was posted online at a website provided by Indiana University Northwest. An introductory letter was drafted by the taskforce. This letter explained the purpose of the study and directed interested respondents to the website. The letter was sent out as an e-mail to 751 members of the NISC. NISC members comprise a diverse range of senior centers with reference to location (urban/suburban/rural), characteristics of participants, and types of programs. Due to the limited resources available, the study could not be expanded to non-NISC members and may therefore have impacted the reliability/validity of the findings. This type of sampling could be best described as a nonrandom type of convenience sampling as it was limited to NISC members. A total of 187 respondents completed the online survey, yielding a 24.9% response rate.

Based on the selection criteria described in the next section, 35 respondents were selected to represent the most innovative senior centers. The second questionnaire was administered in person (interviews) by members of the taskforce.

Data Collection and Analysis Process

Data collection and analysis occurred in two stages. The initial data were collected by an online questionnaire and then transferred to an Excel file. In the first stage, six critical concepts for assessment were determined—expansiveness of innovation, feasibility and sustainability, utilization of resources for implementation, potential for replication, impact on participation, and cooperation from stakeholders. After identifying the six critical concepts, the taskforce developed working definitions for each of them and a 3-point scoring system was created (as described in Table 1). The 187 responses were categorized by the authors of this study into five major foci of innovation—programmatic, fundraising, and resource development; marketing and outreach; facilities; volunteer and staff development; and community collaborations. Each of the 21 members was then assigned to one category (through self-selection). Each member of the taskforce then evaluated each entry in that particular category on a 3-point scale for every critical concept (six in all) and gave the entry an overall score (range 6-18). The individual evaluator scores for each category were then combined to create composite, mean scores. There was minimal variation in the mean scores among members. In the final step of the first stage, the entries with the highest scores were identified, which led to the final list of 35 senior centers.

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Table 1.

Criteria for Selection of Innovative Senior Centers

	Criteria	Conceptualization	Score 1	Score 2	Score 3
Criterion No. 1	Expansiveness of innovation	The breadth of the innovation. Was the innovation limited to a specific program/activity or multiple programs and endeavors? Was there a rethinking of a significant proportion of the program model?	If the innovation was limited to one specific program/activity	If the innovation was related to 2-5 programs/activities	If the innovation resulted in a rethinking of mission, a conceptual model was identified (health and fitness, education, intergenerational, etc.) and program offerings redesigned
Criterion No. 2	Cooperation from stakeholders	How many stakeholders were involved in the planning process—board, staff, participants, funders, etc.?	If only one set of stakeholders were involved in planning	If more than one set of stakeholders were involved in planning	If all possible stakeholders were involved in the planning process
Criterion No. 3	Utilization of resources	What was the extent and type of resources (monetary and material) utilized for this innovation? Respondents were asked to place a monetary value on the manpower and nonmaterial resources utilized	Less than US$10,000	Between US$10,000 and US$100,000	More than US$100,000
Criterion No. 4	Impact on participation	Did participation increase as a result of this innovation?	Participation increased by 10%	Participation increased between 10% and 20%	Participation increased by greater than 20%
Criterion No. 5	Potential for replication	What is the probability that this idea/innovation can be replicated in other senior centers?	Replication was difficult—with reference to cost, location, and nature of participants	Replication was possible with some conditions/restrictions—such as the cost, type of participants, location, and public funding policies. The replication would be relevant to most senior centers	Highly replicable—with reference to cost, ease of adaptation, relevance for a broad range of participants, and locations
Criterion No. 6	Feasibility and sustainability	What are the long-term prospects of this innovation at the senior center? Are there concrete and well-thought-out plans for continuation?	The innovation will be sustained in the short term (1-3 years)—by evidence of funding, board support, staff ability, and demonstrated need for program	The innovation will be sustained for more than 3 years but less than 5 years—by evidence of funding, board support, staff ability, and demonstrated need for program	The innovation will be sustained for more than 5 years—by evidence of funding, board support, staff ability, and demonstrated need for program

In the second stage, the 35 finalists were interviewed (via telephone or in person) by members of the taskforce (through assignment by study authors). The responses of the finalists, as well as their interpretation by taskforce members, were purely subjective. Reviewing the interviews of the 35 finalists, the taskforce noticed common themes with respect to programming, operating philosophy, and service perspectives. Based on the common themes of innovation and programming that were found in the 35 short-listed senior centers, six models or categories of emerging senior centers were identified by members of the taskforce in two follow-up meetings (postinterviews). The members then decided (by consensus) to attach each of the 35 senior centers to a specific model. Using the multiple case study method of analysis, specific defining characteristics of the various emerging models, their service/program design, and impact on community were identified and highlighted.

Consumer Profile

The CC model differs significantly from all the other models in its focus on a multigenerational consumer base. In this model, various generations—children, adults, and older adults—are served under one roof. While specific programs are designed for each age cohort, several programs and services are available to all age groups. The other models (WC, LLA, EC, and CP) all focus on the relatively healthy and mobile older adult. Only the CCT model with its focus on a continuum of care concept allows for specific programming for older adults at various stages of aging. Although the CP model provides a restaurant-style experience for all members of the community (regardless of age), most recreational and educational programs are limited to older adults only. An important aim of all the models (with perhaps the exception of the CCT model) is to attract the “younger” older adults or the baby boomers that are in short supply in traditional senior centers as noted earlier in the review of literature.

With reference to race and ethnicity, the consumer profile is highly dependent on the location of the senior center models. While the CC, EC, and WC models tend to be located in suburban areas or new developments, the LLA and the CP have been located in both suburban and urban areas. The latter two models attract a diverse clientele, although Hispanic older adults are the least likely to attend, even when present in the community. The CCT model also tends to attract a diverse consumer base but is highly dependent on the location of these programs. Programs located in the southern United States report a significantly higher African American participation rate than those in the northern United States.

Organizational Mission and Philosophical Focus

The names assigned to each model underscore their organizational missions. As with a traditional senior center, all models provide an environment for socialization, social support, resource information, and interpersonal engagement. The organizational mission of the CC model is to be a focal point of services and programs within a community regardless of age. The proponents of this model believe that providing multigenerational programming achieves two outcomes—it prevents age segregation (thereby reducing stigma) and addresses the needs of older adults who want to engage in activities with other generations. However, the mission of the WC, LLA, CCT, EC, and CP models is to cater only to the needs of the older adult population. While the WC’s mission is to focus on improving the health and well-being of older adults, the LLA and CP models focus on intellectual stimulation and creative pursuits for older adults. The CCT model also focuses on the health and well-being of older adults, but its mission is to serve older adults at every stage in their aging process. Proponents of this model believe in an incremental, gradually expanding service that meets the increasing needs (health, support, and social service) of older adults as they age. The EC model focuses on civic engagement, volunteerism, and resource generation through the utilization of the skills and expertise of the older adult population. Another focus of the EC model is to create programs that generate income through various entrepreneurial ventures.

Program Design and Offerings

Of all the models, the CP model has the most limited range of programs. In addition to the meal service (in a café-style environment), a few recreational and educational programs are provided in the afternoons and early evenings. Most of these programs are restricted to older adults (55+) and focus on intellectual stimulation, limited exercise, performing arts, or health literacy. The CC, WC, EC, and LLA models offer a range of recreational programs such as arts and crafts, cards, board games, trips, performances, cultural programs, and meals. All the models also offer some level of health education and screenings, information and referral services to other community-based programs, and varying degrees of exercise programs. However, the CC model specifically provides non-age-segregated programs to a greater extent than those offered by other models. As with the WC model, the CC model is built around a state-of-the art recreational facility that includes a gym, indoor and outdoor sports courts, pools, and sports leagues. In many cases, the intergenerational mingling occurs organically in the CC model rather than having to be scheduled as in some traditional senior centers.

The WC model has the most structured and well-defined slate of programs/services geared toward health and fitness. At the core of the WC model is a state-of-the-art fitness facility that may include a fitness center, basketball and tennis courts, indoor running tracks, personal training and fitness classes, saunas, and swimming pools. While traditional recreational and information/referrals programs are also offered in the WC, a concerted effort is made to provide evidence-based and professional (supported by licensed health care and fitness professionals) health-based programs such as workshops, screenings, testing, and interventions that enhance the well-being of their participants.

The LLA model focuses on continuing education and caters to the knowledge acquisition needs of their members. Programs (for-credit and noncredit courses), workshops (e.g., culinary, pottery, arts), and travel are geared specifically to meet the learning needs of the older adults. While all models provide for a diverse range of volunteer opportunities, the EC model creates the most structured program that provides training, placement, and coordination services for volunteers/older workers in the community.

The CCT model, in addition to providing the recreational, educational, and health literacy programs mentioned above, also focus on the needs of the frail and disabled older adult. In this model, similar to the assisted living facility model, services are provided at a central location as well as at the residence of the older adult. In other words, along with home-delivered meals (that are offered directly by or through contract by many traditional senior centers), the CCT model also provides for home health care, chore assistance, nursing, medical, physical therapy, and any other services that allow the individual to remain safely and comfortably in their own homes.

Hours of Operation

The issue of hours of operation has been a thorny one for most senior centers. Due to limited funding and resources, most traditional senior centers open in the early morning and close around 5:00 p.m. or even earlier. Traditional senior centers also remain closed on weekends and holidays. Most of the models cited here have expanded hours and days of service. While the CC and WC models open early and remain open until late in the evenings (as well as weekends), the CP model operates around the breakfast and lunch program. Therefore, the CP model closes early (by 4:00 p.m.) except on a rare occasion when there are artistic performances or lectures, which is similar to the EC model that also has traditional hours of service—early morning to early evenings (4:00 or 5:00 p.m.). However, due to their fitness centers and recreational facilities, the CC and WC models need to remain open for longer hours and on weekends/holidays to cater to the paying customer (members or nonmembers).

The LLA model may operate on a flexible schedule as many classes and travel are scheduled in the evenings or weekends to accommodate the younger older adult with work or family responsibilities. The hours of operation of the CCT model depends on where the services are being provided. On-site hours of operation are the same as other models—early morning to early afternoon. But in this model, there may be a dedicated phone service or professional available after hours to coordinate home-based and medical needs.

Service Sites and Location

Many proponents of change have called for the “senior center without walls” concept where programs and services are offered at multiple sites in partnerships with various community providers (Pardasani, 2004c; Ryzin, 2005; Young, 2006). The benefits of this concept are threefold: it increases the range of programs/services available to a consumer, avoids duplication and waste of resources, and allows for an integrated system of community-based care. However, nervousness about losing consumers to “rival” agencies, funding policies, and traditional turf battles pose a challenge to this idea. Researchers have already demonstrated that most senior centers work with diverse providers through structured and informal collaborations, but the scope of such partnerships could be expanded further (Krout, 1998; Pardasani, 2004b, 2004c).

The CC, WC, EC, and CP models all operate primarily from one main site. In the CC, WC, and EC models, there is usually one large facility with extensive resources and functional spaces. In the CP model, all programs are centered on a café that is centrally located in a downtown area. All four models may offer referrals to services at other facilities and sites, but the central focus of programming is their own facility. The LLA is one model that is least connected to the one-site policy. Because of the nature of programming—educational courses, performing arts, cultural events, and connections with educational institutions—multiple sites may be more relevant to their needs.

In the case of the CCT model, services may be provided at one main site, but then home-based services are also provided for the frail or homebound older adult. Also, medical and social work staff may be available at one site during the day but may be connected through a professional service after hours. In this model, it is entirely possible that the main site only offers traditional programs during daytime hours like meals, recreational programs, assessments, and information and referrals, but all other services are provided through linkages and coordination with other providers. However, case coordination still takes place at the main site.

One critical factor in the location of service sites is access. While most of these models tend to be located primarily in urban or suburban regions, they may be less frequent in rural regions due to the reasons cited above. The CP model also locates cafés in urban, downtown areas to be more accessible to the community rather than only to older adults. In the LLA model, transportation may be provided for a fee. The CCT model may also utilize public transportation services such as para-transit, but its clients’ needs are significantly different and in many cases maybe more critical.

Main Sources of Funding

Most of these models, except the LLA and CP models, depend on public sources of funding. Furthermore, OAA, state, and county allocations remain stagnant (Ryzin, 2005; Young, 2006), senior centers have to devise strategies to supplement their incomes. One of the chief hurdles for resource generation is that public funders may have stipulations on the type and scope of additional (external) funding sought by the senior center. For instance, if a senior center receives funding to provide meals to older adults, they cannot charge them for the meals. However, they are allowed (with certain restrictions) to accept voluntary contributions from consumers.

While the extensive facilities operated by CC’s are usually publicly funded (e.g., parks and recreation departments, taxes, special bonds/levies, etc.), some funds may be generated through the charging of nominal fees. These subsidized fees could be charged for use of the recreational facilities (depending on the policies of the public funder), specific programs, or for space rentals. If the CC model receives OAA funding or has contracts with the department of aging in their counties, then the meals and some other programs are provided at no cost to the older adults.

The LLA and WC models may operate a traditional senior center program with public funding, but the fitness and educational programs are sustained through consumer fees. The CCT model may receive traditional funding support for their onsite programs but are also able to access public or private health care funds (e.g., Medicare, Medicaid, etc.) for specific home care, case management, and health care services.

The CP model has been created entirely through private funding support. While the consumers (both older adults and nonolder adults) are charged for their meals and participation in some programs designed for older adults only, this income is supplemented by support from the sponsoring organization. There has been an attempt to explore public funding for such a program, especially in regions where there are no senior centers.

Identification as “Senior Center”

It should be noted that many of the emerging models (CC, WC, LLA, CCT, and CP) shy away from the use of the term senior centers to identify themselves. They all report the rationale for their choice to be the negative image of senior centers. Frequently, these models use nondistinguishing names to identify themselves.

Impact

The impact of these models can be delineated on multiple levels.