Open Access Dissertation
Date of Award
Julie M. Novak
As the pool of eligible recipients continues to grow, understanding service system utilization and barriers can help ensure very old adults can access support from their communities when needed. Mounting research demonstrates that investment in community-based services to ensure seniors remain independent translates to saved government dollars. As a contributing researcher of a multi-year county-wide older adult needs assessment in Monroe County, Michigan, data collected from 1,870 people revealed a communication disjuncture between seniors and service providers. In response, officials convened a post assessment working group that focused on communication and outreach. Along with members of the Community Advisory Group (CAG), we determined that additional research could better inform how service providers engage the most senior and vulnerable members of their community. Thus, a community-based participatory research approach was used to conduct an applied, qualitative study aimed to understand how everyday interactions influenced service utilization in late old age. The research was guided by an ecological health communication research framework to respond to academic calls for multilevel examinations of interactions among individuals and their social environment.
Interpersonal connections diminish with age; a phenomenon that is most acute in late old age as families and friends are geographically dispersed or outlived. For those in their 80s who are reluctant to connect through technological means, the network of resources to draw from becomes even more limited. Diminishing microsystems and a lack of experience and apprehensiveness to technology implied that communication disparities increased with age. As informal communication resources diminish, information disparities are remedied when older adults get to sites where they may congregate with other individuals who they can learn from. Local companions were key communication resources for credible and trusted information, advice, and appraisals about community-based services though contingent on older adults getting to sites where they could interact with other seniors.
Communication infrastructure theory offered a frame for unveiling how participants’ diminishing social network interrelated with the communication environment to impede connections to community-based service organizations. In addition to the trans-level utilization impediments, enabling elements of the communication infrastructure were identified so those resources can be leveraged to foster connections between older adults and community-based service organizations. This action-oriented study sought to inform interventions to bridge the senior-provider divide by understanding how interpersonal, mediated, and organizational connections can be improved or leveraged as communication resources in Monroe County to improve communication and connections with older adults. Findings from this study suggest a new outreach approach for connecting to older adults through their communication ecology. The findings add to the growing convergence of evidence that calls for improved communication competence with older adults to minimize poor interactions that hinder accessing resources that can benefit their social, emotional, and physical well-being.
Leach, Carrie, "Understanding The Utilization Of Community-Based Services In Late Old Age: A Participatory Approach For Connecting Through The Communication Ecology" (2019). Wayne State University Dissertations. 2223.