The Uncertainty of Aging: The Physical and Mental Health Needs of Homebound Seniors Living in the Tenderloin Community Partners Curry Senior Center The Curry Senior Center, located in San Francisco’s Tenderloin neighborhood, is a non-profit organization that provides comprehensive services to approximately 2,600 seniors annually. Operating since 1972, this center serves independent, low- income seniors living within the Tenderloin & South of Market neighborhoods of San Francisco. Curry Senior Center Community Adjunct Faculty: David Knego, Executive Director Community health assessment purpose To explore the physical and mental health needs of homebound seniors 85 years and older living in San Francisco’s Tenderloin district. Key questions to tackle For homebound seniors 85 years and older living in the Tenderloin:  What are the priority mental health needs  What are the priority physical health needs  What services are utilized  What are some services not utilized  What are the gaps in mental and physical health services that need to be addressed  How can providers and gatekeepers address these gaps in services Background The population of older adults makes up 17.6% of the population In SF. As the urban area with the largest number of older adults living alone in the nation, the demand for relevant programs and an adequate health care system that can meet the physical and mental health needs of this population is impossible to ignore (DAAS 2006). However, access to primary and psychiatric care is limited, costly and is becoming an epidemic problem with the growth in this segment of the population (Etters & Harrison, 2008; Zeltzer & Kohn 2006). How did we conduct this assessment? Between June-July 2011, SFSU graduate students conducted  9 in-depth interviews with homebound seniors over 85 years old living in the Tenderloin  12 key informant interviews with providers that care for this population. From August-September 2011, data was compiled and analyzed. What did seniors have to say about homebound senior’s health needs? Homebound seniors want:  More opportunities for social engagement that values autonomy and independence.  More vigor and variety in current exercise programs.  Better transportation to access activities for social engagement Kathleen Gali, Liseli Mulala-Simpson, Alexandra Geary-Stock San Francisco Ststae University, Department of Health Education, Master of Public Health program What did providers have to say about homebound senior’s health needs? Providers expressed:  An increase in social engagement is a great way to combat the isolation and depression increasing in this population  An increase in transportation is imperative for seniors to access more services.  A need to increase in-home visiting services and in-home support that addresses mobility and fall prevention.  How a decrease in funding to utilized services such as adult day health, home visiting services and dental services is detrimental to the health of an ever-growing population of seniors. Recommendations 1. Intergenerational Support Program for Seniors: School students receive credit for visiting homebound seniors 1. New Technology: (like computers, smart technology, and WII consoles) for social engagement purposes and to provide an opportunity to increase the variety of exercise options 1. Increase Advocacy and Disseminate Research: Among community members, health care organizations, policy makers and the general public 2. Diversify Services: meditation and guided visualization training to increase self esteem. 1. Education on Aging: Cultural humility training about ageism to all staff in related agencies in all healthcare settings 1. In-Home Mental Health Screening and Education: Mental health screening and basic education by providers currently offering other in-home services 1. Fall Prevention Screening and Inventory: In-home support providers will screen for and check off basic fall prevention inventory 1. Increase in and Evaluation of Current Para-Transit: Increase in more para transit services and evaluation of current system Acknowledgements We would like to thank Curry Senior Center, David Knego, MSW * Jessica Wolin, MPH * Judith Ottoson, PhD * Paul Rueckhaus, MPH * and all the key informants and senior participants who shared their perspectives in this assessment. Senior responses continued Homebound Seniors expressed:  Unfamiliarity with mental health services or that these services are not needed  A lack of self worth by devaluing their own perspective & contribution to society