Supporting People as They Age in Community: Senior Centers
THIS SERIES OF ARTICLES EXPLORES HOW RHODE ISLAND CAN SUPPORT PEOPLE AGING IN COMMUNITY THROUGH HOUSING, TRANSPORTATION, SENIOR CENTERS, AND ACCESS TO INFORMATION.
Rhode Island’s population is among the oldest in the country, and the number of older adults in the state continues to grow rapidly. By 2040, people over age 65 will make up a quarter of the state’s population, up from 14% in 2010. The vast majority of these older adults will age in the community, rather than nursing homes or other forms of institutional care. For many people, aging in community is preferred because it offers greater independence, lower costs, and more opportunities for social interaction and community engagement. However, some older people struggle financially, physically, and emotionally to stay in homes or communities that are not designed to accommodate their changing needs. Robust programs, policies, and supports are needed in order for aging in the community to truly benefit seniors, their caretakers, and the state as a whole.
Senior centers play an important role for people aging in the community. They help older people stay healthy and engaged by offering opportunities for recreation, social engagement, and volunteering; providing information, outreach, and service referrals; and delivering nutrition and health services. Senior centers serve as a community-based source of support for older adults to retain their independence, self-reliance, and social connections, thereby delaying or preventing institutionalization.
As our population of older adults expands and changes, the role of senior centers as part of a continuum of long-term care is being reevaluated and adapted to meet the needs of today’s seniors.
There are opportunities to offer new services and activities and explore innovative funding models. Senior centers are integrating healthcare more deeply into their services, cultivating spaces that attract younger seniors, and experimenting with how to best serve this generation of older adults. This article examines how senior centers can effectively enable today’s seniors to remain active, socially engaged, healthy, and independent.
A Hub for Vital Services & Support
Created in 1965 with the passage of the Older Americans Act (OAA), senior centers are intended to be a source of community-based support to help older Americans remain as independent as possible. There are an estimated 11,000 publicly funded senior centers in the U.S., visited by 11 million adults each day.1 On average, about three-fourths of these adults visit their center one to three times per week, spending an average of just over three hours per visit.2
Senior centers offer a wide range of services and activities. They provide health programs targeting physical activity, exercise, fall and injury prevention, nutrition and healthy eating, and chronic disease management. A number of educational, social, and recreational activities are typically available. Most centers are congregate meal sites, offering a space where people can eat and socialize, and many serve as shelters and warming centers in emergency situations. Some senior centers provide transportation for participants, although seniors often have to rely on public transportation and paratransit services to reach urban and suburban centers.
Fig. 1 Services & Activities Provided by Rhode Island Senior Centers
Source: Raimondo (2016).3
All adults over age 60 are eligible for senior center programs, although many centers open their programs to adults 55 and older. Most senior center services are publicly funded and free for seniors, although some centers have a nominal annual membership fee. Emerging models are adding fees for enhanced programming, such as educational and fitness classes that involve more expensive equipment or professional program leaders.(a)
(a) For example, the Wise Owl Senior Center in Wickenburg, Arizona charges $2 for its Silver Sneakers exercise class and operates a van service that transports older adults to programs within a five mile radius of the city for a sliding-scale fee.
Research demonstrates that senior center programs can help older people manage or delay the onset of chronic diseases and improve their social, emotional, mental, and economic well-being.2
Participants have better psychological well-being and perceived social benefits including more friendships,4 lower stress,5 and lower rates of depression.6 Structured health programs at senior centers have been shown to improve diet and nutrition, reduce falls, and increase self-reported general health and overall well-being.7
The Landscape of Seniors Centers in Rhode Island
In Rhode Island, 45 senior centers serve as hubs of social and human services for 208,000 residents 55 or older.8 These centers respond to the diverse needs of their local communities, fostering independence and community engagement. Several are located within larger community centers, and 11 are in the city of Providence. Some are operated by nonprofit entities, others by municipal governments. The centers vary in their size and program offerings. Thirty-two of Rhode Island’s senior centers are congregate meal sites and 15 are sites for The POINT, the state’s information and assistance program for older adults.9 While a few centers provide transportation for participants, most visitors must find their own transportation or use state-funded transportation programs for older adults.
Fig. 2 Senior Centers in Rhode Island
In focus groups with older Rhode Islanders conducted by the Aging in Community Subcommittee of the Long Term Care Coordinating Council, participants discussed the value of senior centers in their lives.(b) They described senior centers as their “home away from home,” their “family,” “a place where friendships are made,” a “life saver,” and a vital source of friendship and companionship. Many people frequent senior centers daily for the emotional and social support they receive, and describe the centers as filling a void created by the loss of loved ones or the loneliness of living alone.
Focus group participants enthusiastically described the enjoyment of joining friends for meals, looking forward to trips, participating in recreational programs, or just socializing. Some enjoy the opportunity for learning through classes and educational programs, while others participate in recreational activities and trips to theaters, shopping, musical performances, casinos, and sightseeing activities. For younger seniors, many of whom are newly retired, the centers contribute to their overall health and well-being through a variety of exercise classes, nutritional information, and health education.
(b) Focus groups were conducted with older adults throughout the state at East Providence Senior Center, the Edward King House (Newport), the Leon Mathieu Center (Pawtucket), St. Martin de Porres Senior Center (Providence), South Kingstown Senior Center, Salvatore Mancini Resource and Activity Center (North Providence), Richmond Community/Senior Center, Pilgrim Senior Center (Warwick), St. Elizabeth Place (Providence), and Landmark Hospital/Senior May Breakfast (Woonsocket). The 100 focus group participants included a mix of men and women ranging in age from 65 to 94. Participants were married, single, and widowed and lived in their own homes, senior housing, rented apartments, and assisted living communities. While focus group facilitators did not specifically inquire about senior centers, the topic often arose spontaneously during the discussions.
The Aging in Community Subcommittee also conducted a survey of senior center directors from across Rhode Island.(c) Many participants identified their center’s greatest strength as the ability to tailor services to the needs of the community with the intention of promoting independence. Their biggest challenge is the ability to respond to a new generation of baby boomers coming of age. Another challenge identified by many center directors is a reduction in government funding.
Reimagining The Senior Center
(c) The survey was distributed to 27 senior center directors through the Rhode Island Senior Center Directors Association. Fifteen directors responded.
Across the country, senior centers are evolving to meet the needs and interests of today’s older population.
New models are developing that address growing concerns about the relevance of centers to seniors of all ages, changing ideas about retirement, stigma around the “senior” label, and funding challenges. In 2012, a National Institute of Senior Centers (NISC) taskforce researched promising approaches and identified six innovative models for what senior centers may look like in the future.10
The Community Center model serves all ages of people under one roof, promoting intergenerational interaction and combating age segregation and, therefore, stigma and isolation. The Café Program is centered around community meals for all ages offered in restaurant-like gathering spaces, along with recreational and educational programming specifically for seniors. The Lifelong Learning/Arts model focuses on providing learning, travel, and cultural opportunities, while the Entrepreneurial Center promotes senior productivity through civic engagement, continued employment, and volunteer activities. The Wellness Center and Continuum of Care/Transitions models focus on health and wellness. The former is primarily for relatively healthy seniors, while the latter is designed to address an array of health issues that arise as seniors age, including services specifically for those who are frail or homebound.
Fig. 3 Six Innovative Models for the Senior Center of the Future
Source: Pardasani & Thompson (2012).10
Senior Centers & Health
There is a growing trend among senior centers to offer health and wellness activities and prevention-related programming. For instance, more than 60% of centers offer chronic disease screening and over 75% offer fitness and/or health education.11 In addition, many traditional senior center offerings already address the social determinants of health, including nutrition, meals, education, socialization, support services, and referrals for care. If strengthened and financially bolstered, senior centers could expand their services to further improve the health and well-being of older adults and prevent premature institutionalization.
While enhancing the role senior centers play in health and wellness seems like a natural fit, questions remain as to whether formal health services should be integrated into senior centers or left to sites with more established capacity. Depending on a community’s institutional make-up and population, creating deliberate collaborations between senior centers and sites with medical, nursing, or physical therapy offerings may be the optimum choice and most efficient use of resources.(d)
In San Diego, California, for example, senior centers have focused on improving the health of lower-income seniors through strategic partnerships with schools of social work, law, public health, and nursing; meal sites; local health centers and other organizations that offer health education and preventive screenings; and sources of financial and legal assistance and other social services. This network of supports can provide needed services as well as an “early warning system” for health problems that might otherwise be missed until they become quite serious and costly.12
Funding for Seniors Centers
Financial support for senior centers is a patchwork of federal, state, and municipal funding supplemented with membership fees, private donations, and fundraising events. In Rhode Island, senior centers typically have an annual budget in the range of $350,000 to $500,000. Allocations and funding sources vary widely across centers. Federal dollars come from a variety of grants and funding streams. Title III-B grants from the Older Americans Act (OAA) are used for services including health and wellness programs, transportation, nutrition education, and case management. Other federal grants like Integrated Services Grants, Senior Health Insurance Information Program (SHIIP) funds, and the Medicare Premium Pay Plan fund specific services like health insurance counseling.
(d) These kinds of collaborations are being explored and promoted by the new Aging and Disability Business Institute located in the National Association of Area Agencies on Aging, with funding from the Administration on Community Living and private foundations.
At the state level, the Rhode Island General Assembly appropriates funds in the state budget for community service grants channeled to senior centers through the Division of Elderly Affairs (DEA). In the past, DEA allocated these funds based on historical amounts from prior years; however, this year they shifted to a funding formula based on population.(e) While the total amount of funding for fiscal year 2018 remained the same as in fiscal year 2017 ($400,000), some centers received less money than in the prior years, while others received more. Some senior centers also receive small legislative grants awarded directly by state legislators from their communities.
Most senior centers also receive municipal funding, as well as in-kind services such as free space or building maintenance. In many cases in Rhode Island, cities and towns are the primary source of funding for local senior centers. For example, centers in East Providence, Lincoln, East Greenwich, Warwick, and Coventry receive most of their funding from their local municipality.13 However, other centers in Rhode Island receive little municipal funding.
One of the most critical challenges facing senior centers is shrinking government funding. In Rhode Island, legislative appropriations for senior centers dropped from $860,786 in FY 2006 to $400,000 in FY 2017.14 At the federal level, the OAA is one of the key pieces of legislation funding services for seniors. It was allocated $1.9 billion in 2014, but just $368 million of this budget went to home and community-based services and only a small portion of that was for senior center operations.15 OAA funds are distributed based on each state’s population of adults over age 60. By one estimate, the federal allocation for home and community-based services (only part of which goes to senior centers) is equivalent to around $10 per year for each older American, or $27 per person when funding for meal programs is included.10 This per-person allocation is barely enough to support senior centers at their current level of activity, let alone expansion.
These declines in federal and state funding present a critical challenge to the continued viability of senior centers and their ability to meet the needs of a growing older population. Private funding may not be sufficient to close the gap. One way Rhode Island could increase funding for senior centers would be to establish a program of community senior service grants that would fund local senior centers on the basis of a municipality’s population of non-institutionalized people age 65 and older, rather than historical allocations not tied to population. Funding could start at $5 per senior (or the amount of the municipality’s FY 2017 award, whichever is greater) and gradually increase to $10 per senior. The funds would be allocated to municipalities or nonprofit community agencies that operate senior centers.
Another option for increasing funding would be to channel Medicaid funds for long-term care to healthcare and prevention services at senior centers. This funding would enable senior centers to expand and offer new services aimed at helping older adults remain mentally and physically healthy. For example, centers could employ case managers, patient navigators, social workers, or community health workers to support older adults as they navigate the healthcare and social service system, adhere to their medical regimens, maintain healthy lifestyles, and secure housing. In addition, these professionals could strengthen psychosocial support for loneliness, depression, substance use, and other behavioral issues. Locating these services at senior centers in the community could provide easier access for older adults and a more comfortable, informal setting than the sometimes cold and intimidating medical environment.
(e) Over the past four years, legislation was introduced to distribute the community service grants for senior services based on the population over age 65 in each community, providing $5.00 per each person in the community age 65 and over as a base amount and increasing that each year until $10 per each person age 65 and over was reached. This legislation, however, was not passed.
Currently, Rhode Island Medicaid pays for case management and nursing assessments through home and community-based services and the Department of Elderly Affairs copay programs. “Preventive Service” is available for people who require minimal assistance with activities of daily living (ADLs) but do not meet a “Long Term Care” level of care. Preventive services include adult day health services and home care provided by nurses, CNAs, and homemakers. These services could be extended and provided in the senior center setting, and could be expanded to include services provided by behavioral health professionals.(f) However, senior centers are not currently licensed as healthcare providers to receive state Medicaid funding and changes in regulations would be needed to enable them to receive Medicaid reimbursement.
Directing greater state healthcare funds to senior centers aligns with Rhode Island’s Reinventing Medicaid initiative, which focuses on rebalancing Medicaid spending from higher-cost institutional environments to home and community-based services. Medicaid expenditures on long term services and supports in Rhode Island accounted for $850 million in FY 2016, $503 million of which went toward institutional care.16 If the state wanted to budget additional funds for preventive health services at senior centers, spending $20 for each of the 170,000 Rhode Islanders over age 65 would total a little over $3.4 million. This would truly represent an investment in preventive community-based care for older adults and could dramatically reduce the costs of treatment in more expensive institutional settings such as hospitals, emergency rooms, and nursing homes.2
The Future of Senior Centers in Rhode Island
As people live longer, baby boomers continue to age, and the older population grows, policymakers and community leaders will need to make decisions on how to best support the health and well-being of older Rhode Islanders. Many older adults can age in the community when there are policies and infrastructure that offer them the supports and services they need to remain at home.
(f) In California, multi-purpose senior centers provide such services through Medicaid for clients meeting a nursing home level of care.
Senior centers can serve as an essential hub in this network of support, meeting a wide variety of needs from social engagement and mental stimulation to meals and fitness to healthcare and social services. An interlocking system of preventive measures and supports, as in some of the models and examples outlined in this article, can help seniors stay in their own homes and avoid unnecessary institutionalization in nursing homes. This can take the pressure off Medicaid funding while sustaining older adults’ energetic contributions to their communities for many more years.
However senior centers evolve, they will continue to be an integral component of the social structures, supports, and public policies that promote the well-being of older adults. They can help Rhode Island do everything it can to provide opportunities for older adults to stay engaged and active and remain integral parts of their communities well into their older years.
In 2014, Rhode Island’s state legislature passed the Aging in Community Act, which created an Aging in Community Subcommittee of the Long Term Care Coordinating Council tasked with studying the programs and services needed to support the state's growing older population. This policy brief is one in a series sharing findings from the subcommittee’s final report, the result of eighteen months of research by a team of experts. The report assessed the current level of community livability and “age-friendliness” in Rhode Island, inventoried available services and resources, identified best practices, and proposed recommendations for building age-friendly communities. This brief shares the report’s findings on senior centers.
1. Pardasani, M., Sporre, K., and Thompson, P. M. (2009) New Models of Senior Centers Taskforce Final Report, Arlington, VA: National Institute of Senior Centers.
2. National Council On Aging (2017) Fact Sheet: Senior Centers, Arlington, VA.
3. Raimondo, Marianne (2016) “Senior center programming [unpublished raw data].”
4. Aday, R. H., Kehoe, G., and Farney, L. (2006) “Impact of senior center friendships on aging women who live alone,” Journal of Women & Aging, 18: 57-73.
5. Farone, D. W., Fitzpatrick, T. R., and Tran, T. V. (2005) “Use of senior centers as a moderator of stress-related distress among Latino elders,” Journal of Gerontological Social Work, 46(1): 65-83. Maton, K. (2002) “Community settings as buffers of life stress? Highly supportive churches, mutual help groups and senior centers,” in Revenson, T.A., et al. (editors) A Quarter Century of Community Psychology, Boston, MA: Springer.
6. Choi, N. and McDougall, G. (2007) “Comparison of depressive symptoms between homebound older adults and ambulatory older adults,” Aging Mental Health, 11: 310-322.
7. Skarupski, K. and Pelkowski, J. (2003) “Multipurpose senior centers: Opportunities for community health nursing,” Journal of Community Health Nursing, 20: 119-132. Albert, S. M., King, J., Boudreau, R., Prasad, T., Lin, C. J., and Newman, A. B. (2014) “Primary prevention of falls: Effectiveness of a statewide program,” American Journal Of Public Health, 104(5): e77-e84. Aday, R. H. (2003) “Identifying important linkages between successful aging and senior center participation,” paper presented at the Joint Conference of the National Council on Aging/American Society on Aging, March, Chicago, IL. Maton, K. (2002).
8. Division of Elderly Affairs (2017) 2017 Pocket Manual: The Rhode Island Guide to Services for Seniors and Adults with Disabilities, Cranston, RI: Rhode Island Department of Human Services.
9. This information was obtained from the Rhode Island Division of Elderly Affairs in 2015 and 2016 as part of research conducted by the Aging in Community Subcommittee of the Long Term Care Coordinating Council.
10. Pardasani, M. and Thompson, P. (2012) “Senior centers: Innovative and emerging models,” Journal of Applied Gerontology, 31(1): 52-77.
11. Casteel, C., Nocera, M., and Runyan, C. (2013) “Health promotion and physical activity programs in senior centers,” Activities, Adaptation, and Aging, 37(3): 213-223.
12. Pettigrew, K.A. (2013) “Senior community centers of San Diego as a preventive care model,” American Journal of Preventive Medicine, 44(15): 534-538.
13. Maigret, Maureen (2015) “About Senior Centers,” Unpublished report distributed to the Rhode Island Long Term Care Coordinating Council’s Aging in Community Subcommittee.
14. Aging in Community Subcommittee (2016) Aging in Community, Providence, RI: Long-Term Care Coordinating Council.
15. Fox-Grage, W. and Ujvari, K. (2014) “The Older Americans Act,” Insight on the Issues, 92.
16. Rhode Island Executive Office of Health and Human Services (2017) Rhode Island annual Medicaid expenditure report, SFY 2016, Cranston, RI.
Type of Research
- Responds to questions of Policy Leaders with research projects that closely align with state priorities
- Provides implications for challenging state issues