Study Finds Wellness Teams Boost Health in Senior Housing

Housing with services can improve the health and well-being of residents in low-income older adult housing communities, according to a new study highlighting the positive impact of the Right Care, Right Place, Right Time (R3) program. The R3 initiative, developed by Hebrew SeniorLife, integrates wellness teams into senior housing communities to proactively support the health and social engagement of low-income residents, who are often more vulnerable, have more limited social networks, and have higher morbidity rates than other older adults.

Published in The Gerontologist, the study, entitled “Housing and Community Partner Views on the Benefits of Housing With Services: The Right Care, Right Place, Right Time Program,” examined the perceived effects of the R3 program on approximately 400 residents across seven affordable housing sites in the Greater Boston area. Partners reported that residents better connected with and utilized resources, which led to a reduction in emergency transportation. Additionally, residents appeared to have felt more empowered, which alleviated distress.

The R3 program embeds wellness teams — each comprising a wellness coordinator such as a licensed social worker and a wellness nurse — into affordable senior housing. Together, they:

• Educate residents and promote self-care
• Provide issue-specific counseling (e.g., home modifications, medication management)
• Monitor high-risk residents and connect them with health resources
• Coordinate with health care providers, payers, and care managers
• Facilitate hospital-to-home transitions
• Lead group programs and distribute educational materials
   

The study evaluated housing and community partner experiences, which the researchers say can help establish expectations for program impact while also helping to understand how to engage and motivate partners in future endeavors. Benefits to housing sites included increasing staff’s ability to support residents through information provision, direct support, service coordination, and community partnerships; enabling housing staff and management to focus on other responsibilities; reducing turnover, vacancy, and lease noncompliance costs; and bolstering the marketability and reputation of their properties.

The study also found that community partners perceived more appropriate utilization of services by residents (e.g., reducing emergency transports), which could result in lower costs. Further, many housing partners reported that additional staffing due to R3 enhanced housing sites’ abilities to perform pre-existing tasks, procedures, and routines. Some housing partners viewed R3 staff as extensions of existing departments, such as social work, resident services, or programming.

Additionally, many housing partners reported that the R3 program provided residents with additional attention and support at the housing sites, thus complementing or substituting for families unable to assist residents.

According to the researchers, Edward Alan Miller, PhD, MPA; Pamela Nadash, PhD, BPhil; Elizabeth Simpson, MPH; and Marc A. Cohen, PhD, of the LeadingAge LTSS Center at the University of Massachusetts Boston, this kind of qualitative study “can tease out nuances not accessible through other data sources, which is especially important if such models are to be replicated more broadly beyond the demonstration phase.”

The researchers previously documented the positive effects of R3 on health care use and costs. Quantitative findings from parallel research indicate significant declines in ambulance transfers and slower growth in inpatient hospital and emergency department utilization and hospital readmissions among residents in R3 buildings compared to residents at comparison group sites.

Funding
This study was supported by Hebrew SeniorLife; Beacon Communities LLC; Boston Scientific Foundation; Massachusetts Health Policy Commission; Coverys Community Healthcare Foundation; Enterprise Community Partners; Massachusetts Department of Housing and Community Development; MassHousing; and Pioneer Institute.

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Hebrew SeniorLife cares for more than 4,500 seniors a day across seven campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline, Brookline; Jack Satter House, Revere; and Leyland Community, Dorchester. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a portfolio of more than $98 million, making it one of the largest gerontological research facilities in the U.S. in a clinical setting. It also trains more than 500 geriatric care providers each year. For more information about Hebrew SeniorLife, visit our website or follow us on our blog, Facebook, Instagram, Threads, and LinkedIn.

About Right Care, Right Place, Right Time (R3)
R3 has been part of life at Hebrew SeniorLife’s three supportive living communities: Center Communities of Brookline, Jack Satter House in Revere, and the Simon C. Fireman Community in Randolph. It now serves more residents at the expanded Fireman Community and at the newly opened Leyland Community in Dorchester. Other R3 partner locations include the Riverside Towers in Medford, the Brookline Housing Authority senior housing sites in Brookline, the Hamilton Wade Douglas House in Brockton, the Milton Residences for the Elderly in Milton, and the MLK Towers in Roxbury.  

Hebrew SeniorLife Executive Vice President of Senior Living Kim Brooks works closely with R3 Executive Director Stephanie Small and the R3 leadership team — Mimi Lewis, Rebecca Donato, Anya Gorodetskaya, Effie Hathaway, and Angela Labonte — who support the staff members doing this important work across 15 communities.

About LeadingAge LTSS
The LeadingAge LTSS Center @UMass Boston conducts research to help our nation address the challenges and seize the opportunities associated with a growing older population. The LTSS Center is the first organization of its kind to combine the resources of a major research university with the expertise and experience of applied researchers working with providers of long-term services and supports (LTSS).