Progress 10/01/12 to 09/30/15

Outputs
Target Audience:I integrated principles and specific interventions of Vital Involvement Practice into my large Masters of Social Work Foundation course on Human Behavior and the Social Environment, so that most of our incoming MSW students learn to see elements of Vital Involvement Practice as part of all effective social work practice -- whether or not they are taught these elements under the name of "Vital Involvement Practice" elsewhere in the curriculum. I incorporated VI analysis of elder role model interviews into my PhD course on Qualitative Research. I gave an SSW-wide colloquium on Vital Involvement Practice. In two of the three years covered by this final report, I taught a graduate level course "Introduction to Vital Involvement Practice" in the Integrated Behavioral Health Masters Degree Program of the University of Minnesota's College of Continuing Education. Students received instruction and participated in classroom discussion, role play opportunities, individual practice and reporting, and group supervision around implementing Vital Involvement Practice in a variety of work settings and client groups. (In addition to elder clients, these students' practice clients include refugee communities, substance abuse clients, EBD teens and young adults, and families in the child welfare system.) We created and implemented an annual training-and-refresher program for Service Coordinators to implement VI. Practice (VIP) as part of their job in Service-enriched Housing properties for low-income seniors. We also implemented an electronically mediated, quarterly group, VIP consultation meeting involving AHEPA Service-Coordination Quality Assurance and Management staff session. As Chair of our MSW program's new Health, Disability, and Aging practice concentration for the first two years of this project, I integrated elements of Vital Involvement Practice into the curriculum of three required courses in this practice concentration, and have taught guest class sessions in all of these classes. We did regular on-site observation and telephone-mediated supervision at AHEPA's two properties in Bloomington, MN. These two sites, plus one site in Indianapolis, have become AHEPA's intensive sites. We also did ongoing "Go-to Meeting" supervision of AHEPA's QA staff to help them direct Service Coordinators to increase the Value Added in VI activities promoted in each property. I shared VIP principles with staff and Advisory Board in planning and initiating Giving Voice: A Chorus for People with Alzheimer's and Care Partners. I included qualitative data on VI in the Giving Voice evaluation data gathered throughout the first year of this project. We are utilizing monthly AHEPA Service Coordinator reports of VI Instances and relevant data segments from Giving Voice qualitative evaluations as data for developing our meaningful preliminary measures of VI in individual elders, in program participants, and in a residential facility, as a whole. Because the focus of this project (the aging population) is, itself, a disadvantaged population, all target audiences include either members of this population or those who provide formal / informal service to members of this population -- within the state of Minnesota and nationally. I integrated consideration of older adults and principles and specific interventions of Vital Involvement Practice into my large Masters of Social Work Foundation course on Human Behavior and the Social Environment, so that most of our incoming MSW students learn to see elements of Vital Involvement Practice as part of all effective social work practice -- whether or not they are taught these elements under the name of "Vital Involvement Practice" elsewhere in the curriculum. MSW students consistently report that I also integrated these principles into a coding assignment for my Doctoral Seminar on Qualitative Research, thus introducing our incoming Doctor Cohort to the construct of Vital Involvement (VI) and its translation into social service practice. I continue to provide guest lectures in two advanced MSW concentration courses: 1) Advanced SW Practice in Health, Disabilities, & Aging; and 2) Health, Disability and Aging: Advanced Interventions, and to teach a graduate-level practice course through the Department of Integrated Behavioral Health: Introduction to Vital Involvement Practice. I conducted training workshops with 100+ Service Coordinators from all over the country (new practice role in the Service-Enriched Housing model for subsidized senior housing) at the annual 4-day conference/retreat for Service Coordinators employed by AHEPA National Housing Corporation (www.ahepahousing.org/). Workshops involved conceptual review and team exercises, enabling Service Coordinators to share experiences, successes, problems, tips, and suggestions with one another. I have worked with the AHEPA Service Coordination Division to develop on-line Vital Involvement Practice trainings for new staff and refresher materials for long-term staff. I have worked with Quality Assurance staff to: 1) Review Service Coordinator monthly reports of Vital Involvement among residents in their buildings; and 2) Direct their supervision of regional Service Coordinators to improve their on-site promotion of Vital Involvement among residents. We have integrated instructive commentary on monthly exemplar-stories of resident Vital Involvement into AHEPA's monthly Service Coordinator communications. We continue to create outreach and experiential learning opportunities for the AHEPA Service Coordination Division, such that: 1. We continue to train Service Coordinators in the VISEH-intensive sites, to become increasingly proficient in promoting VI among residents through creative individual support, programming and accessing of community resources for individual residents; 2. We teach QA personnel to encourage and support all Service Coordinators in promoting VI among residents through creative individual support, programming and accessing of community resources for individual residents; 3. We work with AHEPA Management and QA personnel to develop and implement appropriate measures of VI for their own monthly QA reports and for eventual use across comparable QA in senior housing facilities in general; and 4. We can use monthly VI stories from each property as data for developing meaningful measures of VI in individual elders and in a residential facility, as a whole. Changes/Problems:Several changes/problems have occurred, to which we have responded by modifying various aspects of the project to continue making progress on overall project goals. The most serious changes concern measurement development. Two major obstacles have slowed progress in this goal area. The first concerns construct elaboration. As we learn more about the complexity of the VI construct, we recognize the increasing complexity of developing measures that are appropriately valid, target, and practical to administer. So progress on preliminary measures is inevitably accompanied by understanding of the increased complexity that highlights problems with progress thus far. We have developed a preliminary scale for individual VI, but we now recognize it as flawed enough that it probably does not merit further development and refinement in its current form. The second problem concerns co-ordinating with particular collaborators. My initial inter-institutional measurement collaborator decided to focus his efforts on refining and expanding the scope of existing nursing home outcome measures, rather than to continue working on our Project. Our plannedcollaborator / supplementary funder for work on the measure has undergone organizational changes and has put our measurement project on what they tell us is only a temporary hiatus. In addition, my primary measurement-development collaborator in the U of MN School of Public Health (replacement for the originally designated collaborator on the East Coast) reprioritized his own projects and has also delayed our work together for at least a year. Progress on measurement development has been less significant than I'd hoped. Specific community project collaborators have also changed, due to internal staff and management changes at various facilities. The Program Manager at Carondelet Village (with whom we'd arranged our collaboration) left that organization for a different kind of position in an entirely different kind of service organization. This Manager's replacement was far more interested in focusing on the Act on Alzheimer's Initiative than in continuing to pursue our Vital Involvement work. We have therefore substituted a new community collaborator (AHEPA Senior Housing), that sponsors and manages service coordination in 90+ subsidized senior housing properties around the United States. Their properties are located in major metropolitan areas, smaller cities, and small, rural communities. As described throughout this report, our work with them has blossomed and has enabled us to continue to make progress on all three long-term project goals. Supplementary funding to continue Action Research at Perham Living did not come through, and we have had to suspend ongoing action research with that facility at the current time. We have continued to make progress on most major content areas of the proposed project. What opportunities for training and professional development has the project provided?My faculty role in a professional / academic program that trains social service providers for the entire state has given me an ongoing opportunity to integrate VI principles and intervention methods into already established curriculum throughout the University of MN, both in the Masters of Social Work Program and also in the Masters of Integrated Behavioral Health Program. I integrated consideration of older adults and principles and specific interventions of Vital Involvement Practice into my large Masters of Social Work Foundation course on Human Behavior and the Social Environment, so that most of our incoming MSW students learn to see elements of Vital Involvement Practice as part of all effective social work practice -- whether or not they are taught these elements under the name of "Vital Involvement Practice" elsewhere in the curriculum. MSW students consistently report that I also integrated these principles into a coding assignment for my Doctoral Seminar on Qualitative Research, thus introducing our incoming Doctoral Cohort to the construct of Vital Involvement (VI) and its translation into social service practice. This project has coincided with my appointment for what now is a second term as Associate Editor for Arts and Humanities, of The Gerontologist, the flagship journal of the Gerontological Society of America. Although possibly seemingly unrelated to health and wellbeing, this editorship has more deeply familiarized me both with the important contributions humanities concepts can make to our understanding and optimize the experience of aging, and also with the growing body of literature that demonstrates the effectiveness for health and psychosocial wellbeing, of elders engaging in arts participation activities. This expansion of expertise greatly enriches our understanding of the VI construct, our implementation of VI practice, and the domains of activities and services professions within which we should be disseminating our construct and intervention approaches. I have continued to provide guest lectures in two advanced MSW concentration courses: 1) Advanced SW Practice in Health, Disabilities, & Aging; and 2) Health, Disability and Aging: Advanced Interventions, and to teach a graduate-level practice course through the Department of Integrated Behavioral Health: Introduction to Vital Involvement Practice. Colloquia to SSW faculty initiate opportunities for collaboration in integrating VI principles and practice into such disparate major statewide intervention domains as Mental Health services for newly arrived Minnesotans, substance abuse treatment and recovery, and health care treatment for older adults. The project has facilitated my involvement with the emergent profession of service coordination in senior housing. This involvement has, in turn, contributed to my opportunities for doing ongoing training of gerontological professional outside of a formal academic setting, for doing ongoing training-cum-supervision of QA staff. These training-related engagements have provided a rich source of qualitative data about multiple expressions of VI among low-income elders in senior housing, and about the ways the depth of individual VI and community social capital increase with ongoing exposure, encouragement, and support for VI. How have the results been disseminated to communities of interest?Results and accomplishments have been disseminated to professionals through training workshops and lectures (in person and online), local, national, and international trainings and workshops, national conferences, and publications both in print and electronically. Results and accomplishments have also been disseminated through regularly scheduled classes at the University of Minnesota. I have infused VI principles and practices into my own classes, and have given VI-specific lectures in multiple classes throughout the School of Social Work and Department of Integrated Behavioral Health. Doing the kind of ongoing program staff training and supervision we have been involved in enables us to disseminate and utilize findings in an ongoing way, with extremely fast turnaround. As noted in the previous item, the project has facilitated my involvement with the emergent profession of service coordination in senior housing. This involvement has, in turn, contributed to my opportunities for doing ongoing training of gerontological professional outside of a formal academic setting, for doing ongoing training-cum-supervision of QA staff. These training-related engagements have provided a rich source of qualitative data about multiple expressions of VI among low-income elders in senior housing, and about the ways the depth of individual VI and community social capital increase with ongoing exposure, encouragement, and support for VI. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? We integrated consideration of older adults and principles and specific interventions of Vital Involvement Practice into my large Masters of Social Work Foundation course on Human Behavior and the Social Environment, so that most of our incoming MSW students learn to see elements of Vital Involvement Practice as part of all effective social work practice -- whether or not they are taught these elements under the name of "Vital Involvement Practice" elsewhere in the curriculum. MSW students consistently report that I also integrated these principles into a coding assignment for my Doctoral Seminar on Qualitative Research, thus introducing our incoming Doctor Cohort to the construct of Vital Involvement (VI) and its translation into social service practice. I continue to provide guest lectures in two advanced MSW concentration courses: 1) Advanced SW Practice in Health, Disabilities, & Aging; and 2) Health, Disability and Aging: Advanced Interventions, and to teach a graduate-level practice course through the Department of Integrated Behavioral Health: Introduction to Vital Involvement Practice. I conducted multiple national training workshops, each with 90+ Service Coordinators from all over the country (new practice role in the Service-Enriched Housing model for subsidized senior housing) at the annual 4-day conference/retreat for Service Coordinators employed by AHEPA National Housing Corporation (www.ahepahousing.org/). AHEPA senior housing sites are located in large metropolitan areas, smaller cities, and small towns across the United States. Workshops involved conceptual review and team exercises, enabling Service Coordinators to share experiences, successes, problems, tips, and suggestions with one another. Along with AHEPA Administration and Quality Assurance personnel, we have presented workshops for national and international practitioners at annual meetings of the American Society on Aging. We have renamed our ongoing project Arts, Wellness, and Vital Involvement in Aging (AWVIA). I have worked with AHEPA Service Coordination Division to develop on-line Vital Involvement Practice trainings for new staff and refresher materials for long-term staff. I have worked with Quality Assurance staff to: 1) Review Service Coordinator monthly reports of Vital Involvement among residents in their buildings; and 2) Direct their supervision of regional Service Coordinators to improve their on-site promotion of Vital Involvement among residents. We have integrated instructive commentary on monthly exemplar-stories of resident Vital Involvement into AHEPA's monthly Service Coordinator communications. We have created outreach and experiential learning opportunities for the AHEPA Service Coordination Division, such that we have and continue to train Service Coordinators in the AWVIA-intensive sites, to become increasingly proficient in promoting VI among residents through creative individual support, programming and accessing of community resources for individual residents; 2. We teach QA personnel to encourage and support all Service Coordinators in promoting VI among residents through creative individual support, programming and accessing of community resources for individual residents; 3. We work with AHEPA Management and QA personnel to develop and implement appropriate measures of VI for their own monthly QA reports and for eventual use across comparable QA in senior housing facilities in general; and 4. We can use monthly VI stories from each property as data for developing meaningful measures of VI in individual elders and in a residential facility, as a whole. We have elaborated the VI construct in ways that begin to clarify: 1) Locus of value added with respect to each documented instance of VI or of promoting VI (PVI); 2) Personal VI Domain (the domain of individual function that experiences positive effects of each documented instance of VI or of PVI; 3) Core Values enacted (the meaningful personal core values enacted by documented instances of VI or of PVI). Together, these elaborations contribute to our growing ability to: 1) understand both the multiple importances and meaningful contributions (individual; community; societal) of VI; 2) Develop training modules and materials that clearly target these contributions and link them to professional behaviors and interventions; and 3) Document outcomes, both as reflected in outcome measures already implemented and with data already collected for other purposes (using secondary data analysis), and also in terms of developing meaningful, construct-specific tools for measuring VI. While working with Perham Living, we developed a preliminary measurement tool, to evaluate VI in individual frail elders. This measure, however preliminary, bodes well for our long-term ability to identify, promote, and document the demonstration of VI in individuals. It also bodes well for the possibility, in the future, of developing a measure that will permit meaningful comparison of VI among individual elders, and in a given frail elder, at different periods in time. Using grounded theory methodology, we have re-analyzed previously collected, semi-structured interviews with elder role models, to further deepen our understanding of VI construct. These analyses are also intended to enrich our ideas for documenting, measuring, and promoting VI behaviors among older adults that encourage them to approximate elder role models in their own lives. Analysis has certainly facilitated our work with AHEPA service coordinators and has contributed to the development of an emergent theory/model of becoming an elder role model. We will continue to develop this model as part of our approved 3-year renewal project.

Publications

• Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Kivnick, H.Q. (2012) Arts and Humanities in Teaching Social Work Students About Aging. Presentation in symposium Integrating the Arts and Humanities in Teaching Gerontology, Gerontological Society of America Annual Scientific Meeting, San Diego, CA, Nov, 2012.
• Type: Websites Status: Published Year Published: 2013 Citation: Kivnick, H.Q. (2013) Living Vital Involvement. Webinar for ALPA (Advocacy Leadership for Positive Aging) training program. http://alpa.lifeplanningnetwork.org/curriculum-overview/
• Type: Websites Status: Published Year Published: 2013 Citation: Kivnick, H.Q., Wells, C.K., & Frederick, C.C. (2013) Chronic Health Conditions, Child Welfare, and Vital Involvement: Strategies for Promoting Well-Being. On-line training module for University of Minnesota Center for Advanced Studies in Child Welfare. http://cascw.umn.edu/portfolio-items/chronic-health-conditions-child-welfare-and-vital-involvement-strategies-for-promoting-well-being/
• Type: Websites Status: Published Year Published: 2012 Citation: Center for Advanced Studies in Child Welfare (Producer) & Kivnick, H.Q. & Wells, C.K. (Content Authors) (2012) Special Health Care Needs, Child Welfare, and Vital Involvement: When things go well. [Online training module]. Available from https://umconnect.umn.edu/p81112965/
• Type: Book Chapters Status: Awaiting Publication Year Published: 2016 Citation: Kivnick, H. Q., & Wells, C. K. (In Press). Ego Integrity : In S. K. W. (Ed.), Wiley-Blackwell's Encyclopedia of Adulthood and Aging. Hoboken, N.J.: John Wiley and Sons
• Type: Journal Articles Status: Published Year Published: 2014 Citation: Kivnick, H.Q., & Wells, C.K. (2014) Untapped Richness in Erik H. Erikson's Rootstock. The Gerontologist. 54 (1): 40-50 doi: 10.1093/geront/gnt123.
• Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Duncan, L., Kivnick, H.Q., and Byers, C. (2015) Vital Involvement in affordable senior housing: the Creative Approach. Workshop, American Society on Aging, Annual Conference, Chicago, IL, March, 2015.
• Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Duncan, L., Kivnick, H.Q., and Lutterman, M. (2014) Vital Involvement in Service-enriched Low-income Senior Housing. Workshop, American Society on Aging, Annual Conference, San Diego, CA, March, 2014.
• Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Vital Involvement & Positive Psychology. Workshop presentation, American Society on Aging, Annual Conference, San Diego, CA, March, 2014.
• Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Vital Involvement through Arts Engagement: Paths to/from the Self of Cognitively Impaired Elders. Symposium presentation, Gerontological Society of America Annual Scientific Meeting, Washington, D.C., Nov, 2014
• Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Schmidt, P.B., Kivnick, H.Q., & Maier, J. (2013) A Caelo Usque Ad Centrum (From the Sky to the Center): Personal Flourishing through Vital Engagement. Workshop, American Society on Aging, Annual Conference, Chicago, IL, March, 2013
• Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Kivnick, H.Q., Carlson, P.B., and Lane, G.L. (2013) Promoting Vital Involvement at Carondelet: Practice and Wellness with a Mission, American Society on Aging, Annual Conference, Chicago, IL., March, 2013
• Type: Other Status: Published Year Published: 2013 Citation: Kivnick, H.Q. (2013) Person-Centered Care, Vital Involvement, & Thriving in a Rural Nursing Home. Invited seminar at the School of Social Work, University of Hong Kong, Hong Kong, 7/2/13
• Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Geron, S.M. & Kivnick, H.Q. (2012) Moving Beyond Traditional Geriatric Assessment (Co-chairs). Symposium, Gerontological Society of America Annual Scientific Meeting, San Diego, CA, Nov, 2012.
• Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Kivnick, H.Q. (2012) How Life Gets Better: Vital Involvement, Balance; Integrity. Presentation in symposium Proposing that Life Gets Better: Personal Accounts and a Jungian Perspective, Gerontological Society of America Annual Scientific Meeting, San Diego, CA, Nov, 2012.
• Type: Other Status: Published Year Published: 2014 Citation: Vital Involvement, Culture Change, and Thriving in Old Age. Seminar presented at Portland State Institute on Aging, Portland, OR, July 14, 2014.
• Type: Other Status: Published Year Published: 2014 Citation: Kivnick, H.Q. VISEH program in AHEPA Service-Coordinated Housing ? Vital Involvement and Creative Arts. 5-day training and consultation at AHEPA National Service Coordinators' Conference, Indianapolis, IN, 9/7-12/14
• Type: Other Status: Published Year Published: 2013 Citation: Kivnick, H.Q. Promoting Vital Involvement as part of Creative Wellness in Service-Enriched Housing. 3-day training and consultation at AHEPA National Service Coordinators' Conference, Orlando, FL, 9/9-11/13
• Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Kivnick, H.Q. Moving Through the Territory. Symposium presentation at Gerontological Society of America Annual Scientific Meeting, New Orleans, LA, Nov, 2013
• Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Kivnick, H.Q., Sailer, S., & Grant, L.A. (2012) Person-centered Care in a Rural Nursing Home: Efficacy, Satisfaction, and Vital Involvement. Symposium, American Society on Aging, Annual Conference, Washington DC, March, 2012.
• Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Kivnick, H.Q., Schmidt, P.B., & Maier, J. (2012) The Art of Flourishing: An Exploration of Happiness and Well-Being. Workshop, American Society on Aging, Annual Conference, Washington DC, March, 2012.
• Type: Other Status: Published Year Published: 2013 Citation: Kivnick, H.Q. Vital Involvement in Service-Enriched Housing. 2-day AHEPA Quality Assurance Staff training, Indianapolis, IN, 10/21-22/13.
• Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Kivnick, H.Q. Carlson, L.B., and Lane, G.L. (2012) Vital Involvement: Application in a community-based setting. Symposium, American Society on Aging, Annual Conference, Washington DC, March, 2012.
• Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Kivnick, H.Q., & Wells, C.K. (2012) Vital Involvement: Enriching Gerontological Assessment, Follow-up, and More. Presentation in symposium Moving Beyond Traditional Geriatric Assessment, Gerontological Society of America Annual Scientific Meeting, San Diego, CA, Nov, 2012
• Type: Other Status: Published Year Published: 2012 Citation: Vital Involvement: Expanding Healthy IDEAS. (2012) Training presented for the Depression Assessment Training Project (DAPS Project), St. Paul, MN, Feb., 2012.
• Type: Journal Articles Status: Published Year Published: 2015 Citation: Pruchno, R., Bowers, B. J., Castle, N. G., Gonyea, J. G., Kivnick, H., Meeks, S., & Williamson, J. B. (2015). Is Gerontology in Crisis? The Gerontologist, 55(6), 893. doi:10.1093/geront/gnv141
• Type: Book Chapters Status: Awaiting Publication Year Published: 2016 Citation: Kivnick, H.Q. (In Press) Lifelong Strengths That Ground Later-Life Wisdom. In A.W. Brown, R.R. Karpen, and H.Q. Kivnick (Eds.), The Big Move. Bloomington, IN: Indiana University Press.
• Type: Book Chapters Status: Accepted Year Published: 2016 Citation: Kivnick, H. Q., & Wells, C. K. (In Press) Integrity and Despair. In M.H. Bornstein, M.E. Arterberry, K.L. Fingerman, & J.E. Lansford (Eds.), The SAGE Encyclopedia of Lifespan Human Development. Thousand Oaks, CA: Sage.
• Type: Other Status: Published Year Published: 2015 Citation: Duncan, L., Kivnick, H.Q., and Byers, C. (2015) Vital Involvement in affordable senior housing: the Creative Approach. Workshop, American Society on Aging, Annual Conference, Chicago, IL, March, 2015
• Type: Other Status: Published Year Published: 2015 Citation: Kivnick, H.Q., Maier, J., & Schmidt, P. (2015) Art & Creative Engagement: Vital Involvement in Everyday Life. Workshop presentation, American Society on Aging, Annual Conference, Chicago, IL, March, 2015.

Progress 10/01/13 to 09/30/14

Outputs
Target Audience: Because the focus of this project (the aging population) is, itself, a disadvantaged population, all target audiences include either members of this population or those who provide formal / informal service to members of this population -- within the state of Minnesota and nationally. I will discuss all target audiences in terms of how my contact with them relates to the three major project goals of: #1) Practice #2) Construct development #3) Measurement development Formal Classroom Instruction: #1 and #2 I have integrated principles and specific interventions of Vital Involvement Practice into my large Masters of Social Work Foundation course on Human Behavior and the Social Environment, so that most of our incoming MSW students learn to see elements of Vital Involvement Practice as part of all effective social work practice -- whether or not they learn these elements under the name of "Vital Involvement Practice" elsewhere in the curriculum. I have also integrated these principles into a coding assignment for my Doctoral Seminar on Qualitative Research, thus introducing our incoming Doctoral student cohort to the construct of Vital Involvement (VI) and its translation into social service practice. As Chair of our MSW program's new Health, Disability, and Aging practice concentration (2010-2014), I have integrated elements of VI Practice into the curriculum of three required courses in this practice concentration, and have taught guest class sessions in all of these classes. Such classroom instruction, over time, familiarizes large numbers of the state's newly graduated Masters-level social workers with the principles of VI practice, that are increasingly important to vital aging. Workshops: #1 and #2. AHEPA I conducted two 90-minute workshops with 100+ Service Coordinators from all over the country (new practice role in the Service-Enriched Housing model for subsidized senior housing) at the annual 4-day conference/retreat for Service Coordinators employed by AHEPA National Housing Corporation (www.ahepahousing.org/). The first of these workshops introduced the construct of VI and elements of VI Practice, discussed ways that VI practice builds on and enriches Service Coordinators' current job activities. The second workshop provided role-playing opportunities to integrate VI Assessment tools into existing AHEPA needs assessments and annual resident reviews, and reporting procedures for VI activities as they are integrated into monthly Quality Assurance reports. These workshops were part of my multi-year collaboration with AHEPA, to create and document an effective VISEH (Vital Involvement in Service-Enriched Housing) practice model in AHEPA's sites. (As noted earlier, AHEPA manages 90+ service-enriched housing properties in urban, suburban, and rural areas throughout the United states.) This year's workshops were designed both to introduce new Service Coordinators to the practice model, and to reinforce the model for Service Coordinators who have been practicing and reporting VI Practice since last year's conference, at which I introduced the model. Outreach; Experiential Learning Opportunities: #1 and #3. AHEPA We are doing regular on-site observation and supervision at AHEPA's two properties in Bloomington, MN. These two sites, plus one site in Indianapolis, have become AHEPA's intensive sites for introducing their VISEH model (See above), that includes on-site programming in multiple domains of wellness promotion (e.g., arts participation; physical therapy; food shelf) as well as ongoing supervision of Service Coordinators, to maximize resident and community vital involvement from all activities. I also conduct virtual supervision meetings with AHEPA's QA staff to grow their ability to integrate VI activities into each Service Coordinator's practice, in such a way that: We train Service Coordinators in the VISEH-intensive sites, to become increasingly proficient in promoting VI among residents through creative programming and accessing of community resources for individual residents; We teach QA personnel to encourage and support all Service Coordinators in promoting VI among residents through creative programming and accessing of community resources for individual residents; We work with AHEPA Management and QA personnel to develop and implement appropriate measures of VI for their own monthly QA reports and for eventual use across comparable QA in senior housing facilities in general; and We can use monthly VI stories from each property as data for developing our meaningful measures of VI in individual elders and in a residential facility, as a whole. Giving Voice Chorus Since April, 2014, I have served on the Planning and Advisory Committee for the Twin Cities' new chorus for Alzheimers people and their care partners (Giving Voice). I do participant observation in chorus rehearsals (weekly, beginning Sept., 2014) and performances, noting expressions of VI among choir participants and staff, and consulting with staff about ways to optimize VI in individuals and participant groups in the choir. I am planning to be part of the coming year's qualitative evaluation of the choir, in terms of the experiences of participants, staff, and community audience members. Changes/Problems: SHIFTS IN COLLABORATION Emerging collaborations with Giving Voice Alzheimer's Chorus, with Dr. Diana White, and with Dr. Aaron Eakman (all discussed throughout this report) have come about as part of my own processes of gathering community-based data, disseminating findings, and engaging in VI Practice as part of my process of doing engaged community research. What opportunities for training and professional development has the project provided? Project Provides Training and Professional Development As discussed throughout previous sections of this report, our accomplishments over the past year have involved my providing ongoing training, consultation, and supervision to AHEPA personnel, related to Project Goals #1 (Practice), #2 (Construct Development), and #3 (Measurement Development). Opportunities for My Own Training and Professional Development 1) As part of participating in activities described in previous sections of this report (e.g., conference attendance; conference participation; local workshops, presentations, and trainings), I have had the opportunity to continue to learn about the model of "service-enriched" or "service-coordinated" senior housing. In addition to demonstrating promising financial and performance outcomes for participants, the model as implemented by AHEPA holds great promise for integrating the explicit promotion of resident VI as part of their mode of daily operation. This organization and its service co-ordination staff and allied professionals have become the focus of a major collaboration for this MAES project, related to all three project goals: Practice; Construct Development; Measurement Development. We plan to begin submitting collaborative research funding grants within the next six months. 2) Analyzing elder role model interviews (discussed under "Measurement Development") has considerably deepened my understanding of and appreciation for the NVivo qualitative research software application. This increase in my own competency has improved the level of guidance I can provide to my PhD students -- to such an extent that I now plan to incorporate teaching this software into my required PhD Qualitative Research Seminar, both as a tool for qualitative analysis, and also as a scaffolding for understanding qualitative thinking as a way of organizing disparate ideas. I anticipate that my students (and the generations of students they may be expected to teach in their futures) will be much the richer for this professional development on my part. 3) My recent involvement in the Giving Voice Alzheimer's Chorus will likely include responsibility for the first two years of the project's evaluation. Within the past decade, research has demonstrated considerable capacity for productive arts participation (particularly music) among alzheimer's people - at least throughout the late middle stage of the disease. And research on programs in specific arts (e.g., music; dance; painting; theater) indicates that participants demonstrate improvements on various measures of cognitive, emotional, social, and physiological functioning. Indeed, recent work by the Music and Memory program suggests that even among late-stage, institutionalized alzheimer's patients, listening to music on an Ipod calms agitation and restores capacities for meaningful verbal interaction and vocalization. The VI construct provides a psychosocial basis for: understanding the dynamics of these processes; optimizing them in alzheimer's people; and, potentially, identifying earlier-life behaviors that will be able to mitigate some negative effects of later-life alzheimer's. Particularly in Minnesota, a state known for high choral participation, the positive practical implications are enormous, for mobilizing an inherent statewide asset to cope with an unavoidable consequence of current demographic shifts. How have the results been disseminated to communities of interest? As discussed throughout previous sections of this report, our accomplishments over the past year have continued to involve my disseminating the VI construct and its practice and evaluation/measurement elements to a wide range of communities of interest (statewide; nationally; internationally), contributing to progress in Project Goals #1 (Practice), #2 (Construct Development), and #3 (Measurement Development). Practice See earlier-described training, consultation, and ongoing supervision provided for AHEPA staff. All conference presentations, trainings, workshops, and publications constitute opportunities to disseminate construct of VI and elements of VI Practice to communities of interest, reaching: >Academics, Researchers, Practice administration colleagues Direct practice colleagues throughout the field of aging / gerontology; and >Direct practice colleagues in fields related to health care, disabilities, child welfare, and substance abuse. VIP is relevant to effective practice with all of these client populations in at least three ways: 1) Client populations in all of these fields are aging. Correspondingly, the existing elder and aging populationincludes members of all of these particularly challenged client groups. As we promote VI among elders, we need to recognize that groups that have been challenged throughout life are also capable of demonstrating VI and promoting VI in their communities -- both now in their old age, and also at earlier life stages. 2) Engaging in VI contributes to psychosocial health, growth, and well-being at every stage in the life cycle. In addition, high VI in early life provides a wealth of potential strengths and supports that the elder can exercise and rely on as later-life disabilities may require. 3) Notions of intergenerational similarities, parallels, and direct connections promote empathy, psychosocial health, growth, and well-being at every stage in the life cycle. Construct Development Every one of the activities mentioned in this report helps enrich, clarify, elaborate, and further develop the VI construct, identify its linkages to accepted and emergent developmental theory, and increase both its practical applicatibility and also our capacity to define and measure it meaningfully. Measurement Development All Practice and Construct-related activities contribute to our ongoing development of meaningful measurement tools, in line with the notion that meaningful measurement must be grounded in both practice and in theory. All measurement tools are being developed in collaboration with provider sites that serve communities of interest. What do you plan to do during the next reporting period to accomplish the goals? Practice Continue with all AHEPA-related activities, as described throughout this report. We are collaborating with AHEPA on securing grant funding to support my ongoing consultation/supervision with them. We plan to collaborate on submitting grant applications to quantify resident improvements (by property) since initiation of the VISEH project in the Fall of 2013. We plan to conduct statistical analysis of AHEPA's regularly reported indicators of resident well-being, comparing the following four population groups: 1) Intensive VI sites in MN; 2) AHEPA natonwide properties with VI-trained SC's; 3) control HUD SC senior housing properties without VI-trained SC's (in MN; outside MN); and 4) control HUD independent senior housing properties (in MN; outside MN). Develop and implement qualitative and quantitative evaluation strategies with Giving Voice Alzheimer's Chorus, including expressions of VI in our framework of participant analysis. Continue to teach VI practice at the University of Minnesota, through Continuing Education for Social Workers, through the College of Continuing Education, Integrated Behavioral Health program, and through workshops, trainings, supervision, consultation, and conference presentations. Construct Development Continue to: 1) Gather new data as part of practice projects described above; 2) Analyze new data from current projects; and 3) Re-analyze old data, together with reviewing accumulating literature, in terms of the ever-more-robust VI construct. In particular, we will continue to conduct detailed qualitative analysis of the construct, using the NVivo application with earlier elder role model interviews. And we will continue to feed emerging elements of construct development back into the implementation of the major practice projects in which we are involved. That is, in each new analysis we will utilize the most recent iteration of the emerging VI construct. Continue publication and conference presentations to disseminate the emerging construct, and discuss potential practice- based applications. Measurement Development Continue work on articulating meaningfully differentiable dimensions of VI, as a basis for collaborating with measurement experts in developing and pilot testing meaningful, quantifiable measures of VI. Collaboration with measurement experts makes it possible to do preliminary testing of emergent measurement tools, as part of research that is already underway in their own projects. We are increasingly convinced that only with a valid, appropriately normed measurement tool can we begin to utilize the VI construct as: 1) An outcome measure for programming and interventions with elders; and 2) A widely understood and adopted goal for aging policy and implementation. I have quite recently been approached by the Goodman Group's National Director of Life Enrichment (Managed Senior Living & Health Care Facilities; <http://thegoodmangroup.com/>; four facilities in MN) to discuss helping them to develop a measure of meaningful individual engagement, suitable for residents of skilled nursing, memory care, and assisted living facilities. They have been implementing resident enrichment programs involving animals, spirituality, music, and support of everyday enriched living, and are seeking an appropriate measure for the outcomes they want to be seeing. This collaboration could provide an exciting local opportunity for me to move forward on measurement development. As noted earlier, we are collaborating with AHEPA on securing grant funding for additional research support in measurement development.

Impacts
What was accomplished under these goals? #1 Practice Our biggest practice accomplishment has been continuing to develop the VISEH model that introduces VI Practice into Service-Enriched Housing as currently practiced (and currently being elaborated) by AHEPA National Housing Corporation (www.ahepahousing.org/). (AHEPA manages 90+ service-coordinated subsidized senior houring properties in urban, suburban, and rural areas throughout the United states.) As described throughout, we are working with AHEPA to integrate VI Practice into the practice repertoire of the emerging profession of Service Coordinator, and into AHEPA's unique practice model of service enriched housing. We continue to work intensively with three properties (two in Bloomington, MN) to develop (train; document; review; supervise) the practice of VI-Enriched Service Coordination. This project also includes work with AHEPA's Quality Assurance (QA) management and implementation team to document VI Practice as implemented by Service Coordinators, and to document VI, itself, as demonstrated by individual elder residents and as promoted throughout each property/community. This project is now in its second year and we are currently planning a quantitative study to evaluate the following outcomes: 1) Resident well-being; 2) Building programming and use of resources; 3) Service Coordinator performance and satisfaction. The second practice accomplishment concerns our involvement with the Giving Voice Chorus -- a recently established Twin Cities chorus for Alzheimer's people and their care partners. The chorus' founding principles closely overlap the VI construct. As a participant observer in chorus rehearsals and performances, I am able both to: 1) observe VI being exercised and strengthened in people (early-to-mid-stage Alzheimer's people) who are experiencing a loss of personal capacity for VI; 2) advise chours staff on ways to optimize VI, based on individual participants' unique abilities and interests. I am currently working with the chorus staff to develop the qualitative component of the chorus evaluation, so that we gather data that shed maximum light on VI as expressed in Alzheimer's people and their care partners. #2 Construct Development As we continue to collect new data, re-analyze old data, present research findings, and do trainings, workshops, and work in other practice collaborations, we continue to refine our understanding of the VI construct in various sectors of the elder population. In particular, we have continued to explore meaningful conceptual overlaps between Vital Involvement and other widely-used constructs related to well-being among elders, e.g.: quality of life; well-being; nursing home quality; person-centered care; senior housing quality. These overlaps become particularly meaningful as we seek to communicate and collaborate with professionals in health care, community programming, senior housing, arts engagement, Quality Assurance and evaluation -- and also with policy ex[erts -- as all of these concern our elder population. In particular, we have begun to look explicitly at VI as demonstrated by elders who live with various levels of care and service (ranging from nursing home residents to fully independent elders who live in their long-time dwellings and continue to participate fully in community life). As we develop measures for individual VI, we are aking: >Should we be considering different VI measures for such different populations as: 1) extremely fragile elders (e.g., nursing home residents); 2) elders with dementia; 3) cognitively intact, fully-independent elders? > Does the VI construct exist as one long spectrum on which all adults may be meaningfully evaluated and compared, regardless of level of physical and cognitive ability or disability? >Should we be focusing on domains of VI expression, relative extent of VI expression, strategies for utilizing VI in the service of psychosocial health, etc.? We increasingly understand differences between demonstrating VI (as an elder client; as a community member) and promoting VI (as a direct practitioner; as a program designer or manager; as a policy maker; as member of community or family). Understanding these differences is crucial to training professionals and to meaningfully evaluating outcomes. We have continued to introduce the VI construct, quite explicitly, into the Nursing Home Culture Change movement (also known as person-centered care; patient-centered care; household model), as part of a common value system for implementations and evaluations of these models. As Section Editor for the Humanities and Arts section of The Gerontologist (the flagship journal of the Gerontological Society of America), I continue both to ingrate arts and humanities concepts in gerontology into our overall understanding of the VI construct, and also to introduce gerontological scholars in the arts and humanities to considering the VI construct in their own scholarship and practice work. In particular we have begun to add the VI construct into the panel discussions that follow the showing of feature-length films by the Humanities and Arts Committee at the annual Gerontological Society meetings #3: Measurement Coding protocols from earlier-conducted qualitative interviews with elder models in long-term care is demonstrating that the current iteration of our VI scale taps construct elements that are meaningfully different from one another, and are consistently recognizable across raters and across individual elders. We are increasingly recognizing the difference between measures that evaluate the practice of Person-Centered Care (PCC), on the one hand, and those that evaluate the outcomes of such care as experienced and expressed by individual elders. The first focuses on practice as implemented by professionals. The second focuses on client behaviors, attitudes, growth, and development as a result of such professional practice. As part of this recognition, we re-crafted and re-submitted a previously rejected manuscript (Brief Report of the VI evaluation work we did at Perham (see recent Annual Reports)). Also as part of this recognition, we have begun a provisional collaboration with Dr. Diana White (Portland State University), known for her work developing measures and conducting evaluations of PCC practice in various senior residential and long-term care facilities. She is currently piloting a new measure of PCC in facilities throughout Oregon. We have established the common ground that enhanced individual VI is a desirable and expectable outcome in residents of PCC long-term care facilities. Indeed, VI is probably a more conceptually meaningful outcome than conventional measures of resident satisfaction or physical well-being. We are therefore exploring the possibilty of trying to work together to develop a measure of VI, whose items can be provisionally incorporated into Dr. White's long-term work on PCC. The Occupational Science construct of occupation ("a meaningful chunk of activity") also has much in common with VI. Dr. Aaron Eakman, Director of Occupational Science at Colorado State University, has developed and recently normed two different measures of meaningful activity in seniors. We have recently begun working with his instruments (EMAS (Engagement in Meaningful Activity Survey) and MAPA (Meaningful Activity Participation Assessment)) to determine the conceptual validity of incorporating items from these scales into our measurement of VI. AHEPA's VISEH program is beginning to offer on-site physical / occupational therapy (PT/OT) and general programming at the properties that are our intensive sites (see Target Audience: Outreach, Experiential Learning Opportunities). The on-site PT/OT practitioners are excited about the prospect of integrating measurement of meaningful occupation with that of VI.

Publications

• Type: Journal Articles Status: Published Year Published: 2014 Citation: Kivnick, H.Q., & Wells, C.K. (2014) Untapped Richness in Erik H. Erikson's Rootstock. The Gerontologist 54(1) 40-50. doi:10.1093/geront/gnt123
• Type: Book Chapters Status: Awaiting Publication Year Published: 2015 Citation: Kivnick, H.Q., & Wells, C.K. (In Press). Ego Integrity. In S. Krauss Whitbourne (Ed.). Wiley-Blackwell's Encyclopedia of Adulthood and Aging. Hoboken, N.J.: John Wiley and Sons.
• Type: Journal Articles Status: Under Review Year Published: 2015 Citation: Kivnick, H.Q., Wells, C.W., Sailer, S., Anderson, G., & Grant, L. Vital involvement, meaningful living, and person-centered care: An action research project. Under review at Action Research
• Type: Book Chapters Status: Under Review Year Published: 2015 Citation: Kivnick, H.Q. Anticipatory Mastery: Lifelong Strengths Ground Later Life Wisdom. In M. Gullette and R.R. Karpen The Big Move. Under final review at Indiana University Press.

Progress 01/01/13 to 09/30/13

Outputs
Target Audience: Because the focus of this project (the aging population) is, itself, a disadvantaged population, all target audiences include either members of this population or those who provide formal or informal service to members of this population. I will discuss all target audiences in terms of how my contact with them relates to the three major project goals of #1) Practice #2) Construct development #3) Measurement development Formal Classroom Instruction: #1 and #2. I taught a graduate level course "Introduction to Vital Involvement Practice" in the Integrated Behavioral Health Masters Degree Program of the University of Minnesota's College of Continuing Education. Students received instruction and participated in classroom discussion, role play opportunities, individual practice and reporting, and group supervision around implementing Vital Involvement Practice in a variety of work settings and client groups. (In addition to elder clients, these students' practice clients include refugee communities, substance abuse clients, EBD teens and young adults, and families in the child welfare system.) I integrated principles and specific interventions of Vital Involvement Practice into my large Masters of Social Work Foundation course on Human Behavior and the Social Environment, so that most of our incoming MSW students learn to see elements of Vital Involvement Practice as part of all effective social work practice -- whether or not they are taught these elements under the name of "Vital Involvement Practice" elsewhere in the curriculum. As Chair of our MSW program's new Health, Disability, and Aging practice concentration, I have integrated elements of Vital Involvement Practice into the curriculum of three required courses in this practice concentration, and have taught guest class sessions in all of these classes. Workshops: #1 and #2. I conducted two 90-minute workshops with 100+ Service Coordinators from all over the country (new practice role in the Service-Enriched Housing model for subsidized senior housing) at the annual 4-day retreat for Service Coordinators employed by AHEPA National Housing Corporation (www.ahepahousing.org/). The first of these workshops introduced the construct of Vital Involvement and elements of Vital Involvement Practice, discussed ways that Vital Involvement Practice builds on and enriches Service Coordinators current job activities. The second workshop provided role-playing opportunities to integrate Vital Involvement Assessment measures into existing AHEPA needs assessments and annual resident reviews, and reporting procedures for Vital Involvement activities as they are integrated into monthly QA reports. These workshops are part of what we are designing to be a long-term collaboration with AHEPA, to create and document an effective VISEH (Vital Involvement in Service-Enriched Housing) model in AHEPA's sites. Outreach; Experiential Learning Opportunities: #1 and #3. We are doing regular on-site observation and supervision at AHEPA's two properties in Bloomington, MN. These two sites, plus one site in Indianapolis, have become AHEPA's intensive sites for introducing their VISEH model (See above), that includes on-site programming in multiple domains of wellness promotion (e.g., arts participation; physical therapy; food shelf) as well as ongoing supervision of Service Coordinators, to maximize resident and community vital involvement from all activities. We are also working with AHEPA's QA staff to integrate VI activities into each Service Coordinator's monthly QA report, in such a way that: 1) We train Service Coordinators in the three VISEH-intensive sites, to become increasingly proficient in promoting VI among residents through creative programming and accessing of community resources for individual residents; 2) We teach QA personnel to encourage and support all Service Coordinators in promoting VI among residents through creative programming and accessing of community resources for individual residents; 3) We work with AHEPA Management and QA personnel to develop appropriate measures of VI for their own monthly QA reports and for possible use across comparable QA in senior housing facilities in general; and 4) We can use monthly VI stories from each property as data for developing our meaningful measures of VI in individual elders and in a residential facility, as a whole. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? As discussed throughout previous sections of this report, our accomplishments over the past year have involved my providing training and professional consultation and supervision related to Project Goals #1 (Practice), #2 (Construct Development), and #3 (Measurement Development). OPPORTUNITIES FOR MY OWN TRAINING AND PROFESSIONAL DEVELOPMENT As part of participating in activities described in previous sections of this report (e.g., conference attendance; conference participation; local workshops, presentations, and trainings, I have had the opportunity to begin to learn about two models of senior housing, both of which hold great promise as sites for integrating the explicit promotion of resident VI as part of their mode of daily operation. Service-Enriched Housing, for financially disadvantaged elders. This model has become the focus of a major collaboration related to all three project goals. Co-housing. In this model, cooperatives of individual residences (apartments in a single building; townhouses in a development; new construction) seek intergenerational occupancy with the intention of residents providing generationally appropriate supports for one another. Community fees, responsibilities, and services are apportioned among residents and outside vendors, in order to achieve the goal of a community that can support the vital involvement of each member, and where each member expresses VI at least in part through activities that sustain the ability of the community to continue to support VI in everyone. I am only beginning to understand this model, and do not yet have any specific collaborations in mind. Sites representing both models have expressed willingness to become involved in providing data for our VI measurement development tools. How have the results been disseminated to communities of interest? As discussed throughout previous sections of this report, our accomplishments over the past year have involved my disseminating the VI construct and its practice and evaluation elements to a wide range of communities of interest, contributing to progress in Project Goals #1 (Practice), #2 (Construct Development), and #3 (Measurement Development). Practice See earlier-described training, consultation, and ongoing supervision I provided for service coordination staff in AHEPA. All conference presentations, trainings, workshops, and publications constitute opportunities to disseminate construct of VI and elements of VI Practice to communities of interest, reaching: Academic, Research, Practice administration colleagues Direct practice colleagues throughout the field of aging / gerontology Direct practice colleagues in fields related to health care, disabilities, child welfare, and substance abuse. VIP is relevant to effective practice with all of these client populations in at least three ways: A. Client populations in all of these fields are aging. Correspondingly, the existing elder and aging population includes members of all of these particularly challenged groups. As we promote VI among elders, we need to recognize that groups that have been challenged throughout life are also capable of demonstrating VI and promoting VI in their communities. B. Engaging in VI contributes to psychosocial health, growth, and well-being at every stage in the life cycle; C. Notions of intergenerational similarities, parallels, and direct connections promote psychosocial health, growth, and well-being at every stage in the life cycle. Construct Development Every one of the activities mentioned in this report helps enrich, clarify, elaborate, and further develop the VI construct. Measurement Development All Practice and Construct-related activities contribute to our ongoing development of measurement tools, in line with the notion that meaningful measurement must be grounded in both practice and in theory. All measurement tools will be developed in collaboration with provider sites that serve communities of interest. What do you plan to do during the next reporting period to accomplish the goals? Practice Continue with all AHEPA-related activities, as described throughout this report. We are collaborating with AHEPA on securing grant funding to support my ongoing consultation/supervision with them. Continue to teach VI practice at the University of Minnesota, through Continuing Education for Social Workers, and through workshops, trainings, supervision, consultation, and conference presentations. Construct Development Continue to gather new data as part of practice described above, and to analyze new data and re-analyze old data, together with reviewing accumulating literature, to develop the full robustness of the VI construct. Continue publication and conference presentations to disseminate the emerging construct and discuss potential practice-based applications. Measurement Development Continue work on articulating meaningfully differentiable dimensions of VI, as a basis for collaborating with measurement experts in developing and pilot testing meaningful, quantifiable measures. We are collaborating with AHEPA on grant funding to support additional research assistance in measurement development.

Impacts
What was accomplished under these goals? #1 Practice Throughout previous sections of this report, we have identified elements of the project that have contributed to accomplishing Goal #1: Practice. The biggest practice accomplishment has been creating the VISEH model that introduces Vital Involvement Practice into Service-Enriched Housing as currently practiced (and currently being elaborated) by AHEPA National Housing Corporation. As described throughout, we are working with AHEPA to integrate VIP into the practice repertoire of the emerging profession of Service Coordinator, and into their unique practice model of service enriched housing. We are currently working intensively with three properties (two in Bloomington, MN) to develop (train; document; review; supervise) the practice of Vital Involvement-Enriched Service Coordination. This project also includes work with AHEPA's Quality Assurance (QA) management and implementation team to document VIP as practiced by Service Coordinators, and to document Vital Involvement, itself, as demonstrated by individual elder residents and as promoted throughout each property/community. #2 Construct Development Throughout previous sections of this report, we have identified elements of the project that have contributed to accomplishing Goal #2: Construct Development. As we continue to collect new data, re-analyze old data, present research findings, and do trainings, workshops, and work in other practice collaborations, we continue to refine our understanding of the Vital Involvement construct in old age. In particular, we have begun to explore meaningful conceptual overlaps between Vital Involvement and other, widely but unduly narrow, constructs such as: quality of life; well-being; measures of nursing home quality; measures of senior housing quality. These overlaps become particularly meaningful as we seek to communicate and collaborate with professionals in health care, community programming, Quality Assurance and evaluation, and policy as all of these concern our elder population. In a different direction, we have begun to look explicitly at VI as demonstrated by elders who live with various levels of care and service (ranging from nursing home residents to fully independent elders who live in their long-time dwellings and continue to participate fully in community life). As we develop measures for individual VI, should we be considering different measures for extremely fragile elders (e.g., nursing home residents; dementia patients) from those that are appropriate for more active, engaged, fully-independent elders? Or does the construct exist as one long spectrum on which all adults may be meaningfully evaluated and compared, regardless of level of ability or disability? These considerations emerge as we consult and collaborate with a range of facilities for elder citizens. We have also begun to understand differences between demonstrating VI (as an elder client; as a community member) and promoting VI (as a direct practitioner; as a program designer or manager; as a policy maker; as member of community or family). Understanding these differences is important in training professionals and evaluating outcomes. We have begun to introduce the VI construct, quite explicitly, into the Nursing Home Culture Change movement (also known as person-centered care; patient-centered care; household model), as part of a common value system for individual implementations and evaluations of these models. We have continued to interject the VI construct and elements of VI Practice to Child Welfare system administrators, researchers, and direct practitioners. As Section Editor for the new Humanities and Arts section of The Gerontologist (the flagship journal of the Gerontological Society of America), I am in a position both to ingrate arts and humanities concepts in gerontology into our overall understanding of the VI construct, and also to introduce gerontological scholars in the arts and humanities to considering the VI construct in their own scholarship and practice work. #3 Measurement Development Throughout previous sections of this report, we have identified elements of the project that have contributed to accomplishing Goal #3: Measurement Development. I am gradually becoming part of the Pioneer Network / Person-Centered Care community that includes direct practitioners and administrators; policy makers and evaluators; programmers; and funders. Involvement with colleagues in this network facilitates the possibilities for collaboration. In addition, such involvement increses my ongoing exposure to innovations in practice and evaluation, and increases the extent to which our measure-in-development can: 1) Remain solidly grounded in practice and in the real, everyday lives of elders; and 2) Truly reflect clinically meaningful differences in the behaviors and underlying outlooks of individual members of our expanding elder population. We are coming to recognize the difference of measures that evaluate the practice of Person-Centered Care, on the one hand, and those that evaluate the outcomes of such care as experienced and expressed by individual elders. The first focuses on practice as implemented by professionals. The second focuses on client behaviors, attitudes, growth, and development as a result of such professional practice. As part of this recognition, we are in the process of re-crafting a previously submitted manuscript (Brief Report of the VI evaluation work we did at Perham (see recent Annual Reports)). We now understand that work more clearly as a example of Action Research, which we are coming to recognize as a potentially effective way to bring elder care evaluation into alignment with the values that underlie Person-Centered Care. SHIFTS IN COLLABORATION Scott Geron / Assessment: Dr. Geron's own work in Assessment (conducted primarily at the beginning of client work with a service provider, as part of care planning) has necessitated a delay in progress on our collaborative efforts. My involvement with the Person-Centered Care movement and those who are developing measures for its evaluation has led to potentially productive collaborations on ongoing efforts to measure VI in elder clients, and Promoting VI as demonstrated by practitioners. Carondelet Village has undergone a major management change, resulting in a shift to a system-wide focus on Alzheimers prevention, services, and care. VI practice has moved to a lower position on their radar, and our collaboration has diminished over the past year. Our new relationship with AHEPA has emerged as a mutually beneficial, exciting collaboration that is proving to be a rich site for our ongoing project work.

Publications

• Type: Journal Articles Status: Published Year Published: 2013 Citation: Kivnick, H.Q., & Wells, C.K. (2013) Untapped Richness in Erik H. Eriksons Rootstock. The Gerontologist. doi: 10.1093/geront/gnt123.
• Type: Books Status: Under Review Year Published: 2014 Citation: Gullette, M.M. & Kivnick, H.Q. (Eds) The Big Move: Humanistic Insights on Moving Into a Continuous Care Community. Monograph in later rounds of review at the University of Indiana Press, based on five original essays. The monograph constitutes a kind of humanistic grand rounds -- focusing on a gerontologists autobiographical account of an increasingly common life transition in aging (moving into a CCRC). Five scholars draw on existing scholarship and contemporary thought, to consider this experience through different domains within the arts and humanities of aging.
• Type: Book Chapters Status: Under Review Year Published: 2014 Citation: Kivnick, H.Q. Life Between the Turning Points: Renewing Lifelong Themes In Adapting To A Transition Of Aging. Chapter in above book, under review.

Progress 01/01/12 to 12/31/12

Outputs
OUTPUTS: We have continued to develop Vital Involvement Practice (VIP) as a practice and evaluation modality to promote diverse strengths and vitalities in older adults. This year's project continues to build on ongoing work as follows: 1) THEMATIC ANALYSIS - EVALUATION - ASSESSMENT. In collaboration with Perham Health and Living (Perham, MN) we have continued to refine our analysis of qualitative interview data from nursing home residents and residents of the corporation's senior housing apartments. This work: a) Continues to build on our previous efforts to understand VI themes; b) Assists this nursing home in understanding and consolidating its culture change evaluation; and c) Provides additional clarity around specific elements of resident-centered nursing home care (e.g., particular staff behaviors; practices implemented in individual households) that are noteworthy in promoting resident VI. 2) TRAINING - PRACTICE: We have continued to teach VIP to MSW students through the University of Minnesota School of Social Work curriculum, and to social workers throughout MN as part of the School's summer CEU program. We have continued to consult with a community-based health-and-wellness consortium to support ongoing efforts to promote VI as part of overall optimal health care services for community residents, and as part of community life for facility residents. We have also partnered with the Center for Advanced Study of Child Welfare in beginning to develop training materials that utilize VI constructs in promoting individual and family well-being at earlier stages in the life cycle. These materials have and will continue to train Child Welfare workers who serve families at risk throughout the state of Minnesota. 3) DISSEMINATION: We have given presentations on VIP at national and local venues. We have continued to incorporate VIP concepts into national trainings for creative arts programming for elders, as delivered by the National Center for Creative Aging (NCCA). Presentations to Target Audiences have included the Annual Conference of American Society on Aging (multiple presentations), the Annual Scientific Meeting of the Gerontological Society of America (multiple presentations), and training and consultation at local elder service agencies including Jewish Family Service's Depression Assessment Program for Seniors (DAP), and Care Management staff at Carondelet Village Consortium, St. Paul, MN, Sept 2012. PARTICIPANTS: PARTNER INDIVIDUALS: (Specific roles discussed in narratives) Courtney Wells, MSW, MPH, Project R.A. Beth Carlson, RN, MS, Campus Administrator, Carondelet Village Georgia Lane, MSW, Consortium Manager, Presbyterian Homes and Services (Carondelet Circle). Sue Sailer, MSW, Director of Social Services, Perham Health & Perham Living. Leslie A. Grant, Ph.D., University of Minnesota, Associate Professor and Director of the Center for Aging Services, Carlson School of Management Scott Geron, Ph.D., Professor of Social Work, Boston University PARTNER ORGANIZATIONS: (Specific roles discussed in 2011 and 2012 narrative sections) Carondelet Village. Perham Health and Living, Perham, MN. Presbyterian Homes and Services. U of MN Center on Aging. MAGEC (Minnesota Area Geriatric Education Center). National Center for Creative Aging. Clinical and Translational Science Institute, University of Minnesota U of MN School of Social Work U of MN Center for Continuing Educaton PROSPECTIVE PARTNERS (Collaborations in development) See explanation in Project Modifications, below Andrea Gallagher, President, Senior Concerns U of MN Center for Advanced Study of Child Welfare (see Project Modifications). TARGET AUDIENCES: TARGET AUDIENCES Nursing home staff, program directors, and administration (rural and urban) Assisted Living staff, program directors, and administration (rural and urban) Community Programs in Aging: Administrators, program directors, and staff NCCA (National Center for Creative Aging) artists, trainers, and program directors. Masters-level social work students; MN licensed social workers Vital Aging Network Direct Care Providers, Case Managers, and Care Coordinators in Aging Health Care Providers Prospective Baby Boomer retirees Workplace retirement planning programs Life-span and aging scholars and researchers Governmental policy-makers, evaluators, and regulators for aging services PROJECT MODIFICATIONS: Because of its extraordinarily depth, VIP is proving difficult to teach quickly to professionals as an integrated whole. We have therefore begun to conceptualize this project's work as moving along three parallel but separate tracks: BIG PICTURE: This track seeks to reinvigorate the VI construct as fundamental to the fields of gerontology and life-span development. We are working on such a manuscript for a special "Back to Our Roots" issue of The Gerontologist, scheduled for publication early in 2014. VIP ELEMENTS as meeting existing community demands: Here we will continue to develop elements of VIP that are acquiring traction and collaborators in their own right. Components include: Assessment scale: As noted earlier, Scott Geron and I are preparing a manuscript on the shortcomings of existing geriatric assessment tools and models. We will be proposing VI as a construct whose measurement could significantly enrich the assessment and evaluation processes in work with the older adults who are increasing in number at an astronomical rate. Continuing Education: In 2013 my graduate-level VIP course will be housed either in the U's College of Continuing Education (likely) or Center for Spirituality and Healing (possible but less likely). Initially, this move will expand the readily accessible pool of students (increasing impact). In the longer term, this move will enable us to develop alternative versions of the course to develop and teach the material in ways that are optimally accessible to varying populations of medical and social service providers. As noted earlier, the new MSW curriculum includes VIP modules in 3 of 5 required classes in its new Health, Disabilities, and Aging (HDA) practice concentration. SPECIFIC LINKS TO ALREADY ESTABLISHED PRACTICE NICHES. This newly identified track enables us to leverage professional relationships and projects that are currently tangential to VIP -- but where connections and mutual enrichments are powerfully clear. These collaborations will focus on continuing to create VI-based tools and trainings that supplement practices and ideas (and use terms) that are already in well-established use by others. We will pay less attention to learners' understanding of VI constructs in their own terms (e.g., in VI terms), and more attention to the effective utilization of VI constructs in the terms in which existing niches have already established themselves. Collaborators include Andrea Gallagher, Leslie Grant, and CASCW--all mentioned earlier. As part of this overall modification, we have expanded the project's name and scope to include the life cycle as a whole. Our primary focus will remain the broad stage of life currently referred to as old age. The expanded name more accurately reflects the true scope of VIP's applicability. This expansion facilitates more direct translation of ideas from work with one population subgroup to that with others. Further, it facilitates conceptualization of projects and services that involve intergenerational populations, rather than continuing our conceptual isolation of population groups and their needs.

Impacts
1) THEMATIC ANALYSIS -- EVALUATION -- ASSESSMENT It remains true that no good measure exists for a nursing home (NH) resident's experience of self in the world, of purposeful living, or of everyday life meaning. The preliminary -- and still quite provisional -- VI rating scale we developed last year represents a major step in our ability as gerontologists to: 1) Measure VI in individual elders; 2) Describe specific themes of VI (resident VI; staff VI); and 3) Understand environmental elements (e.g., NH "culture"; architecture; policies; staffing patterns; staff job descriptions and behaviors) that promote different levels and kinds of VI. The scale has been enthusiastically received by individual health and social service care providers and administrators. Although its small and non-random sample limit the scale's immediate usefulness, its conceptual validity supports the value of continuing its development. As elder living options and care facilities proliferate, the need increases for meaningful VI measures, and for deeper understanding of how particular environmental elements support -- and don't -- positive outcomes. The emerging rating scale contributes to our capacity to evaluate resident outcomes under NH culture change, and to understand the critical interactions between elder VI and elements of their residential and social environments. COLLABORATION: Geriatric Assessment authority Scott Geron, (Boston U) and I created and presented a national conference symposium (See Publications.) We have begun to use symposium papers and audience comments to write a journal article identifying major limitations in geriatric assessment and promising directions for improvement. We will use that article as the basis for designing and proposing research that develops our provisional VI scale into a psychometrically sound assessment tool that can enrich the field's capacity to initiate, guide, and evaluate comprehensive, multi-dimensional care-plans and life-plans for elders across a wide spectrum of ages and abilities. Andrea Gallagher, President of Senior Concerns (a CA community elder-services nonprofit), has incorporated VI constructs into the Life Planning Tool used in her agency's Adult Day Center and Case Management programs. She has offered her agency as a pilot site for future VI projects. 2) TRAINING -- PRACTICE SSW offered my VIP course in 2012, and includes VIP modules in 3 of 5 required classes in its new Health, Disabilities, and Aging (HDA) practice concentration. We continued to provide VIP consultation to Carondelet Village, to support their ongoing promotion of VI among participating elders. 3) DISSEMINATION As Humanities and Arts Editor (H&A) of The Gerontologist (major journal of the Gerontological Society of America), I have begun to incorporate principles and concepts of VI into the wider interdisciplinary discourse on the fundamental meanings of aging to individuals and societies. This discourse influences research, practice, policy, educational, and civic life. VI constructs informed the development and 2011 launching of TG's H&A section, and the journal's more recent addition of a regular "On Film and Digital Media" feature.

Publications

• Center for Advanced Studies in Child Welfare (Producer) & Kivnick, H.Q., Lind Seal, K., & Haskins, N. (Content Authors) (2010) Attachment through Music, Movement and Mirth: Part 1, Get Going! [Online training module]. Available from https://umconnect.umn.edu/p55792724/.
• Center for Advanced Studies in Child Welfare (Producer) & Kivnick, H.Q., Lind Seal, K., & Haskins, N. (Content Authors) (2010) Attachment through Music, Movement and Mirth: Part 2, Clean Up! [Online training module]. Available from https://umconnect.umn.edu/p20258170/.
• Center for Advanced Studies in Child Welfare (Producer) & Kivnick, H.Q. & Wells, C.K. (Content Authors) (2012) Special Health Care Needs, Child Welfare, and Vital Involvement: A case study of an exemplar family. [Online training module]. Available from http://www.cehd.umn.edu/ssw/cascw/PracResources/Modules/ModuleHome.as p.
• Kivnick, H.Q., & Pruchno, Rachel (2012). On Film and Digital Media. The Gerontologist. 52(4), 439-440.
• Kivnick, H.Q., Sailer, S., & Grant, L.A. (2012) Workshop, Person-centered Care in a Rural Nursing Home: Efficacy, Satisfaction, and Vital Involvement. Electronic conference proceedings (abstract), American Society on Aging, Annual Conference, Washington DC, March, 2012.
• Kivnick, H.Q., Carlson, L.B., & Lane, G. (2012) Symposium, Vital Involvement: Application in a community-based setting. Electronic conference proceedings (abstract), American Society on Aging, Annual Conference, Washington DC, March, 2012.
• Kivnick, HQ, Braverman Schmidt, P, & Maier, J (2012) Symposium, the Art of Flourishing: An examination of happiness and well-being. Electronic conference proceedings (abstract), American Society on Aging, Annual Conference, Washington DC, March, 2012.
• Kivnick, H.Q. & Wells, C.K. (2012) Vital Involvement: Enriching gerontological assessment, follow-up, and more. In Symposium Moving Beyond Traditional Geriatric Assessment. Electronic conference proceedings (abstract), Gerontological Society of America, Annual Scientific Meeting, San Diego, November 2012.
• Kivnick, H.Q. (2012) How Life Gets Better: Vital involvement; balance; integrity, In Symposium When Life Gets Better. Electronic conference proceedings (abstract), Gerontological Society of America, Annual Scientific Meeting, San Diego, November 2012.
• Kivnick, H.Q. (2012). Arts and Humanities strengthen social work education in gerontology. In Symposium Integrating the Arts and Humanities in Teaching Gerontology. Electronic conference proceedings (abstract), Gerontological Society of America, Annual Scientific Meeting, San Diego, November 2012.

Progress 01/01/11 to 12/31/11

Outputs
OUTPUTS: We have continued to develop Vital Involvement Practice (VIP) as a practice and evaluation modality to promote diverse strengths and vitalities in older adults. This year's project included: 1) THEMATIC ANALYSIS - EVALUATION - ASSESSMENT. In collaboration with Perham Health and Living (Perham, MN) we have analyzed qualitative interview data from nursing home residents and residents of the corporation's senior housing apartments. This work builds on our previous efforts in understanding VI themes, assists the nursing home in its culture change evaluation, and provides additional clarity around those elements of resident-centered nursing home care that are effective in promoting resident VI; 2) TRAINING - PRACTICE: We have continued to teach VIP to MSW students at the University of Minnesota School of Social Work, and to social workers throughout MN as part of the School's summer CEU program. We have continued consultation with a community-based health-and-wellness consortium to support their ongoing promotion of VI among participating elders; 3) DISSEMINATION: We have given presentations on VIP at national and statewide conferences (Rating VI in Frail Elders; VIP in Independent, Assisted Living, and Nursing Home Facilities; VI as underlying creative arts programming and participation). We have continued to incorporate VIP concepts into national trainings for creative arts programming for elders, as delivered by the National Center for Creative Aging (NCCA). DISSEMINATION Presentations to Target Audiences >Memorial Sloan Kettering Hospital, New York, NY -Seminar for Department of Psychiatry: Introduction to VIP: Maximizing Client Strengths, Feb 3 -Grand Rounds for Department of Psychiatry: Erikson Renewed: VI Across the Life Cycle, Feb 4 >SCOPE (Sarasota County Openly Plans for Excellence) Winter Forum, Sarasota, FL, Feb 26-27 Keynote panelist: The importance of VI in community planning for the US county with the highest concentration of elder residents. >MacPhail Center for Music, Minneapolis, MN: Music for Life Panel (March 3): VI and the Aging Brain >Clinical and Translational Science Institute: 2011 Collaborative Pilot Grant Research Awards Dinner, Nov 9 Patient-Centered Eldercare -- Does It Make a Difference? >Annual Conference of American Society on Aging (2 presentations) >Annual Scientific Meeting of Gerontological Society of America (3 presentations) Collaborations-in-Planning Resulting from Dissemination Presentations. >Institute for Age-friendly Housing (Chris Kennedy, Ex Dir). This institute promotes the development of age-friendly housing communities that are creative in terms of financial management, physical and organizational structures, and service integration (macro-level). We recognize VIP as a set of principles that must underlie micro-practice (programming; staffing; everyday interactions) if these housing communities are to succeed at their goal of promoting the community engagement and vitality among resident elders. >Life-Planning Network (Andrea Gallagher, Ex Dir). The network supports individuals in planning for purposeful old age. Such planning must integrate VI (promoting VI in others; contributing to community). PARTICIPANTS: PARTNER INDIVIDUALS: Sara Martinez, Rsch Asst (R.A.). Courtney Wells, R.A. Gwendolyn Anderson, R.A. Beth Carlson, RN, MS, Campus Administrator, Carondelet Village. Georgia Lane, MSW, Consortium Manager, Presbyterian Homes and Services. Sue Sailer, MSW, Perham Health and Living. Leslie A. Grant, Ph.D., University of Minnesota, Associate Professor and Director of the Center for Aging Services. PARTNER ORGANIZATIONS: (Specific roles discussed in narratives) Carondelet Village. Perham Health and Living, Perham, MN. Presbyterian Homes and Services. U of MN Center on Aging. MAGEC (Minnesota Area Geriatric Education Center). National Center for Creative Aging. Clinical and Translational Science Institute, University of Minnesota PROSPECTIVE PARTNERS (Collaborations in development) Institute for Age-friendly Housing (Chris Kennedy, Ex Dir). Rethinking Your Future (Andrea Gallagher, Ex Dir). Life-Planning Network (Andrea Gallagher, Ex Dir). Scott Geron (psychometrician), Professor of Social Work, Boston University. TARGET AUDIENCES: Nursing home staff, program directors, and administration (rural and urban). Assisted Living staff, program directors, and administration (rural and urban). Community Programs in Aging: Administrators, program directors, and staff. NCCA (National Center for Creative Aging) artists, trainers, and program directors. Masters-level social work students. MN licensed social workers. Vital Aging Network. Direct Care Providers, Case Managers, and Care Coordinators in Aging. Health Care Providers. Prospective Baby Boomer retirees. U of M Center on Aging. GSA (Gerontological society of America) members. ASA (American Society on Aging) members. Aging Housing developers, administrators, program directors, and staff. Workplace retirement planning programs. PROJECT MODIFICATIONS: The 2011 project year has continued to build on last year's early work (as a project modification) on developing a quantifiable measure of VI in elders. The VI construct remains conceptually central in the growing movement toward maximizing individual strength and wellness (rather than simply mitigating weakness, disorder, and disease) as part of health care and social services for older adults. This emerging measure enables us to begin to gather evidence to support the value of VIP in all domains of elder life in the US.

Impacts
1) THEMATIC ANALYSIS -- EVALUATION -- ASSESSMENT Measures of nursing home (NH) consumer satisfaction tap residents' satisfaction with services provided by the facility (eg, staff behaviors; physical facility; organized activities; food). No good measure exists for a resident's experience of self in the world, purposeful living, or everyday life meaning. This gap in instruments is apparent when staff look for ways to document their observations that "... our residents have come to life..." or "...this is a place that any one of us would like to live." All of these experiences overlap the VI construct. Analysis of semi-structured interviews with residents from Perham Health and Living (see Outputs) utilized an iterative process of examining each interview transcript by separating thoughts into meaningful units, conceptualizing VI themes represented in each unit, and developing and assigning thematic codes. We reached a final set of 35 codes by achieving consensus among 3 raters on sample transcripts. Ranking the codes according to level of VI yielded 8 categories, representing 8 levels of VI. (Ranking considered VI expressed in terms of complexity of cognitive, physical, and emotional activity.) These levels constitute a rudimentary rating scale that represents a major step in our ability as gerontologists to: A) Measure VI in individual elders; B) Describe specific themes of VI (resident VI; staff VI); and C) Understand environmental elements (e.g., NH "culture"; architecture; policies; staffing patterns; staff job descriptions and behaviors) that promote different levels and kinds of VI. As elder living options and care facilities proliferate, the need increases for meaningful measures of VI, and for deeper understanding of how particular environmental elements support -- or fail to support -- positive outcomes. The emerging rating scale contributes to our capacity to evaluate resident outcomes under NH culture change, and to understand the critical interactions between elder VI and elements of their residential and social environments. Collaboration-in-planning w/ Scott Geron, Psychometrician (Boston University). VI Assessment: A) Refining VI scale; B)Integrating administration of VI assessment tool with individual VIP. 2) TRAINING -- PRACTICE SSW offered a course on VIP in 2011, and will do so in 2012. SSW has revised the Advanced Practice Curriculum for its MSW Program, beginning Fall, 2012. The revision process has integrated VIP into the required core curriculum for the new Health, Disability, and Aging Practice Track. We continued to provided VIP consultation to a community-based health-and-wellness consortium to support their ongoing promotion of VI among participating elders (Carondelet Village). Consultation led to: A) Production and administration of a revised, 1-day VI Skills refresher class for Resident Assistants at Presbyterian Homes nursing homes; B) Production of a exemplary script for ongoing skills development in practice excellence among Pres. Homes Resident Assistants; C) Development of a workshop for gerontological professionals on implementing VIP in community-based settings.

Publications

• Kivnick, H.Q, Wells, C.K., Anderson, G., Grant, L.A., Sailer, L., & Martinez, S.R. (2011). Rating Vital Involvement in Nursing Home Residents. Electronic conference proceedings (abstract), Gerontological Society of America, Annual Scientific Meeting, Boston, November 2011.
• Kivnick, H.Q., Carlson, L.B., & Lane, G. (2011) Vital Involvement: Application in a community-based setting. Electronic conference proceedings (abstract), American Society on Aging, San Francisco, 2011.
• Maier, J., Schmidt, P., Kivnick, H.Q. (2011) Flow: Vital Involvement After Middle Adulthood. Electronic conference proceedings (abstract), American Society on Aging, San Francisco, 2011.
• Kivnick, H.Q., & Pruchno, R. (2011). Bridges and Boundaries: Humanities and Arts Enhance Gerontology. The Gerontologist. 51(2), 142-144. doi:10.1093/geront/gnr007
• Kivnick, H.Q. (2011) Renewing Lifelong Themes in Adapting to a Transition of Aging. Electronic conference proceedings (abstract), Gerontological Society of America, Annual Scientific Meeting, Boston, November 2011.
• Kivnick, H.Q., & Lee, H.Y. (2011) Vital Involvement Themes of Cancer Coping in Elder Korean American and Caucasian American Survivors. Electronic conference proceedings (abstract), Gerontological Society of America, Annual Scientific Meeting, Boston, November 2011.

Progress 01/01/10 to 12/31/10

Outputs
OUTPUTS: We have continued to develop Vital Involvement Practice (VIP) as a practice modality for promoting diverse strengths and vitalities in frail elders. This year's project included several components: 1) TRAINING - CURRICULUM ADMINISTRATION. We implemented over 30 of these 8-hour VIP trainings, completing the training project begun last year for Presbyterian Homes. We have also participates in program planning for The Consortium at Carondelet Village (a collaboration between Presbyterian Homes and the Sisters of Carondelet), to incorporate VIP into the assessment and care planning protocols to be implemented as an integral part of their Wellness Club and Enrichment Club programming. 2) THEMATIC ANALYSIS -- EVALUATION. We have focused on the Promotion of Vital Involvement (PVI) instance as the fundamental practice skill for VIP. Preliminary consideration of 173 PVI stories (reports of PVI instances) from Aspenwold staff led to the identification of meaningfully different dimensions of VI; 3) PRACTICE; AND 4) NATIONAL AND LOCAL PRESENTATION. We have given presentations on VIP at two national and five state and local conferences (VIP practice in assisted living and nursing home facilities; VIP as underlying creative arts programming and participation). We have continued to incorporate VIP concepts into national trainings for creative arts programming for elders, as delivered by the National Center for Creative Aging (NCCA). PARTICIPANTS: PARTNER INDIVIDUALS: Rusudan Kilaberia, R.A. Sara Martinez, R.A. Georgia Lane, MSW, Consortium Manager, Presbyterian Homes and Services. Laura Magnuson, Learning and Development, Presbyterian Homes and Services. Mary Springer, Learning and Development, Presbyterian Homes & Services. Leslie Grant, Ph.D., U of MN Carlson School of Management. Sue Sailer, MSW, Perham Memorial Home. PARTNER ORGANIZATIONS: (Specific roles discussed in narratives) Presbyterian Homes and Services. The Consortium at Carondelet. Perham Memorial Hospital and Home. U of MN Center on Aging. MAGEC (Minnesota Area Geriatric Education Center). National Center for Creative Aging. PROFESSIONAL DEVELOPMENT PRESENTATIONS: Aging Services of MN, Annual Institute: Feb 11 Using Vital Involvement Skills in Your Culture Change Journey. Mayo Clinic, Dept. of Social Services, Feb 18 Promoting Vital Involvement: Maximizing Client Strengths in Medical Social Services. St. Kate's March 4, Colloquium for Health Practice Students Vital Involvement Practice for Health Care Team Building in Aging. MAGEC, Statewide Geriatric Clinical Fellows Presentation, April 9: Vital Involvement for Administrators Kivnick, H.Q. (2010) Minnesota Gerontological Society, Annual Conference, April 30 Three Dimensions of "Promoting Vital Involvement" (PVI). TARGET AUDIENCES: Nursing home staff and administration Assisted Living staff and administration Nursing Home and ALF Administrators and Program Directors Administrators and program directors and staff for community programs in aging NCCA (National Center for Creative Aging) artists, trainers, and program directors. Masters-level social work students MN licensed social workers Vital Aging Network Direct Care Providers, Case Managers, and Care Coordinators in Aging Prospective Baby Boomer retirees U of M Center on Aging GSA (Gerontological society of America) members ASA (American Society on Aging) members PROJECT MODIFICATIONS: The most exciting project development / modification in 2010 was our progress toward developing a quantifiable measure of VI in elders. This progress was catalyzed by discussion at a U of M Center on Aging meeting, that led to a meeting with staff responsible for evaluating Culture Change / Person Centered Care at Perham Memorial Home. We realized that we were closer than we had thought, to having a usable evaluation tool. So we put unanticipated effort into that project. We now realize that the existence of this evaluation tool makes it far more practical for facilities to adopt VIP, in that they now have access to a direct measure of the practice's intended outcome -- rather than having to rely on measuring associated constructs as proxies. This initial tool provides a basis for further revision. It also provides a basis for developing a corresponding tool for assessing VI in community-dwelling elders. The VI construct is conceptually central in the growing movement toward maximizing individual strength and wellness (rather than simply mitigating weakness, disorder, and disease) as part of health care and social services. This tool enables us to begin to both monitor participant progress and also gather evidence to support the value of the practice

Impacts
TRAINING A course on VIP will be offered in 2011; it has been approved by the School of Social Work to become a regular course. We administered 30 sessions of an 8-hr training curriculum for Presbyterian Home. Continuing to track their 3-year training project, responses confirm that: A) Staff understanding and promotion of VI in residents is fundamental to maximizing all other domains of practice training in the culture change project; B) Supervisors and administrators must provide real support for staff to promote VI in residents. In order to do this effectively, they must be able to see ways in which accustomed practice may squash (rather than promote) VI. We provided VIP training for two social workers hired by The Consortium at Carondelet Village, and for statewide ALF administrators, through MAGEC. THEMATIC ANALYSIS: RATING SCALE: We conducted more detailed thematic analysis of the 173 PVI stories, clarifying properties and levels of the three dimensions identified earlier: Density; Outward Focus; Time Span. For conceptual reasons we combined the last two dimensions and focused on Outward Focus as effectively representing the essence of the VI construct "Meaningful, reciprocal engagement with the world outside the present self". Using the original 173 PVI stories, we identified markers for High and Low VI threads, both for VI expressed by residents, and for PVI expressed by residents toward other residents, staff, family members, etc. Within these High and Low categories we established numeric levels associated with markers. We experimented with using this preliminary VI Rating Scale on qualitative data gathered from nursing home and ALF residents, as part of resident evaluation. We have confirmed both that the Scale can meaningfully be applied to such open-ended data, and also that scores vary appropriately from resident to resident. We are currently establishing inter-rater reliability. PRACTICE. We are currently collaborating with two practice agencies: 1) Perham Memorial Hospital and Home (Perham, MN). We will be piloting the VI rating scale, to explore the meaning of purposeful living among frail elders living in the nursing facility and independent housing at PMHH, as part of a small grant for evaluating Person-Centered Care in Rural Healthcare. This collaboration was arranged by Professor Leslie Grant, Ph.D., in the U of M Carlson School of Management; 2) We are working with The Consortium at Carondelet Village (St. Paul, MN), to more efficiently incorporate VI assessment and planning tools into their intake, enrollment, and action planning procedures. We plan to expand this collaboration to include data sharing, to enable us to develop a second version of the VI Rating Scale, for use with community-dwelling elders as a way to monitor individual growth in VI, and to evaluate VI-oriented programming.

Publications

• Kivnick, H.Q. (2010). Dancing vital involvement: A creative old age. Journal of Aging, Humanities, and the Arts, 4(4). DOI: 10.1080/19325614.2010.537970
• Kivnick, H.Q., Martinez, S.R., & Kilaberia, R. (2010) Rating the Outward focus of Vital Involvement. Electronic conference proceedings (abstract), Gerontological Society of America, Annual Scientific Meeting, New Orleans, November 2010.
• Kivnick, H.Q. (2010) Arts and Humanities in Teaching Social Work Students About Aging. Electronic conference proceedings (abstract), Gerontological Society of America, New Orleans, November 2010.
• Kivnick, H.Q. (2010) Vital Involvement: Theory Underlying Practice for Creativity. Electronic conference proceedings (abstract), American Society on Aging, Chicago, 2010.
• Kivnick, H.Q., Lane, G.L., & Kilaberia, R. (2010) VIP for Administrators: Transcending Nursing Home Culture Change. Electronic conference proceedings (abstract), American Society on Aging, Chicago, 2010.
• Kivnick, H.Q. (2010) Vital Involvement: Underlying Theory for Practice. Electronic conference proceedings (abstract), American Society on Aging, Chicago, 2010.

Progress 01/01/09 to 12/31/09

Outputs
OUTPUTS: We have continued to develop Vital Involvement Practice (VIP) as a practice modality for promoting diverse strengths and vitalities in frail elders. This year's project included several components: 1) TRAINING CURRICULUM DEVELOPMENT AND ADMINISTRATION. We revised and finalized VIP slides and workbook materials for 16 hours of training (two 8-hour days), to be delivered to line staff and designated supervisory staff at all skilled nursing facilities operated by Presbyterian Homes, as part of their 3-year culture-change project. We implemented over 30 of these 8-hour VIP trainings and have met biweekly with Presbyterian Homes Management and Project staff as part of this training. We have participated We have also begun to participate in program planning for the Optimum Aging Consortium (a collaboration between Presbyterian Homes and the Sisters of Carondelet), to incorporate Vital Involvement Practice into the assessment and care planning protocols to be implemented as an integral part of their Wellness Club and Enrichment Club programming. 2) THEMATIC ANALYSIS: We have focused on the Promotion of Vital Involvement (PVI) instance as the practice skill on which VIP rests. Preliminary consideration of 173 PVI stories (reports of PVI instances) from River Village staff has led to the identification of three dimensions in each instance 3) NATIONAL PRESENTATION: We have given presentations on VIP at three national and two state and local conferences (VIP practice in assisted living and nursing home facilities; VIP as underlying creative arts programs). We have begun to incorporate VIP concepts into national trainings for creative arts programming for elders, as delivered by the National Center for Creative Aging (NCCA); POLICY DISCUSSION: We have begun a series of discussions with personnel from the DHS Division of Aging and adult Services about implementing elements of the Blueprint for 2010 in ways that explicitly promote (rather than ignore or squash) vital involvement in elders. PARTICIPANTS: PARTNER INDIVIDUALS: Rusudan Kilaberia, R.A. PARTNER ORGANIZATIONS: PRESBYTERIAN HOMES AND SERVICES: Vital Involvement Practice curriculum training materials were prepared for and delivered to PH&S Household Coordinators and for Nursing Assistants at Statewide PH&S Skilled Nursing Facilities in Minnesota. Contacts: Sharon Klefsaas, Executive Director of Service Strategies; Dan Strittmater, Strategic Initiatives Project Manager. MINNEAPOLIS COMMUNITY AND TECHNICAL COLLEGE: Create VIP training curriculum to be taught as part of MCTC curriculum. Contact: John Hart, Director Workforce Development and Training. MINNESOTA CREATIVE ARTS AND AGING NETWORK (MNCAAN): Collaborate in trainings for engaging elders in creative arts activities. Contact: Pat Samples, Executive Director. KAIROS DANCE THEATER - THE DANCING HEART: Collaborate in trainings for engaging elders in creative arts activities. Contact: Maria Genne, Executive Director. DEPARTMENT OF HUMAN SERVICES, AGING AND ADULT SERVICES: Discuss policy implementation to promote vital involvement in individual elders. Contact: LaRhea Knatterud; Mary Olsen Baker. PROFESSIONAL TRAINING PROVIDED TO: PRESBYTERIAN HOMES AND SERVICES: VIP Curriculum training to Education Staff; VIP training to Household Coordinators and Nursing Assistants. MINNEAPOLIS COMMUNITY AND TECHNICAL COLLEGE: VIP Curriculum training to identified faculty. NATIONAL GUILD OF COMMUNITY SCHOOLS OF ART: Incorporate VIP training in NCCA training presented collaboratively with other training artists. Trainees include adiminstrators and staff of national community schools of art, who are seeking to provide new programming for elders. GEORGIA LANE, MSW: I provided VIP supervision to social worker / care manager who delivered much of the hands-on training to Presbyterian Homes staff. TARGET AUDIENCES: Nursing home staff and administration Assisted Living staff and administration Presbyterian Homes Management Administrators and program directors and staff for community programs in aging NCCA (National Center for Creative Aging) artists, trainers, and program directors. Masters-level social work students MN licensed social workers Vital Aging Network Direct Care Providers, Case Managers, and Care Coordinators in Aging Prospective Baby Boomer retirees GSA (Gerontological society of America) members ASA (American Society on Aging) members PROJECT MODIFICATIONS: Our involvement with Presbyterian Homes added a great deal of practical richness that led to our clarifying the domains of PVI instances. Involvement with the Liberty Project has led to our involvement with the Optimum Aging Consortium which I am pursuing with the intention of developing future research studies. Although this community practice work competes with more formal research activities for time, it provides the contextual validity that is necessary in developing any new practice model. In so doing, it is immeasurably enriching: 1) Our understanding of the underlying vital involvement construct; 2) Our understanding of the process of promoting vital involvement; 3) Our ability to train practitioners to promote vital involvement in clients; and 4) the VIP practice modality as a whole. My involvement in the NCCA has enabled me to continue to present VIP concepts to the Center's Training Artists, to work with these artists in conducting training on "engaging elders in arts participation"; and to continue to explore the ways arts participation could be used more effectively to promote vital involvement among frail elders.

Impacts
A course on VIP was highly rated by students in the School of Social Work in 2009, will be offered again in 2009, and is in the process of becoming a regular course in the School of Social Work***. Students observe "In the past I've looked at personal strengths and weaknesses of clients. But I never before had a way to look at how the environment fits in, and how it can support strength"; "VIP supports all the elements of empowerment. I never thought of empowering frail old people before." Continuing Education training in VIP was provided for social workers throughout Minnesota. Developing and administering training curriculum for Presbyterian Homes, and tracking the subsequent domains of training that are part of their 3-year project, confirm that: A) Staff capacity to promote vital involvement in residents is fundamental to maximizing all the other domains of nursing home life for which training around the culture change project continues to be implemented; B) Supervisors and administrators must provide real support for staff to promote vital involvement in residents. In order to do this effectively, they must be able to see ways in which accustomed practice may squash (rather than promote) vital involvement; C) As a result of this training and curriculum, we have been included in planning and implementation for the Optimum Aging Consortium (scheduled for inauguration in April, 2010, in St. Paul), with VIP assessment and implementation tools to be incorporated into standard protocols for the Consortium's two main programs; D) I am working on a book proposal with an editor at Johns Hopkins University Press for a book that will discuss VIP as implemented in diverse settings for elders and by diverse professionals who work with elders. This book will introduce elements of the training curricula developed thus far. We have identified the following three dimensions of the PVI instance: Density; Outward focus; Continuity. These dimensions make it easier for trainers to understand how different staff members interpret promoting vital involvement. Some trainees focus only on one dimension. Some focus on another. Some focus on more than one. Optimal PVI includes all three dimensions. We will use this understanding in refining and elaborating training materials and the structure and content of training sessions. In the coming year we plan to conduct more detailed thematic analysis of the 173 PVI stories, clarifying properties and levels of each domain. This more detailed understanding will both continue to enrich our training capacities, and will provide a basis for developing quantifiable measures. Quantitatively measuring PVI will enable us to evaluate training, and also to assess the integrity of the intervention - for clinical research anticipated in the future. Quantitatively measuring Vital Involvement itself will facilitate large-scale research that evaluates VIP and its effectiveness. National presentation of the VIP model and of PVI stories has begun to cultivate fertility for deep understanding, in the minds of scholars, practitioners, and policy makers across such disciplines as aging, arts, community engagement, and social services.

Publications

• No publications reported this period

Progress 01/01/08 to 12/31/08

Outputs
OUTPUTS: We have continued to develop Vital Involvement Practice (VIP) as a practice modality for promoting diverse strengths and vitalities in frail elders. This year's project included several components: 1) THEMATIC ANALYSIS: We have begun to conduct thematic analysis of 155 PVI reports from River Village staff. 2) TRAINING CURRICULUM DEVELOPMENT: We developed VIP slides and workbook materials for one 8-hour training session for Household Coordinators and for two successive 8-hour training sessions for Nursing Assistants at all skilled nursing facilities operated by Presbyterian Homes, as part of their 3-year culture-change project. We implemented 27 of these 8-hour VIP trainings and have met biweekly with Presbyterian Homes Management and Project staff as part of this training. We are in the process of transforming these materials into a stand-alone workbook. 3) NATIONAL PRESENTATION: We have given presentations on PVI at three national conferences (scholarly; practice; personal), and begun to integrate PVI into the foundation of understanding that underlies the work of the National Center for Creative Aging (NCCA). We anticipate beginning to incorporate PVI into NCCA trainings in 2009. PARTICIPANTS: PARTNER INDIVIDUALS: RA's: Nancy Zupfer; Rusudan Kilaberia PARTNER ORGANIZATIONS: >Catholic Eldercare Staff PVI incident reports shared. Contacts: Mary Broderick, President and CEO Janet Carlson, Director of Housing Services Melissa Placheki, Director of Nursing Services >Presbyterian Homes and Services Vital Involvement Practice curriculum training materials prepared for PH&S Household Coordinators and for Nursing Assistants at 10 PH&S Skilled Nursing Facilities in Minnesota Contacts: Sharon Klefsaas, Executive Director of Service Strategies Dan Strittmater, Strategic Initiatives Project Manager >Minneapolis Community and Technical College Create VIP training curriculum to be taught as part of MCTC curriculum Contact: John Hart, Director Workforce Development and Training PROFESSIONAL TRAINING PROVIDED TO: Presbyterian Homes and Services: VIP Curriculum training to Education Staff, VIP training to Household Coordinators and Nursing Assistants Minneapolis Community and Technical College: VIP Curriculum training to identified faculty Georgia Lane, MSW: VIP supervision to social worker / case manager TARGET AUDIENCES: TARGET AUDIENCES GSA members ASA members NH staff PH&S mgmt NCCA artists, trainers, and program directors Masters-level social work students Vital Aging Network Direct Care Providers and Case Managers in Aging Prospective Baby Boomer retirees PROJECT MODIFICATIONS: Although we had planned to concentrate in 2008 on thematic analysis of the PVI incident reports from River Village, the opportunity arose for us to become involved in PH&S' 3-year culture change project by creating VIP curriculum, consulting on curriculum for other domains of nursing home professionals, working with community college faculty, and working with nursing home personnel at various levels. We seized this opportunity, as a basis for preparing and piloting more details training materials for VIP. My involvement in the NCCA has opened the national community of "elders and the arts" to engagement in PVI.

Impacts
A course on VIP was highly rated by students in the School of Social Work in 2008 and will be offered again in 2009. A student observes "Regardless of age, VIP encourages a new kind of personalized attention to the way a client wants to live their life with integrity. This is what social workers want to do with clients of any age." 1) Conducting thematic analysis of PVI incidents from River Village has clarified how much more complex the PVI process is than we had initially conceptualized. a. Understanding this complexity will enable us to improve training by recognizing elements of competence and progress in both promoter and receiver. b. Detailed thematic understanding will enable us to tailor the PVI process (and its training) to distinct promoter / provider groups (e.g., Health Aides; Case Managers; Program Administrators; Elders' family members; Counselors). c. Detailed thematic understanding will enable us to tailor the PVI process to distinct receiver / self-help-user groups (e.g., pre-retirees; new retirees; artists; elders concerned with community engagement). 2) Thematic analysis of River Village PVI incidents clarified that: a. Staff who take seriously the importance of PVI come to regard it as both central to their work in improving residents' lives, and also as what gives meaning to the everyday tasks that constitute their jobs. b. Reciprocity of influence (both Promoter and Receiver must be open to being influenced and changed through the PVI process) is essential to effective PVI. Where staff or management have immutable procedures and one-way flows of authority and decision-making power, staff are not likely to be effective either in promoting vital involvement in residents, or in feeling vitally involved in their jobs. 3) Developing and administering training curriculum for Presbyterian Homes clarified that: a. PVI is fundamental to the other domains of nursing home life for which training around the culture change project is being planned and implemented. b. Staff promotion of PVI in elder residents must become so integral to staff's work with clients in nursing homes, assisted living facilities, and community-based senior programs that they (staff) come to understand it as a meaningful part of their job, rather than an added burden; c. Program and facility administrators, across disciplines, must understand Point 3b, immediately above, so that they provide real support for these behaviors among their staff, rather than simply paying lip service. This notion is related to Point 2b, noted earlier; d. We must convert training curriculum materials into stand-alone training or self-help materials that are tailored to particular user groups (e.g., Health Aides; Case Managers; Program Administrators; Occupational Therapists; Community Program Leaders), so that each set of materials will be maximally useful, meaningful, and adoptable for intended users; 4) National presentation of the VIP model and of PVI stories has begun to cultivate fertility for deep understanding, in the minds of scholars, practitioners, and policy makers across such disciplines as aging, arts, community engagement, and social services.

Publications

• Kivnick, H.Q. (2008). Book Review of An Uncertain Inheritance., Activities, Adaptation, and Aging. 32(2), 163-165.

Progress 01/01/07 to 12/31/07

Outputs
OUTPUTS: We have continued to develop VIP as a practice modality for promoting diverse strengths in frail elders. As a result of policy decisions at River Village, this year's project focused on Assisted Living residents and on staff, at River Village, a 70+ bed assisted living facility operated by Catholic Eldercare in Northeast Minneapolis. Work with Residents: We continued working with the "Sunshine Committee, which involved over 20 residents in identifying and then implementing activities that were experienced by group members as meaningful in creating sunshine within the facility and among its residents, and in "spreading sunshine" in the larger environment. Activities included distributing welcome baskets to new residents, creating and updating a resident directory, organizing and self-staffing weekend game activities, sending certificates of appreciation to particular staff, and filling boxes of items to support US troops in Iraq, and collecting funds for the "Feed My Hungry Children" project. In addition to "spreading sunshine," the group has continued to provide a mechanism through which members are able to experience a satisfying empowerment, express leadership, deepen relationships, and establish expanded social networks within the facility, regardless of cognitive ability. Data recorded on resident charts has proved insufficient to permit evaluation of VIP impact on resident medical conditions, drug use, or hospital utilization. We conducted and transcribed life history interviews with 20 residents, in an effort to understand the earlier-life patterns of vital involvement that form the life-cycle foundation for residents' vital involvement in frail old age. Work with Staff: We provided basic instruction for ALF staff (nursing; home health aides; dining; reception; activity; pastoral; administrative and facilities management) in VIP at the levels of Whole facility; Individual resident; Groups of residents; Individual staff; Groups of staff; Elder's family; Surrounding community. After a period of exploration, staff expressed interest in receiving training and ongoing support in VIP at the level of individual residents. We conducted additional small-group staff trainings. Over a 4-month period, staff provided written documentation of examples of promoting vital involvement (PVI) in residents, and they participated in ongoing supportive training with us (individually and in monthly group discussions). PARTICIPANTS: PARTNER INDIVIDUALS RA's: Georgia LaVoie; Nancy Zupfer PARTNER ORGANIZATIONS: Catholic Eldercare Instruction, training, and supportive supervision provided to staff at River Village and Main Street Lodge facilities Contacts: Mary Broderick, President and CEO Janet Carlson, Director of Housing Services Melissa Placheki, Director of Nursing Services PROFESSIONAL TRAINING PROVIDED TO: K. Hovnanian Homes, Inc., Eden Prairie: re Vital Involvement and active adult communities TARGET AUDIENCES: TARGET AUDIENCES: Young old public at large, via appearance on Public Television series "Life Part 2" Masters-level social work students Vital Aging Network PROJECT MODIFICATIONS: Staffing and activity priorities at Catholic Eldercare were reorganized such that initiating VIP activities on the Memory Care unit was subordinated to life-history interviewing with residents of the main facility. Facility enrollment and resident medical and social record-keeping did not provide enough of the anticipated data, to correlate VIP activities with progress as documented in resident files. So we shifted emphasis to working with staff and residents around individual PVI incidents, as described above.

Impacts
VIP constructs continue to influence the life-planning work of the Minnesota Vital Aging Network. The VIP Workbook is now part of the Life Planning Materials presented by Jan Hively, as she "translates" the four phases of later life identified by Dr. Gene Cohen into activities that can be utilized in pre-retirement and early retirement by individuals who seek to be mindful in creating productive and satisfying old age. We have developed a new schematic format for documenting PVI incidents. Initially, the schematic is proving to be a useful training tool for VIP. We intend to mine it for contributions to analytic clarity, as well. Finally, the schematic was well received as the basis of the opening session for the "Creative Aging" track of the inaugural "Positive Aging Conference," held on Dec 6-8 at Eckerd College in St. Petersburg, FL. In particular, the schematic promises to be useful in adding a psychosocial understanding to the teaching and practicing of creative arts activities with elders. New research documents that such activities make positive cognitive and emotional contributions to community-based elders. We are hopeful that this schematic and the reciprocal processes it illustrates so well will provide a first step toward breaking down the complex VIP workbook into steps that can be meaningfully taught, practiced, and then built on by gerontological practitioners in many disciplines, as well as by elders themselves. In the coming year we will focus on: 1) Thematic analysis of vital involvement patterns in assisted living, based on interview data. 2) Thematic analysis of PVI among ALF staff, based on documented examples.

Publications

• Kivnick, H.Q. (2007) Ties that Bind: Maintaining, modifying, and re-creating your relationships. In M. Skeie & J. Skeie (Eds.). Mapping Your Retirement. Minneapolis MN: MYR Press.

Progress 01/01/06 to 12/12/06

Outputs
We continued to develop Vital Involvement Practice (VIP) as a practice modality for promoting diverse strengths in frail elders. This year's project focused on our working with two sets of residents at River Village, a 70+ bed assisted living facility operated by Catholic Eldercare in Northeast Minneapolis. Regular Assisted Living: All residents who completed individual protocols have made progress on the specific goals they identified. 'Patterns of Wellness' classes continued through August, when the instructor left to have a baby. Residents have proved far more interested in developing meaningful social relationships with one another than in working on individual goals. Both on the basis of working on the VIP protocols, and from conversations that began in the 'Patterns of Wellness' classes, we followed residents' lead in helping them to developing a 'Sunshine Committee,' that would meet regularly to enable members to increase the overall senses of warmth and being welcome for residents in this facility. A core group of 7-10 members have met twice monthly for nearly a year. Members assemble and deliver welcome baskets to new residents and take early responsibility for showing them around the facility. Members have created and distributed a resident phone book. They send cards to hospitalized and returning residents, and to staff for whom residents express special appreciation. The Committee has also begun to host weekend game sessions, to provide social activity/entertainment at a time when facility-scheduled activities are essentially absent. In addition to 'spreading sunshine,' the group seems to provide a mechanism through which members are able to experience a kind of empowerment they have not otherwise found. Leaders of this group are among the facility's most cognitively intact residents. However several more cognitively impaired individuals attend meetings, participate in game sessions, and identify these activities as bright spots in their week. Memory Care Unit: We have developed an abridged protocol for residents of the Memory Care Unit, for which data are gathered from the resident, family members; Unit staff contribute information they may have learned. Summary forms, showing individual achievements, skills, and personal interests, are circulated among Unit staff, as a basis for individual engagement.

Impacts
VIP constructs continue to influence the life-planning work of the Minnesota Vital Aging Network. A course on Vital Involvement Practice was highly rated by students in the School of Social Work in 2006 and will be offered again in Summer 2007. Student comments focus on the way VIP 'emphasizes individual meanings so clients can construct their own interpretations and values of their world;' and '[is] not only empowering but gives clients ownership of their situation and the ability to identify obstacles and create solutions.' Another student observes, 'Age begins to present new challenges that these people haven't faced before. Guiding elders through this matrix of exercises of vital involvement can trigger them into action and meaning they have feared they lost.' Our immediate challenge remains how most effectively to translate this process into one that is meaningful and effective for cognitively impaired elders in assisted living facilities. Ongoing analysis of qualitative and quantitative data will enable us to continue to: 1) Refine the VIP intervention to achieve optimal effectiveness and accessibility; and Disseminate findings to a larger professional, semi-professional, and lay audience. In the coming year we will focus on: 1) Continuing and strengthening the Sunshine Committee; 2) Expanding an appropriate VIP-related program on the Memory Care Unit; 3) Conducting chart reviews and documenting instances of vital involvement among project participants.

Publications

• Several papers are currently in preparation, being developed from presentations at national scientific meetings (2006).

Progress 01/01/05 to 12/31/05

Outputs
Vital Involvement Practice (VIP) continued in its development, as a practice modality for promoting diverse strengths in elders, across diverse living circumstances, SES, and level of physical well being. This year's project focused on working with residents, line staff, and administrators at River Village (see below). Facility-wide Intervention: We have begun to work with the staff of River Village, Catholic Eldercare's new assisted living facility in Northeast Minneapolis. We have conducted basic training sessions with line staff on the underlying philosophy and principles, and in the specific steps and tools of the VIP process. The goal of our work together is to reinforce staff members' inclination to promote strengths among residents and to support one another's work, so that we can create an overall setting that functions to optimize vital involvement at the levels of: individual resident; groups of residents; individual staff; groups of staff; facility-wide practices and procedures; residents' families; surrounding community. We have conducted the entire VIP protocol with 13 individual residents. We have conducted weekly 'Patterns of Wellness' classes, regularly involving 10 residents. We conduct monthly administrative meetings and monthly meetings with supervisory line staff, to review elements of VIP. Intervention and Tools: We have continued to review protocols from VIP group and individual interventions. Contrary to initial expectations, the majority of residents suffer at least mild cognitive confusion, requiring considerable modification in the intervention, and in expectations concerning the pace of progress.

Impacts
VIP constructs have been integrated into the life-planning work of the Minnesota Vital Aging Network, and into the foundation of the community group ElderZest. VIP presentations continue to be well attended and well received at the University, local, state, national, and international levels. Common audience reactions include 'I was never trained to think about clients this way. Suddenly they become whole people to me!' 'This is a whole paradigm shift in how to work with the elderly.' 'This works not only for the elderly, but for thinking about my own life too.' Ongoing analysis of qualitative and quantitative data will enable us to continue to: Refine the VIP intervention to achieve optimal effectiveness and accessibility; and disseminate findings to a larger professional, semi-professional, and lay audience. In the coming year we will focus on developing: 1)simplified elements of VIP practice for use with a cognitively impaired population; 2)a second round of 'Patterns of Wellness' groups in which the most able members can take leadership roles; 3)Vital Involvement support network for cognitively intact residents.

Publications

• Kivnick, H.Q., & Stoffel, S.A. (2005) Vital involvement practice: Strengths as more than tools for solving problems. Journal of Gerontological Social Work. 46(2).
• Kivnick, H.Q. (2005) Vital involvement: A key to personal growth in old age. In L. Kaye (Ed.). Perspectives on Productive Aging: Social Work with the New Aged (pp. 123-148). Washington, D.C.: NASW Press.

Progress 01/01/04 to 12/31/04

Outputs
Vital Involvement Practice (VIP) continued in its development, as a practice modality for promoting diverse strengths in elders, across diverse living circumstances, SES, and level of physical well being. Facility-wide Intervention: We have begun to work with the staff of River Village, Catholic Eldercare's new assisted living facility in Northeast Minneapolis. We have trained senior administrators in the underlying philosophy and principles, and in the specific steps and tools of the VIP process. The goal of our work together is to create a that functions to optimize vital involvement at the levels of: individual resident; groups of residents; individual staff; groups of staff; facility-wide practices and procedures; residents' families; surrounding community. We are now meeting regularly with these administrators, to develop, implement, and evaluate elements of VIP that are appropriate to this facility and its staff. Intervention and Tools: We have continued to review protocols from VIP group and individual interventions in order to revise and refine a basic, standardized VIP modality and associated tools. We have also continued to revise, simplify, and validate training procedures. At the request of line staff in residential and medical facilities, we are working to develop a highly abridged form of VIP. We are trying to resist the temptation to dilute the intervention before it has been fully developed and tested, on the one hand. On the other hand, we recognize that practitioners will not utilize an intervention that is more massive than they feel they can accommodate-regardless of its efficacy. I taught a one-credit skills course in Spring Semester 2004, as a way to begin exploring optimal settings and procedures for training professionals to engage effectively in this intervention. The course was well received and provided valuable feedback for training MSW-level professionals. Students expressed considerable enthusiasm for utilizing VIP with populations other than elders, e.g., the chronically and persistently mentally ill; the physically disabled.

Impacts
VIP constructs have been integrated into the life-planning work of the Minnesota Vital Aging Network, and into the foundation of the community group ElderZest. VIP presentations continue to be well attended and well received at the University, local, state, national, and international levels. Common audience reactions include 'I was never trained to think about clients this way. Suddenly they become whole people to me!' 'This is a whole paradigm shift in how to work with the elderly.' 'his works not only for the elderly, but for thinking about my own life too.' I was invited to give a series of presentations and trainings on VIP in Australia. These sessions were a follow-up to my 1998-and 1999 work in Australia, where I did trainings based on my then-current work with these constructs. My work on VIP (Aka Life Strengths Practice; Elder Role Models) is now credited with having inspired and guided the development of South Australia's Better Practices Project, now honored as a model for community-based gerontological practice in Australia. Also see Field 40. Ongoing analysis of qualitative and quantitative data will enable us to continue to: 1) Refine the VIP intervention to achieve optimal effectiveness and accessibility; and Disseminate findings to a larger professional, semi-professional, and lay audience. We are on track for implementing VIP in 2-3 practice settings, with the goal of submitting a major NIH research proposal when we have used pilot data to determine the most appropriate site for a large-scale clinical trial.

Publications

• No publications reported this period

Progress 01/01/03 to 12/31/03

Outputs
Vital Involvement Practice (VIP) continued in its development, as a practice modality for promoting diverse strengths in elders, regardless of living circumstances, SES, and level of physical well being. Group Intervention: Although quantitative analyses did not identify clear, positive effects of VIP group participation on measures of elder psychosocial well-being, neither do they document deterioration over the 18 months of data collection. Given the mean participant age of 83.8 yrs (77-93) at the beginning of data collection, and the low-income status of all participants, measurable deterioration is widely regarded as expectable. The absence of this expectable deterioration may, therefore, be regarded as a meaningful form of progress. Individual Intervention: We consulted with Catholic Eldercare on their small grant request to the Medtronic Foundation, to incorporate VIP into routine programming for their new assisted living facility, River View, planned to open in 2004. Their request was denied. We are now taking the lead on revising this proposal, for resubmission to Medtronic. While this grant is pending, we are continuing with plans to incorporate VIP into routine programming for Catholic Eldercare's new assisted living facility. Intervention and Tools: Reviewing protocols from the VIP group intervention and from individual VIP interventions implemented in various sites, we identified 5 essential practice steps (and associated tools) common across interventions sites and modalities. As we have presented these steps in conferences and trainings, we have continued to refine both the procedures and the tools. We have described the entire 5-step intervention in an article that we are about to submit for peer-review publication. I will be teaching a one-credit skills course in Spring Semester 2004, as a way to begin exploring optimal settings and procedures for training professionals to engage effectively in this intervention. We are exploring the possibility of integrating VIP into a private oncology practice. We are exploring the possibility of integrating VIP into the assisted living units of a series of Continuous Care Retirement Communities (mostly in Florida) that have successfully developed a related form of practice for their independent- living populations. The multi-site collaborative project described last year, in collaboration with Health Partners (Minneapolis) professional efforts, and I have been unwilling to participate in the project under the direction of its new PI.

Impacts
VIP constructs remain part of the University-wide course on Multidisciplinary Perspectives on Aging. These constructs have been integrated into the life-planning work of the Minnesota Vital Aging Network, and into the foundation of the community group ElderZest. We have continued to present elements of VIP, its theoretical foundations, and its evolution at local, state, regional, and national conferences and workshops. VIP presentations continue to be well attended and well received at the University, local, state, national, and international levels. Common audience reactions include "I was never trained to think about clients this way. Suddenly they become whole people to me!" "This is a whole paradigm shift in how to work with the elderly." "This works not only for the elderly, but for thinking about my own life too." Due to problems at the publisher, the release date of the book on productive aging (in which my VIP work has a major chapter) was delayed for 18 months. I am now assured that the book will be published in Feb-March, 2004. Ongoing analysis of qualitative and quantitative data will enable us to continue to disseminate findings to a larger professional, semi-professional, and lay audience. Over the next two years, we plan to implement VIP in 2-3 practice settings, with the goal of submitting a major NIH research proposal when we have used pilot data to determine the most appropriate site for a large-scale clinical trial.

Publications

• Kivnick, H.Q., Stoffel, S.A., & Hanlon, D. (2003) Eloise's Tale: Vital involvement, occupation, and story, Generations, XXVII(3).

Progress 01/01/02 to 12/31/02

Outputs
Vital Involvement Practice (VIP) continued in its development, as a practice modality for strengthening elders, their community, and their inter-connections. Group Intervention: Quantitative analyses do not identify clear effects of VIP group participation on measures of elder psychosocial well-being. We attribute these disappointing findings to the small size of the complete data set, and to the ways in which we abbreviated the Well Elder protocol, on which we modeled VIP groups: 1) Our group cycle lasted for 3 months of weekly sessions in comparison to a 9-month weekly-session cycle in the Well Elder protocol. 2) Where the Well Elder protocol included monthly individual sessions with each participant, we did not include individual facilitator-participant sessions. Ongoing qualitative data analysis indicates increased vital involvement among some participants. We are currently preparing case studies of these individuals, to document arenas and processes of individual growth. Qualitative analysis of group sessions also provides a basis for ongoing work in identifying themes that emerged as meaningful among our participants. We will utilize case studies and thematic structure to modify the VIP group protocol for subsequent administration. The PI has recently joined the Board of ElderZest, a local nonprofit organized by seniors to promote zestful living among themselves and their contemporaries. We are currently negotiating with other Board Members to identify a residential facility to host the next VIP group cycle, and to assist in modifying the program for optimal effectiveness in the facility. Tools: We have modified the Occupational Profile, pairing it with a set of worksheets to constitute a set of exercises to facilitate Vital Involvement Problem Solving (VIPS). Following up on our 2002 publication in Minnesota Medicine, we are developing these materials with geriatric clinicians at Fairview-University Medical Center, to produce a self-contained tool for teaching elder patients and their providers to utilizing basic Vital Involvement principles in daily living. Individual Intervention: As part of work on the aforementioned tool,we have begun to pilot Vital Involvement Problem Solving with individual elders. Respondents include frail elders who come to our attention around serious medical conditions, and vital elders who are interested in participating in research, and in maximizing personal vitality. We are working to develop appropriate protocols for working with members of these two very different elder populations, on an individual basis, in group workshops, or in a combination of the two. The PI is utilizing preliminary research on vital involvement measures in a multi-site collaboration with researchers at Health Partners (Minneapolis) and Kaiser Permanente (Denver), to explore vital involvement-related correlates of healthy aging among the oldest old patients enrolled in these two HMO's. This project will involve developing and administering a survey to supplement existing HMO data bases. It is intended to provide a foundation for developing intervention protocols to be incorporated into geriatric health care.

Impacts
VIP constructs remain part of the University-wide course on Multidisciplinary Perspectives on Aging. These constructs have also been integrated into the life-planning work of the Minnesota Vital Aging Network. The VIP group format, its theoretical foundations, and its evolution into VIPS were presented at local, state, regional, and national conferences and workshops. VIP presentations continue to be well attended and well received at the University, local, state, national and international levels. A chapter in press with the NASW press will introduce the construct as central to social work practice for productive aging. Ongoing analysis of qualitative and quantitative data will enable us to continue to: 1) Make progress on improving the VIP group intervention; 2) Develop the VIPS protocol for individual and group-based administration; 3) Develop VIP self-help materials; and 4) Develop appropriate strategies for conceptualizing and measuring positive outcomes.

Publications

• Kivnick, H. Q. & Stoffel, S. A. (2002) Promoting vital involvement. Minnesota Medicine 85 (9), 40-43.

Progress 01/01/01 to 12/31/01

Outputs
Vital Involvement Practice (VIP) continued in its development, as a practice modality for strengthening elders, their community, and the connections between them. A final 13-session VIP group cycle was completed at St. Paul Wilder Senior Housing, involving 16 participants. At the participants' request, we developed curriculum for and facilitated a subsequent, advanced-level group that met for ten sessions, focusing on physical exercise and on reworking earlier curriculum material to facilitate ongoing individual improvement in vital involvement. Diane Hanlon (Research Associate, SSW, U of MN) and Sharon Stoffel (Associate Professor of Occupational Therapy and Occupational Science, College of St. Catherine) facilitated group sessions, with the PI participating by consulting and debriefing. Quantitative baseline and 9-month follow-up data have been gathered on all participants. The quantitative data set is being 'cleaned up;' quantitative data will be analyzed in 2002, to determine identifiable effects of VIP group participation on specific measures of elder psychosocial well-being. Ongoing analysis of qualitative data led to our developing an 'Occupational Profile,' as an interdisciplinary tool for representing and reflecting on the daily activities that constitute a primary expression of an elder's identity in and personal efforts at coping with her/his world. Paradoxically, at that life stage when a meaningful sense of identity has most influence on the central task of consolidating integrity, the elder may find daily activities increasingly limited to relatively meaningless tasks of physical maintenance. Vital involvement theory clarifies the importance of dynamic engagement with the world outside the self. Paired with strengths assessment, the occupational profile provides a basis for systematic individual evaluation of elements of daily life, and for making desired changes. Among the uniformly frail elders in our sample, we have identified two initial activity styles: 1) EXTRAVERT OVERACTIVE, characterized by high levels of multi-tasking and many different activities; and 2) DEPRESSED UNDERACTIVE, characterized by slivers of activity ineffectively superimposed on a great deal of 'down time.' Ongoing qualitative analysis will explore patterns of improvement associated with each activity style. The PI presented a poster on the Occupational Profile at the Annual Scientific Meeting of the Gerontological Society of America. We plan to submit at least one manuscript on the Occupational Profile for peer-reviewed publication in 2002. The PI is utilizing preliminary research on vital involvement measures in a multi-site collaboration with researchers at Health Partners (Minneapolis) and Kaiser Permanente (Denver), to explore vital involvement-related correlates of healthy aging among the oldest old patients enrolled in these two HMO's. This project will involve developing and administering a survey to supplement existing HMO data bases. It is intended to provide a foundation for developing intervention protocols to be incorporated into geriatric health care.

Impacts
VIP constructs remain part of the University-wide course on Multidisciplinary Perspectives on Aging, and are regularly presented by the PI as part of the curricula for two Minnesota Area Geriatric Education Center Educational and Clinical fellowship programs: The VIP group format, its theoretical foundations, and its evolution into the Occupational Profile were presented at local, state, regional and national conferences. The team is exploring the possibility of collaborative research on the Occupational Profile, with scholars at the Philadelphia Geriatric Center. VIP presentations continue to be well attended and reveived at the Univeristy, local, state, national and international levels. A Chapter in press with the NASW press will introduce the construct as central to social work practice for productive aging. Ongoing analysis of qualitative and quantitative data will enable us to improve the VIP group intervention for its next iteration, to develop and pilot self-help vital involvement 'products' (to be distributed by MAGEC), and to refine our strategies for conceptualizing and measuring positive outcomes.

Publications

• Kivnick, H. Q. & Kavka, A. B. (2002). Psychodynamic psychotherapy: Psychosocial themes in the Eriksonian alliance. In F. K. Trotman & C. M. Brody (Eds.). Psychotherapy and Counseling with Older Women. New York: Springer Publishing Company, (125-143).

Progress 01/01/00 to 12/31/00

Outputs
Quantitative data from the Hennepin County pilot project were coded, entered into the data base, and subjected to descriptive statistical analysis. Although subject numbers are too small to support statistical significance, trend lines indicate client progress associated with participation in individual Vital Involvement Practice (VIP). These constructs remain part of the University-Wide course on Multidisciplinary Perspectives on Aging, and have been presented by the PI as part of the curricula for two Minnesota Area Geriatric Education Center fellowship programs: 1) Education Fellows; 2) Clinical Fellows. Three 13-session VIP group cycles have been completed at the St. Paul Wilder Senior Housing complex, and a fourth cycle is underway. Group sessions are being facilitated by Diane Hanlon (Research Associate, SSW, U of MN) and Sharon Stoffel (Associate Professor of Occupational Therapy and Occupational Science, College of St. Catherine), with the PI participating by consulting and debriefing. Quantitative baseline data have been gathered on all 31 participants, and follow-up data have been gathered as appropriate. Qualitative documentation has been recorded for all groups. These qualitative data are regularly incorporated into ongoing development of all aspects of the Group VIP format. Participant evaluations are overwhelmingly positive. After completing the cycle, all groups have chosen to continue to meet on a monthly basis. VIP group alumni are currently meeting with project directors to design an 'advanced' or 'second-level' cycle of sessions. Quantitative data have been entered into an Access data base. They will be transferred into SPSS and analyzed in 2001. No residents of the Wilder Senior Housing complex have expressed interest in participating in the individual VIP modality. We hope to develop preliminary psychometrics on the Vital Involvement Measure (VIM) and the Measure of Elder Productive Activity (MEPA) during 2001. VIP was presented as both a philosophy and a modality of practice of strengthening elder clients, their community, and the connections between them. This presentation was part of the keynote address at the Minnesota Gerontological Society's annual meeting, delivered by the PI.

Impacts
The Vital Involvement Practice (VIP) group format and its theoretical foundations were presented at local, state, regional, and national conferences. In South Australia, the Community Options Program published a description of their program, focusing on Vital Involvement Practice as the foundation of their client work. The team is exploring strategies for making VIP groups a regular component of the Wilder Senior Housing Facility, and for introducing the groups elsewhere in MN. The Life Strengths Interview Guide and its underlying theoretical framework are the foundation for a doctoral dissertation in the Department of Leisure Studies and Kinesiology.

Publications

• Kivnick, H. Q., (2000). Assessing for strengths: Better practice for care in home and community. Keynote address, in Home and Community Care: Assessment Cocktail -- the right mix or a quick fix? Adelaide, SA: South Australian Department of Human Services, pp. 3-14.

Progress 01/01/99 to 12/31/99

Outputs
VIP was presented as both a philosophy and a modality of practice with elder clients at the Minnesota Gerontological Society's Age Odyssey Conference; the workshop was presented by the PI and by two case managers from Hennepin County Coordinated Home Services (HCCHS). Quantitative data from the Hennepin County pilot project were coded and entered into the data base; they are now ready for statistical analysis. The three project instruments (Strengths Assessment; Vital Involvement Measure (VIM); Measure of Elder Productive Activity (MEPA) ) were submitted to a process of cognitive interviewing among community-dwelling elders. The instruments were further refined and administration procedures were standardized. We are preparing to develop preliminary psychometrics on the VIM and the MEPA. The PI consulted with Southeast Seniors, adapting the VIM to serve as an evaluation measure for their Home Visitor program. The PI also worked with two HCCHS neighborhood teams, to incorporate constructs of vital involvement and elder productive activity into the County's evaluation of community-based services. An outcome of this joint work was a clarification of such distinct elements of community involvement as: siting an agency service-delivery office in the community; elder input into agency policies and practices in the community; elder involvement in 'non-service-related' activities in the community; elder participation in community life in such a way as to add value to the community. The PI returned to Adelaide, South Australia to provide additional training and do additional speaking on Strengths Assessment and Vital Involvement Practice. A group format for VIP has been developed in collaboration with Sharon Stoffel (College of St. Catherine) and Diane Hanlon (Research Associate, SSW, U of MN). The PI received funding from the U-CARE Foundation to pilot this group format and continue to develop the individual format at University - Wilder Senior Health Clinic in St. Paul. Groups are expected to run for 13-16 sessions. In addition to quantitative evaluation of group participants, the groups themselves will be evaluated by participants, facilitators, and clinic staff. Evaluation data will be incorporated into the ongoing development of the Group VIP format. The first VIP will meet on January 6, 2000. It is anticipated that participants in the first group will function as co-facilitators of subsequent groups. The three instruments plus the conceptual framework for VIP were again presented as part of a graduate-level geriatric assessment course. Each of 10 students administered the instruments to an elder, analyzed findings, and developed an Ability Balance and plan of goals with the elder. These constructs remain part of the University-wide course on Multidisciplinary Perspectives on Aging, and have been presented by the PI as part of the curricula for two Minnesota Area Geriatric Education Center fellowship programs: 1) Education Fellows; 2) Clinical Fellows. One publication is under review; two additional ones are in preparation.

Impacts
Hennepin County pilot participants (case managers) report having adopted Vital Involvement Practice(VIP)as an ongoing philosophy of practice. In South Australia, the Community Options Program refocused agency work with all clients to maximize client vital involvement. The state of South Australia is considering the possibility of mandating the Strengths Assessment Interview as part of intake assessment for all aged services.

Publications

• KIVNICK, H.Q., and KAVKA, A. (1999) It takes two: Therapeutic alliance with older clients. In M. Duffy (Ed.). Handbook of Counseling and Psychotherapy with Older Adults. New York: John Wiley and Sons, 107-131.

Progress 01/01/98 to 12/31/98

Outputs
The Strengths Assessment was again revised and pared down, as part of ongoing work to develop an optimally effective tool for enabling case managers and family members to identify elders strengths, and then to encourage ordinary elders to maximize their elder role model-hood. The concept of Ability Balance was refined, as a graphic strategy for viewing a frail elder's disabilities and problems alonside his/her strengths, values, commitments, and productive activity. This Assessment and its follow-up instruments provide a uniquely effective and parsimonious tool for enabling elders and professional caregivers and case mangers to expand the focus of genontological practice from simply compensating for disability to optimizing strength, vitality, and productive activity, as well. The two additional instruments introduced last year (Vital Involvement Measure (VIM); Measure of Elder Productive Activity (MEPA)) were further revised and are currently being submitted to a process of cognitive interviewing as part of establishing reliability and validity. These instruments will fill a major gab in existing outcome measures. Although elder programs increasingly verbalize the importance of individual strength and community involvement, outcome measures have focused entirely on disabilities, costs, and services allocated. In the absence of tools to measure positive qualities, practitioners and administrators, alike, have been both unwilling and unable to justify expending resources on promoting such qualities. The VIM was included as part of the Measurement Core, in a Pepper Center Grant, submitted to NIA jointly by the University of MN Center on Aging and the Mayo Clinic. The investigator has done speaking and training on Vital Involvement Practice (VIP) in MN, WI, CA, PA, and South Australia. The instruments have been adopted in two geriatric clinical settings in the San Francisco Bay area. We are exploring the possiblity of developing psychometrics on the VIM and MEPA in Australia, as part of their Year of the Older Person. The investigator has been contracted to work w/Hennepin County Community-Based Services to develop an agency-appropriate measure of elder community involvement, as an outcome measure for their community-focused case management program. A group format for VIP is currently in development. In collaboration with the Volunteers of America Senior Resources Program, this group VIP is expected to be introduced at one of Senior Resources' subsidized Senior Highrise buildings in North Minneapolis. The three instruments plus the conceptual framework for VIP were again presented as part of a graduate-level geriatric assessment course. Each of 12 students administered the instruments to an elder, analyzed findings, and developed an Ability Balance and plan of goals with the elder. These constructs remain part of the University-wide course on Multidisciplinary Perspectives on Aging. The three instruments were incorporated into the coursework for two Minnesota Area Geriatric Education Center fellowship programs: 1) Education Fellows; 2) Clinical Fellows. One publication is currently in press; two additional ones are in preparation.

Impacts
(N/A)

Publications

• Kivnick, H. Q. (1998). Through the life cycle: Psychological thoughts on old age. In G. H. Pollock & S. I. Greenspan (Eds.), The couse of life, (Vol. 7, pp. 119-134). Madison, CT: International Universities Press.

Progress 01/01/97 to 12/31/97

Outputs
The Strengths Assessment was again revised and pared down, as part of ongoing work to develop an optimally effective tool for enabling case managers and family members to identify elders strengths, and then to encourage ordinary elders to maximize their elder role model-hood. This tool was incorporated into a graduate-level assessment course. Preliminary versions of two additional instruments were developed and piloted, one for measuring overall client vital involvement, and one for measuring client contribution among frail elders. In a formal Vital Involvement Practice (VIP) pilot study, six case managers at Hennepin County Community-Based Services were trained and supervised in implementing VIP and two case managers were supervised in documenting control clients. A total of 30 elder, community-based long-term care clients are currently participating in this study. One case manager in Big Stone County was trained and supervised in implementing VIP with five community-based long-term care clients. A grant proposal was submitted to the National Institute on Aging, to conduct a randomized clinical trial of VIP at Hennepin County Community-Based Services. The concepts of elder role models and life strengths, psychosocial health, and personal contributions among elders were incorporated into the University course on Multidisciplinary Perspectives on Aging.

Impacts
(N/A)

Publications

• KIVNICK, H.Q. and MURRAY, S.V. (1997). Vital Involvement: An Overlooked Source of Identify in Frail Elders. J. of Aging and
• KIVNICK, H.Q. and JERNSTEDT, H.L. (1996). Mama still sparkles: An elder role model in long-term care. Marriage and Family Review,

Progress 01/01/96 to 12/30/96

Outputs
Based on qualitative analysis of elder-role-model interviews, the concept of "psychosocial legacy" was developed and published. Elder role models were incorporated into Univ of MN courses on Multidisciplinary Perspectives on Aging. Autonomy-based interview Guide ("Strengths Assessment") was revised to develop an optimally effective tool for enabling case managers & family members to identify elders' strengths, and to encourage "ordinary" elders to maximize their "elder role model-hood." This tool was presented in a graduate-level assessment course offered through the Univ of MN Interdisciplinary Center on Aging. Based on analysis of the qualitative data from the 1995 pilot study, procedures were formalized for conducting "vital Involvement Practice" (VIP), an approach to long-term care case management for fragile community-dwelling elders, that encourages these people to maximize personal strengths, values, commitments, and contributions while they receive essential compensatory services. 12 VIP staff training sessions were held in public and private agencies in MN and WI. A formal VIP pilot study was undertaken in Hennepin County Coordinated Home Services, involving 8 case managers and 40 clients over 20 months. Initial funding has come from Hennepin County, the Univ of MN Graduate School, and the MN Cookbook Foundation. Additional funding is sought to complete the pilot, to continue to revise this method of practice, and to conduct a full-scale clinical VIP trial.

Impacts
(N/A)

Publications

• KIVNICK, H.Q. (1996). Remembering and being remembered:The reciprocity of psychosocial legacy. Generations, 20 (3), 49-53.
• KIVNICK, H.Q. (1996). "Hang on." Generations, 20(3), 53.
• KIVNICK, H.Q. (1996). Values II project: Final report. In R.A. Kane (Ed.). Effects of introducing assessment of values/preferences in long-term care programs... Monograph for Retirement Research Foundation.
• KIVNICK, H.Q. and JERNSTEDT, H.L. (in press). Mama still sparkles: An elder rolemodel in long-term care. Marriage and Family Review.
• KIVNICK, H.Q. (1995). "Save it." in M. Cruikshank (Ed. ), Fierce with Reality: An anthology of literature about aging. St. Cloud, MN, North Star Press, 172.

Progress 01/01/95 to 12/30/95

Outputs
Analysis was completed on the transcripts of a series of life-cycle interviews with two elder role models in long term care, according to the same procedure described previously. Based on the analysis of three complete individual protocols, analysis was initiated to identify the underlying structure (i.e., conceptual categories) of Erikson's eight psychosocial themes. In particular, the underlying structure was clarified and refined for the theme Autonomy & Shame/Doubt. Presented keynote address "Elder Role Models and the Underlying Structure of Erikson's Themes" at the annual meeting of the Society for Research in Adult Development. An Autonomy-based interview Guide was developed, enabling case managers to program for the promotion of life strengths among tong-term care clients. Seven case managers were trained and piloted these materials and procedures on a total of nine clients, with the goal of encouraging these "ordinary" elders to maximize their "elder role model-hood." Over 5 months this pilot work accomplished the following: 1) Began to clarify the kinds of clients and case managers who are most/least likely to respond well to strengths-based practice; 2) Confirmed the importance of daily client activity and community contribution; 3) Began to clarify organizational supports that are essential to effective strengths-based practice. A new volunteer RA was recruited and trained to enter data, after the departure of the last volunteer RA. Data were entered in a reorganized FileMaker Pro d.

Impacts
(N/A)

Publications

• NO PUBLICATIONS REPORTED THIS PERIOD.

Progress 01/01/94 to 12/30/94

Outputs
This project began in September, 1995; analysis was completed on transcripts of a series of life-cycle interviews with one elder role model in long-term care. Over 75% of the protocol was relevant to this study and was broken into text passages, each of which was coded according to three parameters: 1) Expressing one or more of Erikson's eight psychosocial themes; 2) Relevant to a particular life stage; 3) Positive, negative, or neutral in valance. Coding disagreements were discussed in order to continue to clarify the conceptual meaning of coding categories. Progress was made on eliminating procedural analytic difficulties. A complete life-cycle chart for this elder role model was printed, clarifying individual thematic strengths and weaknesses. Raised in a rural environment, this elder role model demonstrates particular lifelong strength around CARE & PRODUCTIVITY, COMPETENCE & HARD WORK, and HOPE & FAITH. She uses these strengths in combination with each other to compensate for old-age assaults on INDEPENDENCE. This project is expected to clarify the particular strengths, combinations of strengths, and expressions of strengths that elder role models use to compensate for later-life deficits. This information will serve as a basis for assessing, developing, and maximizing particular strengths in the disabled rural elderly, as a way of enhancing individual, family, and community coping with increasing needs for long-term care.

Impacts
(N/A)

Publications

• NO PUBLICATIONS REPORTED THIS PERIOD.