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Older adults with heart disease, arthritis or other chronic health conditions often have difficulties with everyday activities such as bathing or walking. Among other things, these difficulties can contribute to reduced quality of life and to fear of falling, which may cause anxiety, depression, isolation, and even falls. As a result of difficulties with daily activities, older adults may need help in their homes, or need to move to a family member's home or a nursing home or other facility. Some research suggests that a multi-pronged approach that includes occupational and physical therapy, strength training, and changes in the home that make daily activities easier and safer may help older adults with difficulties performing everyday tasks. New Research in the Journal of the American Geriatrics Society Researchers studied 319 adults who lived in the community (rather than in nursing homes or other institutions). All of the adults were 70 or older who reported some difficulties with everyday activities such as bathing, walking, preparing meals, or traveling by car or public transportation. None were getting help from home health aides, or occupational or physical therapists. At the start of their study, the researchers assigned about half of the adults to an "intervention group" and the other half to a "control group." Over the next six months, adults in the "intervention group" met with a physical therapist who taught them simple balance and muscle strengthening exercises to help them get stronger and improve their balance. They also met with an occupational therapist also asked the adults to tell them which everyday tasks they found most difficult. Then the therapists helped modify the adults' homes to make these tasks easier. Among other things, they arranged for the installation of "grab bars" in showers and baths to help prevent falls. The therapists also helped the older adults problem-solve and figure out ways to overcome difficulties with daily activities by, for instance, pacing themselves, sitting instead of standing to perform tasks, and relying on tools such as grab bars or other simple devices for preparing meal or opening doors easier. This multi-pronged "intervention" cost about $1,200 per person. The adults in the "control group" did not get special help. Both six and 12 months after the start of the study, those in the "intervention group" were better able to perform everyday tasks and take care of themselves. They were also more likely to use problem-solving strategies to make these tasks easier. In addition, they were less frightened of falling than the adults in the control group. Older adults who have difficulty with daily activities or are afraid of falling may do well with this type of intervention, the researchers conclude. Medicare covers services by occupational and physical therapists that improve older adults' abilities to perform everyday activities. Medicare, however, will not cover the cost of changes in the home - such as the installation of grab bars. Efforts should be made to change this, the researchers suggest. What Should I Do? If you or an older loved one is having trouble managing everyday tasks, talk to your or their health care provider and ask for a referral to an occupational and physical therapist. These health care providers can offer advice on making tasks easier and may recommend agencies in the community that offer additional help. For more information about getting help with everyday activities, visit http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=14. The summary above is from the full report titled, "A Randomized Trial of a Multi-component Home Intervention to Reduce Functional Difficulties in Older Adults." It is in the May 2006 issue of the Journal of the American Geriatrics Society (Volume 54, Issue 5). The report is authored by Laura N. Gitlin, PhD; Laraine Winter, PhD; Marie P. Dennis, PhD, EdM; Mary Corcoran, PhD, OTR/L; Sandy Schinfeld, MPH, and Walter W. Hauck, PhD. |
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