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Evaluation of an agency-based occupational therapy intervention to facilitate aging in place
- Authors:
- SHEFFIELD Chava, SMITH Charles A., BECKER Mary
- Journal article citation:
- Gerontologist, 53(6), 2013, pp.907-918.
- Publisher:
- Oxford University Press
Purpose: The United States faces a growing population of older adults and accompanying functional disabilities, coupled with constrained public resources and diminishing informal supports. A variety of interventions that aim to improve client outcomes have been studied, but to date, there is limited translational research that examines the efficacy of moving such interventions from clinical trials to agency settings. Methods: A randomized controlled trial was conducted to evaluate a restorative occupational therapy intervention relative to “usual care” among community-dwelling older adults. The intervention included a detailed assessment from a person–environment perspective and provision of adaptive equipment and home modifications where appropriate. The intervention (n = 31) and control groups (n = 29) were evaluated at 3 months and assessed for changes in functional status, home safety, falls, health-related quality of life (HRQoL; EQ5D), depression, social support, and fear of falling; a 4 subgroup analysis also examined outcomes by waiting list status. An informal economic evaluation compared the intervention to usual care. Results: Findings indicated improvements in home safety (p < .0005, b = −15.87), HRQoL (p = .03, b = 0.08), and fear of falling (p < .05, b = 2.22). Findings did not show improvement in functional status or reduction in actual falls. The intervention resulted in a 39% reduction in recommended hours of personal care, which if implemented, could result in significant cost savings. Implications: The study adds to the growing literature of occupational therapy interventions for older adults, and the findings support the concept that restorative approaches can be successfully implemented in public agencies. (Publisher abstract)
When people with pre-existing disabilities age in place: implications for social work practice
- Authors:
- GILSON Stephen French, NETTING F. Ellen
- Journal article citation:
- Health and Social Work, 22(4), November 1997, pp.290-298.
- Publisher:
- Oxford University Press
Focuses on a population of people with disabilities who are "ageing in place," that is, individuals ageing with pre-existing physical disabilities. A brief overview of people ageing with disabilities and selected background information on the increasing linkages between the ageing and disability communities is provided. Four case examples illustrate the practice implications faced by social workers in partnering with people with pre-existing disabilities and in being sensitive to their desires concerning ageing in place.
Changes in health, mortality, and disability and their impact on long-term care needs
- Authors:
- MANTON Kenneth G., STALLARD Eric
- Journal article citation:
- Journal of Aging and Social Policy, 7(3/4), 1996, pp.25-52.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
This article examines changes in the health of the U.S. elderly population using the 1982, 1994, and 1989 National Long Term Care Surveys. Both disability prevalence and active life expectancy changes are examined. Second, advances in treatments that improved prognoses and were cost-effective are examined. Third, changes in Medicare use-especially when biomedical advances allow some long-term care needs to be met by interventions in early disease stages - are considered. Results suggest that, while the amount of long term care services needed will increase rapidly, the types and amounts of services used by the U.S. elderly population will undergo significant change.
Treating depression in disabled, low-income elderly: a conceptual model and recommendations for care
- Authors:
- AREAN Patricia A., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(8), August 2010, pp.765-769.
- Publisher:
- Wiley
Ten percent of older people in the United States live at or below the poverty line, and the treatment of depression within this group is complicated by several factors, where poor access to resources, disability, and mild cognitive impairment are the main factors that moderate treatment effects. Interventions that not only address the depressive syndrome but also manage social adversity are needed to help this patient population recover from depression. This paper presents a literature review of correlates of depression in late life. In the review the authors propose a treatment model that combines case management to address social adversity with problem solving treatment to address the depressive syndrome. The case of a male patient is outlined – living in poverty, depressed, and physically disabled. The authors’ illustrate how the combination of case management and problem solving treatment can work together to ameliorate depression. In conclusion, the paper suggests that the combination of age, disability, and social adversity complicates the management and treatment of depression. Case management and problem solving treatment are interventions that work synergistically to overcome depression and manage social problems.
Escape loneliness by going digital: a quantitative and qualitative evaluation of a Dutch experiment in using ECT to overcome loneliness among older adults
- Authors:
- FOKKEMA T., KNIPSCHEER K.
- Journal article citation:
- Aging and Mental Health, 11(5), September 2007, pp.496-504.
- Publisher:
- Taylor and Francis
This study evaluates the outcomes of an Internet-at-home intervention experiment that intended to decrease loneliness among chronically ill and physically disabled older adults through introducing them to the use of an electronic communication facility. To determine the effectiveness of the experiment in terms of reducing loneliness, 15 older adults were interviewed three times: shortly before the start, two years later and immediately after termination of the experiment, while their loneliness scores at zero and post-measurement were compared with those of a control group. Both the participants and the control persons experienced a reduction in loneliness over time. However, the reduction was only significant for the intervention participants. Moreover, the changes in loneliness were significantly greater among the participants compared to the control persons. When looking more in detail, the effect of the experiment was only significant regarding emotional loneliness and among the highest educated. Findings of the qualitative research enabled us to understand the mechanisms through which the intervention helped alleviate loneliness. E-mail was found to facilitate social contact. Furthermore, the computer and Internet were often used to pass the time, taking people's minds off their loneliness. Unexpectedly, the intervention also improved people's self-confidence. The decline in loneliness is likely to be greater if persons under more favourable circumstances are selected and if more social functions of the Internet are used.
The role of mastery and social resources in the associations between disability and depression in later life
- Authors:
- JANG Yuri, et al
- Journal article citation:
- Gerontologist, 42(6), December 2002, pp.807-813.
- Publisher:
- Oxford University Press
Although disability is widely acknowledged as a risk factor for late-life depression, few studies have studied the potential of psychosocial factors to alter the association between disability and depression. The present study assessed the impacts of mastery and social resources (social network, social support, and satisfaction with support) on depression and, in particular, whether they modify the link between disability and depression. Research Although disability is widely acknowledged as a risk factor for late-life depression, few studies have studied the potential of psychosocial factors to alter the association between disability and depression. The present study assessed the impacts of mastery and social resources (social network, social support, and satisfaction with support) on depression and, in particular, whether they modify the link between disability and depression.
Valuing older people: positive psychological practice
- Author:
- STIRLING Elspeth
- Publisher:
- Wiley-Blackwell
- Publication year:
- 2010
- Pagination:
- 213p., bibliog.
- Place of publication:
- Chichester
A global guide to positive psychological practice when dealing with older and very old people. The author, previously a clinical psychologist, champions social role valorisation (SRV) in relation to older people and ageing. SRV theory is based on opposing society’s tendency to devalue particular groups of people because they are ‘different. The author applies it, not only to counteract stereotyped attitudes that older people are valueless, but to promote beneficial effects of having our elders active in society and observing and learning from, for example, their coping behaviour. Chapters cover: the psychology and ecology of ageing; preventive psychology in later life; assessment in the new paradigm; new paradigm principles for intervention; older people and cognitive disabilities; new paradigm principles of service design; and psychological therapies with older people.
Promoting positive human-animal interaction: the role of the social worker in the multidisciplinary team
- Authors:
- van HEERDEN M., du PREEZ M.S.E.
- Journal article citation:
- Social Work Maatskaplike Werk, 38(2), June 2002, pp.91-104.
Social work focuses, among other things, on the bond between people and their environment. Discusses the role of companion animals in people's lives, and how human-animal interaction can be used in social work interventions. Makes recommendations on how the social worker can promote positive human-animal interaction through multidisciplinary co-operation.
Coordination and Advocacy for Rural Elders (CARE): a model of rural case management with veterans
- Authors:
- RITCHIE Christine, et al
- Journal article citation:
- Gerontologist, 42(3), June 2002, pp.399-405.
- Publisher:
- Oxford University Press
Describes a pilot initiative sponsored by the Veterans Health Administration (VHA) to improve the health and community tenure of frail older veterans living in rural counties 50-100 miles from two host VHA medical centers. Problems identified for each patient, included risk, social needs, pain, and needs related to disability. As a result of initial assessment, two thirds of CARE (Coordination and Advocacy for Rural Elders) participants received referral/linkage to formal services, more than half to medical providers.
Ethical discussion groups as an intervention to improve the climate in interprofessional work with the elderly and disabled
- Authors:
- FORSGARDE Marianne, WESTMAN Berith, NYGREN Lennart
- Journal article citation:
- Journal of Interprofessional Care, 14(4), November 2000, pp.351-361.
- Publisher:
- Taylor and Francis
Due to social policy reforms in Sweden, professionals with a social and a medical education work together. Reported conflicts within municipal elderly and disabled care, related to professional training, sometimes result in a deteriorated work climate. As an attempt to improve the work climate in interprofessional groups, an intervention study was set up in four 'experimental dwellings' where staff participated in systematic ethical group discussions. Work climate was studied before and after the intervention using a questionnaire measuring sense of coherence, job satisfaction, and burnout among the staff. The small observed changes after intervention indicate that the intervention did not lead to the expected improvement of work climate, but might also result from the chosen scales inability to measure complex social processes. The importance of interprofessional discussions about everyday skills and values is stressed.