Journal Article

Evaluation of an Agency-Based Occupational Therapy Intervention to Facilitate Aging in Place

Chava Sheffield, Charles A. Smith and Mary Becker

in The Gerontologist

Published on behalf of The Gerontological Society of America

Volume 53, issue 6, pages 907-918
Published in print December 2013 | ISSN: 0016-9013
Published online December 2012 | e-ISSN: 1758-5341 | DOI: https://dx.doi.org/10.1093/geront/gns145
Evaluation of an Agency-Based Occupational Therapy Intervention to Facilitate Aging in Place

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  • Gerontology and Ageing
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  • Geriatric Medicine
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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.

Keywords: In-home intervention; Resource allocation; Randomized controlled trial; Policy solutions; Area agency on aging

Journal Article.  6556 words.  Illustrated.

Subjects: Gerontology and Ageing ; Psychology ; Geriatric Medicine ; Biological Sciences

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