Effectiveness of an Occupational Therapy Home Intervention to Increase Safety, Improve Function, and Reduce Falls Among At-Risk Community Dwelling Older Adults

Title	Effectiveness of an Occupational Therapy Home Intervention to Increase Safety, Improve Function, and Reduce Falls Among At-Risk Community Dwelling Older Adults
Author	Sheffield, Chava B.
Advisors	Salkever, David ;
Program	Public Policy
UMBC Department	Public Policy
Document Type	dissertation
Sponsors	University of Maryland, Baltimore County (UMBC)
Keywords	at risk; home environment; home safety; occupational therapy; older adults; randomized controlled trial
Date Issued	2011-01-01
Abstract	The United States faces a growing population of older adults and accompanying disability, coupled with constrained public resources. Innovative policy solutions are needed that improve safety and quality of life for older adults in a cost-effective manner. A randomized controlled trial using a pre-test/post-test design assessed the effectiveness of a novel occupational therapy service involving customized in-home interventions conducted by highly trained therapists. The service reflects a decade of development and field testing to identify the essential elements of the evaluation and intervention process. Eligible individuals included at-risk, community-dwelling older adults who are currently receiving services from local area agencies on aging, have difficulty with some functional tasks but are able to move around within the home, and have the cognitive capacity to participate in the assessment and intervention. The treatment group received a baseline assessment followed by treatment, while the delayed treatment (control) group received a baseline assessment followed by no treatment. At three months, both groups were re-assessed. The data for 71 participants was provided by Howard and Montgomery Counties; complete data was available for 60 participants. The treatment and control groups were compared on baseline covariates; regression adjustments were made as necessary. Analysis utilized Ordinary Least Squares (OLS); model assumptions were tested using regression diagnostics. Significant improvements were found in home safety and quality of life, as were significant reductions in fear of falling. No improvements were found with respect to the other outcome measures. Results were robust to alternative specifications, robust standard errors, and the omission of outliers and influential observations. This study adds to the growing literature of occupational therapy interventions targeting at risk older adults to improve home safety, independence, and quality of life. The contribution of this study is a first step in shifting the design of services for at-risk, community-dwelling older adults. Components of the intervention training could be provided to staff involved in allocating services. If the funding mechanisms can shift away from the dependency model to a model that facilitates independence, older adults could potentially experience better quality of life, and services could be provided to an expanded population.
Identifier	10574
Format	application:pdf
Language	en
Collection	UMBC Theses and Dissertations.
Rights Statement	This item may be protected under Title 17 of the U.S. Copyright Law. It is made available by UMBC for non-commercial research and education. For permission to publish or reproduce, please see http://aok.lib.umbc.edu/specoll/repro.php or contact Special Collections at speccoll(at)umbc.edu.
Source	Sheffield_umbc_0434D_10574.pdf

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Effectiveness of an Occupational Therapy Home Intervention to Increase Safety, Improve Function, and Reduce Falls Among At-Risk Community Dwelling Older Adults

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