Improving Unsafe Environments to Support Aging Independence with Limited Resources

Szanton, Sarah L.; Roth, Jill; Nkimbeng, Manka; Savage, Jessica; Klimmek, Rachel

doi:10.1016/j.cnur.2014.02.002

Cited by 24 publications

(17 citation statements)

References 20 publications

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“…RN-related goals predominantly focus on pain and mood management, fall prevention, strength and balance, medication complexity, and primary care communications. 27 The RN and OT communicate about the respective goals, which may or may not correspond with each other. Although CAPABLE is an inter-professional, multicomponent program, the OT and RN assume distinct roles that are differentiated by discipline.…”

Section: Methodsmentioning

confidence: 99%

Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

Waldersen

Wolff

Roberts

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective To describe functional goals and factors associated with goal attainment among low-income older adults with disabilities living in the community. Design Secondary analysis from two studies of CAPABLE. Functional goals were coded using the International Classification of Functioning, Disability, and Health (ICF) framework. The percentage of goals attained at five months follow-up was computed within each ICF domain. Multivariate logistic regression was used to identify factors associated with goal attainment. Setting Participants’ homes in Baltimore, Maryland Participants CAPABLE participants (n=226) Interventions A five-month, home-based, person-directed, structured program delivered by an inter-professional team: occupational therapist (OT), registered nurse (RN), and handyman. Main Outcome Measure(s) Process of OT goal setting and attainment at the final OT visit. Results Participants identified 728 functional goals (average of 3.2 per participant), most commonly related to transferring (22.0%, n=160 goals), changing or maintaining body position (21.4%, n=156 goals), and stairclimbing (13.0%, n= 95 goals). Participants attained 73.5% (n=535) of goals. Goal attainment was highest for stairclimbing (86.3%), transferring (85.6%), and self-care (84.6%); walking goals were less likely attained (54.0%). Goal attainment was not associated with age, gender, education, depressive symptoms, function, or health-related quality of life but was less likely among participants who had severe pain compared to those without pain (aOR: 0.38, 95% CI: 0.17, 0.86). When participant readiness to change (RTC) score increases by one point on the four-point scale, goal attainment was 62% more likely (aOR 1.62; 95% CI: 1.14–2.29). Conclusion Home-based collaborative goal-setting between older adults and OTs is feasible and particularly effective when individuals are ready or willing to adopt new strategies to achieve identified goals.

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Section: Methodsmentioning

confidence: 99%

Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

Waldersen

Wolff

Roberts

et al. 2017

Archives of Physical Medicine and Rehabilitation

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“…Two promising interventions for multimorbidity are patient-centred medical homes [ 71 ] and Guided Care [ 72 – 74 ]; both of which have the potential to overcome the challenge of home-bound individuals accessing community resources [ 75 ]. Likewise, the effectiveness of physician house call programmes [ 76 ], as well home-support with a more diverse team such as the CAPABLE team (comprising a nurse, an occupational therapist and a handyman) are being evaluated [ 77 , 78 ].…”

Section: A Step-wise Approach To Improve Health Outcomes (Arise-hfmentioning

confidence: 99%

Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): A multidisciplinary position statement

Stewart

Riegel

Boyd

et al. 2016

International Journal of Cardiology

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Background Multimorbidity in heart failure (HF), defined as HF of any aetiology and multiple concurrent conditions that require active management, represents an emerging problem within the ageing HF patient population worldwide. Methods To inform this position paper, we performed: 1) an initial review of the literature identifying the ten most common conditions, other than hypertension and ischaemic heart disease, complicating the management of HF (anaemia, arrhythmias, cognitive dysfunction, depression, diabetes, musculoskeletal disorders, renal dysfunction, respiratory disease, sleep disorders and thyroid disease) and then 2) a review of the published literature describing the association between HF with each of the ten conditions. From these data we describe a clinical framework, comprising five key steps, to potentially improve historically poor health outcomes in this patient population. Results We identified five key steps (ARISE-HF) that could potentially improve clinical outcomes if applied in a systematic manner: 1) Acknowledge multimorbidity as a clinical syndrome that is associated with poor health outcomes, 2) Routinely profile (using a standardised protocol — adapted to the local health care system) all patients hospitalised with HF to determine the extent of concurrent multimorbidity, 3) Identify individualised priorities and person-centred goals based on the extent and nature of multimorbidity, 4) Support individualised, home-based, multidisciplinary, case management to supplement standard HF management, and 5) Evaluate health outcomes well beyond acute hospitalisation and encompass all-cause events and a person-centred perspective in affected individuals. Conclusions We propose ARISE-HF as a framework for improving typically poor health outcomes in those affected by multimorbidity in HF.

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“…Low handgrip strength (HGS) is a strong predictor of mobility impairment, both in women and men [12]. The decrease in the grip strength associated with aging reduces the independence of the older people, leading to the need to use family support or caregivers [13]. It may impair manual dexterity of upper limbs, as well as affect the ability to maintain postural balance and gait independence [14].…”

Section: Introductionmentioning

confidence: 99%

Association between Handgrip Strength, Mobility, Leg Strength, Flexibility, and Postural Balance in Older Adults under Long-Term Care Facilities

Wiśniowska-Szurlej

Ćwirlej-Sozańska

Wołoszyn

et al. 2019

BioMed Research International

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Introduction Low muscle strength is common and important in geriatric syndromes including frailty and sarcopenia. The epidemiology of grip strength of older people under long-term care facilities has been little explored. Purpose The aim of this study was to assess handgrip strength of older women and men covered by institutional care and to analyse the associations between HGS and mobility, leg strength, flexibility, and postural balance. Materials and Methods This is a cross-sectional study carried out at care homes in southeastern Poland. After considering the inclusion criteria, 209 older people aged 65 to 85 were included in the study. Sociodemographic data were collected, and tests of muscular strength, mobility, flexibility, and postural balance were carried out by the use of the stabilometric platform CQ Stab 2P. Results The average handgrip strength in the study group amounted to 19.8 kg, including 14.8 kg in women and 25.9 kg in men. Low grip strength was found in 67.83% women and 52.13% men in institutional care. A negative correlation between handgrip strength (HGS) and the Timed Up and Go (TUG) test was demonstrated, both with and without cognitive task and strength of lower limbs. Gait speed and dynamic balance were positively correlated with HGS. A negative correlation was found between the total length of the centre of pressure (COP) path, the length of the COP path in the lateral-medial direction, and the sway area delimited by the COP and HGS for the dominant hand. Speaking of women, gait speed was most strongly associated with HGS, while among men, it was upper limb flexibility. Conclusion Regardless of gender, HGS is associated with mobility, strength of the lower limbs, and dynamic balance. By means of simple tools, early diagnosis will facilitate the planning of appropriate interventions in order to prevent disability and mortality in long-term care facilities.

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Improving Unsafe Environments to Support Aging Independence with Limited Resources

Cited by 24 publications

References 20 publications

Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): A multidisciplinary position statement

Association between Handgrip Strength, Mobility, Leg Strength, Flexibility, and Postural Balance in Older Adults under Long-Term Care Facilities

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