Date Presented 04/04/19
Deficits in ADL have been linked to the older adults’ ability to remain at home; little research has focused on the environmental modifications, equipment, and other strategies needed. This study used a technology survey and interviews to explore the ADL strategies used by community-dwelling older adults and their perspectives on factors impacting their ability to stay at home. Results will inform the development of effective ADL interventions using technology and environmental supports.
Primary Author and Speaker: Kathleen Foley
Additional Authors and Speakers: Jamie Gentry, Tralisa Myers, Lindsay Rankin, Kristin Shepard
PURPOSE: Deficits in basic self-care activities have been linked to older adults’ ability to remain in their home. Successful aging in place may require contextual supports, such as a caregiver, and adaptive strategies, such as sitting on a tub seat to bathe, to maximize participation in activities of daily living (ADL). There is little evidence identifying what is needed for an older adult to age in place. The purpose of this research is to develop a better understanding of the methods used by older adults to complete their ADL. The results will provide an in-depth description of techniques, technology, and environmental modifications used by community-dwelling older adults to perform ADL tasks as well as their perspectives on factors impacting their ability to stay at home.
DESIGN: This study used a qualitative design with the foundation of the project based on the Occupational Adaptation theory. Information flyers were distributed to recruit men and women 65 years of age and older who resided in the community; interested individuals contacted the investigators. Those residing in an assisted living facility or skilled nursing facility were excluded from the study.
METHOD: Data was collected using: audio recorded semi-structured interviews; a demographic form; and, an assistive technology survey. Interviews were transcribed verbatim; transcripts were analyzed line by line through direct interpretation and coded by two researchers who did not complete the interview. All researchers created categories from the codes and then developed themes from the categories. The demographic results were used to describe the participants. The assistive technology survey results were summarized. Peer debriefing was used to ensure dependability throughout the data collection and analysis processes.
RESULTS: Eight older adults participated in this study, four men and four women, with a mean age of 70.25. The assistive technology survey results revealed that most of the participants used non-slip rugs, slip-on shoes, a shower chair or tub bench, elastic waist pants, and grab bars in the shower. Analyses of the interview transcripts resulted in three themes. First, community-dwelling older adults are intentionally adaptive to complete desired activities; their methods include using technology, modifying their home, altering their habits and routines, and obtaining assistance from others because of safety, convenience, illness or injury, and/or age. The second theme that emerged was the value of independent activities of daily living (IADL). Though the study focused on ADL, all participants discussed the importance of various IADL. The final theme revealed a motivation to adapt for potential challenges in the future. Participants planned for future ADL challenges by seeking supportive physical and social environments, resources, and knowledge to aid them to stay at home.
CONCLUSION: These findings demonstrate that older adults are making intentional adaptations in response to a desire for ADL mastery that is centered around safety concerns, convenience, injury/illness, and age. They value the ability to continue IADL as well and are motivated to plan for future function. OT practitioners can use this information to ensure that technology, environmental modifications, and other ADL-related interventions focus on these areas of concern. By emphasize these factors at the forefront of their recommendations, older adults may be more inclined to follow through resulting in greater occupational participation, increased ability to age in place, and a higher adaptive capacity for future occupational performance. Rising healthcare costs create the need for research on maintaining ADL independence in the older adult population, so they may age in place.
References
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