Effective OT Interventions for Maximizing Functional Performance and Quality of Life in Occupations of Geriatric Populations with Physical Dysfunction Jennifer Hall, OTS January 23, 2015 ASOT 2015 Vision in Action Conference

Geriatric Populations with Physical Dysfunction By 2030, nearly 20% of the U.S. population will be ages 65 or older, and the fastest growing segment among them will be people ages 85 or older. Individuals in this oldest age group have the highest rates of health care utilization, morbidity, and disability. To support productive aging and continued participation despite occupational shifts in habits, roles, and routines, preventive care models Occupational therapy practitioners help keep older adults independent and safe, reducing health care costs associated with hospitalization and institutional care. (Natalie Leland, PhD, OTR/L, BCG; Sharon J. Elliott, DHS, GCG, OTR/L, BCG, FAOTA; and Kimberly Johnson, MSW) (Szanton, S. L., Thorpe, R. J., Boyd, C., Tanner, E. K., Leff, B., Agree, E., &... Gitlin, L. N., 2011) Thirteen million U.S. adults aged 65 and older, almost 40% of community-dwelling older adults, experience some type of disability.

Physical Dysfunction

Research Question What is the evidence for effective OT interventions to improve functional performance and quality of life in ADLs and occupations of geriatric populations with physical dysfunction?

Why address this? Many occupational therapists work with geriatric populations There is a need for evidence-based practice with this population!

Evidence-Based Practice: Adaptive and Compensatory (Gitlin, L., Winter, L., Dennis, M., Corcoran, M., Schinfeld, S., & Hauck, W.,2006) (Gitlin, L., Hauck, W., Dennis, M., Winter, L., Hodgson, N., & Schinfeld, S.,2009) ABLE program: home modifications, home safety, fall recovery techniques, and balance and muscle strength exercises. Focus on functional difficulties, fear of falling, and home hazards and improve self-efficacy and adaptive coping Adaptive equipment and home modifications (Sheffield, C., Smith, C. A., & Becker, M.,2013).

Evidence-Based Practice: Evidence-Based Practice: Restorative Strategies (Lam, L. C. W., Lui, V. W. C., Luk, D. N. Y., Chau, R., So, C., Poon, V.,... Ko, F. S, 2010). (Szanton, S. L., Thorpe, R. J., Boyd, C., Tanner, E. K., Leff, B., Agree, E., &... Gitlin, L. N.,2011). Participants received multicomponent intervention called CAPABLE that was designed to reduce dysfunction in ADLs and improve quality of life. Resistance training, strength and combined functional and resistance training (Henwood, T. R., & Taaffe, D. R.,2006). Training that was tailored for their function and skills, including skills training and problem solving using a cognitive behavioral approach

Evidence-Based Practice: Occupation based The occupation-based cultural heritage intervention (OBCHI). (Hersch, G., Hutchinson, S., Davidson, H., Wilson, C., Maharaj, T., & Watson, K. B.,2012).

Conclusion The evidence indicates that there are numerous occupational therapy intervention strategies that can be used to promote improved function and quality of life in geriatric populations with physical dysfunction.

Questions?

References Gitlin, L., Hauck, W., Dennis, M., Winter, L., Hodgson, N., & Schinfeld, S. (2009). Long-term effect on mortality of a home intervention that reduces functional difficulties in older adults: results from a randomized trial. Journal of The American Geriatrics Society, 57(3), doi: /j x Gitlin, L., Winter, L., Dennis, M., Corcoran, M., Schinfeld, S., & Hauck, W. (2006). A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults. Journal of The American Geriatrics Society, 54(5), doi: /j x Henwood, T. R., & Taaffe, D. R. (2006). Short-term resistance training and the older adult: the effect of varied programmes for the enhancement of muscle strength and functional performance. Clinical Physiology & Functional Imaging, 26(5), doi: /j X x Hersch, G., Hutchinson, S., Davidson, H., Wilson, C., Maharaj, T., & Watson, K. B. (2012). Effect of an occupation- based cultural heritage intervention in long-term geriatric care: A two-group control study. American Journal of Occupational Therapy, 66(2) doi: /j x Lam, L. C. W., Lui, V. W. C., Luk, D. N. Y., Chau, R., So, C., Poon, V.,... Ko, F. S. (2010). Effectiveness of an individualized functional training program on affective disturbances and functional skills in mild and moderate dementia--a randomized control trial. International Journal of Geriatric Psychiatry, 25(2), 133– R.L., & Nichols-Larsen, D.S. (2004). The effect of hippotherapy on ten children with cerebral palsy. Pediatric Physical Therapy, 16, Sheffield, C., Smith, C. A., & Becker, M. (2013). Evaluation of an agency-based occupational therapy intervention to facilitate aging on place. The Gerontologist, 53(6), doi: /geront/gns145 Szanton, S. L., Thorpe, R. J., Boyd, C., Tanner, E. K., Leff, B., Agree, E., &... Gitlin, L. N. (2011). Community Aging in Place, Advancing Better Living for Elders: A Bio-Behavioral-Environmental Intervention to Improve Function and Health-Related Quality of Life in Disabled Older Adults. Journal Of The American Geriatrics Society, 59(12), doi: /j x