EFFECTIVE INTERVENTIONS ADDRESSING FUNCTIONAL DECLINE WITHIN ELDERLY

COMMUNITIES

Shea Sims OTSSpalding University

01/24/2014sheasims_81@hotmail.com

The Objectives of the Vision

• To examine “the what” and “the why” of functional decline within the elderly community

• To discuss “the why” and “the how” the topic and literature is important to OT practice

• To discuss practice experience, implementing literature and knowledge into our profession

What is Functional Decline?

What are Reasons for Functional Decline

Physiological Changes

Psychological Changes

What are Reasons for Functional Decline

The Environment

So why is this of value to OT?THE NEED THE IMPORTANCE

• Aging population is progressive

• Elderly community becoming increasing more independent with life skills

• Increase in depression and disability

• A more supportive environment

• Occupational therapist can help this population maintain or regain independence

• Assess and evaluate appropriate needs for the elderly to remain in their home

• Incorporate guiding principles of occupational therapy practice

• Assure relevant intervention planning

Evidence+Plan= BenefitOccupational Performance

• Using the Occupational Therapy Intervention Process Model (OTIPM) was shown to have a positive effect in ADL

motor and ADL processing status sooner than non occupation based intervention

approaches.

Evidence+Plan=Benefit Depression and Disability

• Using Problem Adaption Therapy (PATH) was shown to reduce depression and disability when therapist utilized the elderly participants ecosystem. This

method was shown to be effective for elders who have limited success in

antidepressant treatment

Evidence+Plan=Benefit Environmental factors( aging in place)• Using The Community Aging in Place,

Advancing Better Living for Elders (CAPABLE) was shown to decrease

functional difficulty when considering home repair in conjunction with intrinsic

factors

My Lived Experience

• Multifactorial

• Collaboration is key

• My guidance means their success

Moving Forward in Practice

References 1.) Fisher, A. G., Atler, K., & Potts, A. (2007). Effectiveness of occupational therapy with frail

community living older adults. Scandinavian Journal of Occupational Therapy, 14, 240-249. doi: 10.1080/11038120601182958

2.) Gitlin, L. N., Hauck, W. W., Dennis, M. P., 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 Amercian Geriatrics Society, 57(3), 476-481. doi: 10.1111/j.1532-5415.2008.02147.x

3.) Kiosses, D. M., Teri, L., Velligan, D. I., & Alexopoulos, G. S. (2010). A home delivered intervention for depressed, cognitively impaired, disabled elders. International Journal of Geriatric Psychiatry, 26, 256-262. doi: 10.1002/gps.2521

4.) Sanford, J. A., Griffiths, P. C., Richardson, P., Hargraves, K., Butterfield, T., & Hoenig, H. (2006). The effect of in-home rehabilitation on task self-efficacy in mobility-impaired adults: a random clinical trial. Journal of the American Geriatrics Society, 54(11), 1641-1648. doi: 10.1111/j.1532-5415.2006.00913.x

5.) Schoene, D., Lord, S. R., Delbaere, K., Severino, C., Davies, T. A., & Smith, S. T. (2013). A randomized controlled pilot study of home-based step training in older people using videogame technology. PLOS ONE, 8(3), doi: 10.1371/journal.pone.0057734

6.) Silsupadol, P., Shumway-Cook, A., Lugade, V., Donkelaar, P., Chou, L., Mayr, U., & Woolacott, M. (2009). Effects of single-task versus dual-task training on balance performance in older adults: a double-blind randomized controlled trial. Archives of Physical Medicine & Rehabilitation, 90(3), 381-387. doi: 10.1016/j

7.) Szanton, S. L., Roland, T. J., Boyd, C., Tanner, E. K., Leff, B., Agree, E., . Qian-Li, X. (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), 2314-2320. doi: doi:10.1111j./1532-5415.2011.03698.x