scholarly journals A Mobile App Directory of Occupational Therapists Who Provide Home Modifications: Development and Preliminary Usability Evaluation (Preprint)

2019 ◽  
Author(s):  
An Thi Nguyen ◽  
Emily Kling Somerville ◽  
Sandra Martina Espín-Tello ◽  
Marian Keglovits ◽  
Susan Lynn Stark
Keyword(s):  
Older Adults ◽  
Phase 1 ◽  
Occupational Therapists ◽  
The United States ◽  
Mobile App ◽  
Community Dwelling ◽  
Phase 2 ◽  
Home Modifications ◽  
The Mean ◽  
Community Dwelling Older Adults

BACKGROUND Home modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. However, the prevalence of home modification is low. One reason is the lack of a centralized database of OTs who provide home modifications. OBJECTIVE This study aimed to develop and test the usability of a mobile app directory of OTs who provide home modifications in the United States. METHODS In phase 1, a prototype was developed by identifying OTs who provide home modifications through keyword Web searches. Referral information was confirmed by phone or email. In phase 2, community-dwelling older adults aged older than 65 years and OTs currently working in the United States were purposefully recruited to participate in a single usability test of the mobile app, Home Modifications for Aging and Disability Directory of Referrals (Home Maddirs). Participants completed the System Usability Scale (SUS) and semistructured interview questions. Interview data were coded, and themes were derived using a grounded theory approach. RESULTS In phase 1, referral information for 101 OTs across 49 states was confirmed. In phase 2, 6 OTs (mean clinical experience 4.3 years, SD 1.6 years) and 6 older adults (mean age 72.8 years, SD 5.0 years) participated. The mean SUS score for OTs was 91.7 (SD 8.0; out of 100), indicating good usability. The mean SUS score for older adults was 71.7 (SD 27.1), indicating considerable variability in usability. In addition, the SUS scores indicated that the app is acceptable to OTs and may be acceptable to some older adults. For OTs, self-reported barriers to acceptability and usability included the need for more information on the scope of referral services. For older adults, barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes. For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information. CONCLUSIONS Home Maddirs demonstrates good preliminary acceptability and usability to OTs. Older adults’ perceptions regarding acceptability and usability varied considerably, partly based on prior experience using mobile apps. Results will be used to make improvements to this promising new tool for increasing older adults’ access to home modifications.

scholarly journals A Mobile App Directory of Occupational Therapists Who Provide Home Modifications: Development and Preliminary Usability Evaluation

10.2196/14465 ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e14465
Author(s):  
An Thi Nguyen ◽  
Emily Kling Somerville ◽  
Sandra Martina Espín-Tello ◽  
Marian Keglovits ◽  
Susan Lynn Stark
Keyword(s):  
Older Adults ◽  
Phase 1 ◽  
Occupational Therapists ◽  
The United States ◽  
Mobile App ◽  
Community Dwelling ◽  
Phase 2 ◽  
Home Modifications ◽  
The Mean ◽  
Community Dwelling Older Adults

Background Home modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. However, the prevalence of home modification is low. One reason is the lack of a centralized database of OTs who provide home modifications. Objective This study aimed to develop and test the usability of a mobile app directory of OTs who provide home modifications in the United States. Methods In phase 1, a prototype was developed by identifying OTs who provide home modifications through keyword Web searches. Referral information was confirmed by phone or email. In phase 2, community-dwelling older adults aged older than 65 years and OTs currently working in the United States were purposefully recruited to participate in a single usability test of the mobile app, Home Modifications for Aging and Disability Directory of Referrals (Home Maddirs). Participants completed the System Usability Scale (SUS) and semistructured interview questions. Interview data were coded, and themes were derived using a grounded theory approach. Results In phase 1, referral information for 101 OTs across 49 states was confirmed. In phase 2, 6 OTs (mean clinical experience 4.3 years, SD 1.6 years) and 6 older adults (mean age 72.8 years, SD 5.0 years) participated. The mean SUS score for OTs was 91.7 (SD 8.0; out of 100), indicating good usability. The mean SUS score for older adults was 71.7 (SD 27.1), indicating considerable variability in usability. In addition, the SUS scores indicated that the app is acceptable to OTs and may be acceptable to some older adults. For OTs, self-reported barriers to acceptability and usability included the need for more information on the scope of referral services. For older adults, barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes. For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information. Conclusions Home Maddirs demonstrates good preliminary acceptability and usability to OTs. Older adults’ perceptions regarding acceptability and usability varied considerably, partly based on prior experience using mobile apps. Results will be used to make improvements to this promising new tool for increasing older adults’ access to home modifications.

scholarly journals Factors influencing Fear of Falling in Community-Dwelling Older Adults in Singapore: A Cross-Sectional Study

2021 ◽  
Author(s):  
Jacqueline Giovanna De Roza ◽  
David Wei Liang Ng ◽  
Blessy Koottappal Mathew ◽  
Teena Jose ◽  
Ling Jia Goh ◽  
...  
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Clinical Factors ◽  
Cross Sectional ◽  
Frail Older Adults ◽  
History Of ◽  
The Mean ◽  
Community Dwelling Older Adults

Abstract BackgroundFalls in older adults is a common problem worldwide. Fear of falling (FoF) is a consequence of falls which has far-reaching implications including activity restriction, functional decline and reduced quality of life. This study aimed to determine the factors associated with FoF in a segment of Singapore’s community-dwelling older adults. MethodsThis descriptive cross-sectional study recruited a convenience sample of adults aged 65 and above from 4 primary care clinics from September 2020 to March 2021. Data were collected on demographic factors and clinical factors including history of falls and frailty as determined by the Clinical Frailty Scale (CFS). FoF was measured using the Short Falls Efficacy Scale–International (Short FES-I), cut-off score of 14 and above indicated high FoF. Logistic regression was used to determine predictors of high FoF.ResultsOut of 360 older adults, 78.1% were Chinese and 59.7% females. The mean age was 78.3 years and 76 (21.1%) had a history of falls in the past six months. Almost half (43.1%) were mildly to moderately frail and most (80.6%) had three or more chronic conditions. The mean FoF score was 15.5 (SD 5.97) and 60.8% reported high FoF. Logistic regression found that Malay ethnicity (OR = 5.81, 95% CI 1.77 – 19.13), use of walking aids (OR = 3.67, 95% CI = 1.54 – 8.77) and increasing frailty were significant predictors for high FoF. The odds of high FoF were significantly higher in pre frail older adults (OR = 6.87, 95% CI = 2.66 – 17.37), mildly frail older adults (OR =18.58, 95% CI = 4.88 – 70.34) and moderately frail older adults (OR = 144.78, 95% CI = 13.86 – 1512.60).ConclusionsFoF is a prevalent and compelling issue in community-dwelling older adults, particularly those with frailty. The demographic and clinical factors identified in this study will be helpful to develop targeted and tailored interventions for FoF.

Heart Failure and Disability in Community-Dwelling Older Adults in the United States—1999 to 2018: Data From National Health and Nutrition Examination Survey

2021 ◽  
pp. 105477382110616
Author(s):  
Yaewon Seo ◽  
Jing Wang ◽  
Donelle Barnes ◽  
Surendra Barshikar
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Logistic Regression ◽  
National Health ◽  
The United States ◽  
Community Dwelling ◽  
Nutrition Examination Survey ◽  
Mediating Effects ◽  
Health And Nutrition ◽  
Community Dwelling Older Adults

To examine the associations of heart failure (HF) with five domains of disability while controlling for covariates. Subjects with HF and aged ≥ 50 years were selected from the 1999 to 2018 National Health and Nutrition Examination Survey data. Five domains of disability were measured with 19 physical tasks. Logistic regression with adjustment for covariates was conducted. The prevalence of HF in 27,185 adults aged ≥ 50 years was 6.37%. After controlling for demographics and smoking, logistic regression showed that HF was associated with 2.8 to 3.4 times increased odds of all domains of disability compared to adults without HF, but with additional adjustments of covariates, the association was attenuated indicating the mediating effects of covariates. The future study may examine the mediating effects of covariates when intervening difficulties with lower extremity mobility and activities of daily living while considering in community-dwelling older adults with HF.

Evaluation of a geriatric day rehabilitation centre: subjective and objective outcomes in community-dwelling older adults

2009 ◽  
Vol 15 (2) ◽  
pp. 117 ◽  
Author(s):  
A. Foley ◽  
S. Hillier ◽  
R. Barnard
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Lower Limb ◽  
Daily Living ◽  
Community Dwelling ◽  
Rehabilitation Centre ◽  
Lower Limb Strength ◽  
The Mean ◽  
Community Dwelling Older Adults

Pre and post testing were conducted on community-dwelling older adults referred to a geriatric day rehabilitation centre (DRC). Consecutive DRC clients were screened for inclusion over a 16-month period and were eligible if: aged 60+ years; cognitively intact; and reason for referral involved spinal or lower limb musculoskeletal impairment, disability or surgery, and/or reduced functional mobility or falls. Clients were excluded if they had a neurological disorder, or did not complete the program. Outcome measures included: lower limb strength; balance; mobility; self-reported pain; activities of daily living; and quality of life. Data were summarised using descriptive statistics and analysed using paired t-tests. Of the 137 participants recruited, 110 were female and the mean age was 79.5 ± 7.3 years. In total, 106 participants completed the DRC program and were assessed at baseline and re-assessed at discharge. The mean length of stay was 12.4 ± 2.9 weeks, with 21.4 ± 5.4 attendances. From baseline to discharge, statistically significant differences were found for all objective measures of physical functioning, balance, and for all lower limb strength tests (P < 0.0001). Glasgow Pain Questionnaire scores demonstrated statistically significant improvements in all five domains of the scale (P < 0.0001). The Barthel Index and Multi-dimensional Functional Assessment Questionnaire both showed a statistically significant improvement in the level of independence in activities of daily living (ADL) (P < 0.05). The Assessment of Quality of Life Questionnaire showed a statistically significant improvement (P = 0.027). The Exercise Benefits/Barriers Scale also showed a statistically significant improvement over DRC attendance (P = 0.005). The Falls Efficacy Scale showed a positive change, but the improvement was not statistically significant (P = 0.80). The study’s results indicate that community-dwelling older adults with physical disabilities and multiple comorbidities who attended the interdisciplinary geriatric DRC, significantly improved their lower limb strength, balance and physical function, and also showed significant decreases in self-reported pain, and improvements in independence in ADL and quality of life. Given the limitations of the current study, further research, in the form of high quality studies with larger sample sizes that involve direct comparisons with other forms of care or against a control group, is needed to determine whether day rehabilitation centre programs provide the optimum mode of rehabilitation for this population in the most cost effective manner.

scholarly journals Remote, unsupervised functional motor task evaluation in older adults across the United States using the MindCrowd electronic cohort

2021 ◽  
Author(s):  
Andrew Hooyman ◽  
Joshua S. Talboom ◽  
Matthew D. DeBoth ◽  
Lee Ryan ◽  
Matt Huentelman ◽  
...  
Keyword(s):  
Older Adults ◽  
Upper Extremity ◽  
Motor Function ◽  
Motor Task ◽  
The United States ◽  
Community Dwelling ◽  
Dominant Hand ◽  
Face To Face ◽  
Community Dwelling Older Adults ◽  
At Home

The COVID-19 pandemic has impacted the ability to evaluate motor function in older adults, as motor assessments typically require face-to-face interaction. This study tested whether motor function can be assessed at home. One hundred seventy-seven older adults nationwide (recruited through the MindCrowd electronic cohort) completed a brief functional upper-extremity assessment at home and unsupervised. Performance data were compared to data from an independent sample of community-dwelling older adults (N=250) assessed by an experimenter in-lab. The effect of age on performance was similar between the in-lab and at-home groups for both the dominant and non-dominant hand. Practice effects were also similar between the groups. Assessing upper-extremity motor function remotely is feasible and reliable in community-dwelling older adults. This test offers a practical solution in response to the COVID-19 pandemic and telehealth practice and other research involving remote or geographically isolated individuals.

scholarly journals Social Isolation and Hospitalization Risk Factors Among Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 95-95
Author(s):  
J Mary Louise Pomeroy ◽  
Gilbert Gimm
Keyword(s):  
United States ◽  
Risk Factors ◽  
Older Adults ◽  
Social Isolation ◽  
The United States ◽  
Community Dwelling ◽  
Psychosocial Risk ◽  
Depression And Anxiety ◽  
Socially Isolated ◽  
Community Dwelling Older Adults

Abstract PURPOSE: This study examines psychosocial risk factors associated with hospitalization among community-dwelling older adults in the United States. METHODS: Using two waves of the National Health and Aging Trends Study from 2011 and 2015, we conducted descriptive and multivariate analyses of individual-level data from a nationally representative sample of 8,003 Medicare beneficiaries ages 65 and older. Associations between hospitalization and risk factors including social isolation, depression, and anxiety were assessed. Covariates included gender, race/ethnicity, age, region, insurance type, falls, and comorbidities. RESULTS: Overall, about 20.9% of older adults reported a hospitalization within the past year and 22.2% were socially isolated. The odds of hospitalization were higher for socially isolated adults (OR 1.17; p = .02), for depressed adults (OR 1.25; p = .01), and for individuals with anxiety (OR 1.25; p = .02). Individuals living in the Western region had lower odds of hospitalization (OR 0.71; p = .001), whereas men (OR 1.13; p = .03), those requiring assistance with activities of daily living (OR 1.48; p &lt; .001), and those having one (OR 1.41; p = .03) or more (OR 3.05; p &lt; .001) chronic health conditions had higher odds of hospitalization. CONCLUSION: Social isolation, depression, and anxiety represent significant psychosocial risk factors for hospitalization among community-dwelling older adults in the United States. Efforts to reduce health care costs and improve health outcomes for older adults should explore ways to strengthen social integration and improve mental health.

Predictors of Emergency Preparedness Among Older Adults in the United States

2020 ◽  
pp. 1-7 ◽  
Author(s):  
Sue Anne Bell ◽  
Dianne Singer ◽  
Erica Solway ◽  
Mattias Kirch ◽  
Jeffrey Kullgren ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Emergency Preparedness ◽  
The United States ◽  
Community Dwelling ◽  
Power Outage ◽  
Evacuation Plans ◽  
Nationally Representative ◽  
Community Dwelling Older Adults ◽  
Hispanic White

ABSTRACT Objectives: Emergency preparedness becomes more important with increased age, as older adults are at heightened risk for harm from disasters. In this study, predictors of preparedness actions and confidence in preparedness among older adults in the United States were assessed. Methods: This nationally representative survey polled community-dwelling older adults ages 50-80 y (n = 2256) about emergency preparedness and confidence in addressing different types of emergencies. Logistic regression was used to identify predictors of reported emergency preparedness actions and confidence in addressing emergencies. Results: Participants’ mean age was 62.4 y (SD = 8); 52% were female, and 71% were non-Hispanic white. Living alone was associated with lower odds of having a 7-d supply of food and water (adjusted odds ratio [aOR] = 0.74; 95% confidence interval [CI]: 0.56-0.96), a stocked emergency kit (aOR = 0.64; 95% CI: 0.47-0.86), and having had conversations with family or friends about evacuation plans (aOR = 0.59; 95% CI: 0.44-0.78). Use of equipment requiring electricity was associated with less confidence in addressing a power outage lasting more than 24 h (aOR = 0.66; 95% CI: 0.47-0.94), as was use of mobility aids (OR = 0.65; 95% CI: 0.45-0.93). Conclusions: These results point to the need for tailored interventions to support emergency preparedness for older adults, particularly among those who live alone and use medical equipment requiring electricity.

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