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Eldercare News & Information
Elderly Achieve Increase in Independent Living and
Life with New Program
'We can teach older people strategies that appear
to have a survivorship benefit'
July 9, 2006 Elderly senior citizens can extend
the time they live independently and also their lives with a
personalized program of occupational and physical therapy, complimented
by a few home modifications, according to a research team at Thomas
Jefferson University.
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Laura Gitlin, Ph.D., director of the Center for
Applied Research on Aging and Health at Thomas Jefferson University in
Philadelphia and her team reported previously that a brief six-visit
program consisting of physical therapy, occupational therapy, home
modification and some instruction in problem-solving helped elderly
individuals in performing daily activities.
The report is in the current issue of the Journal
of the American Geriatric Society.
After six months, those of the 319 men and women
ages 70 and older enrolled in the study who received the intervention
had fewer difficulties with daily living tasks, especially personal care
activities such as bathing and going to the toilet, than those who did
not receive the help. Intervention participants were less afraid of
falling, had more confidence in their abilities to manage everyday
activities and used more effective coping strategies.
In a 14-month follow-up study, Dr. Gitlin, who is
professor of occupational therapy at the College of Health Professions
of Thomas Jefferson University, and her co-workers report that the
efforts had an even larger benefit. They found that only 1 percent of
those receiving the intervention had died, compared to 10 percent in the
control group.
During the same 14-month period, of 31 participants
who had been previously hospitalized and who received the intervention,
none died. In contrast, in the control group, 21 percent who had been
hospitalized died.
These results appear to confirm that we are
helping people address functional difficulties that in turn offsets
further decline, Dr. Gitlin says. As people age, they often confront
difficulties in carrying out everyday activities due to age-related
changes and chronic diseases which can have significant functional
consequences. Chronic conditions such as heart disease, stroke,
arthritis and diabetes often result in older people having problems with
daily tasks such as bathing, dressing and preparing meals.
It may become harder to get out of a chair or get
dressed, says Dr. Gitlin. When you begin to have functional
difficulties, it is very much associated with fear of falling. This is a
serious syndrome among the elderly, resulting in other negative
consequences, including activity limitations, depression and isolation.
People often begin to restrict activities, which has a spiral down
effect. We were interested in affecting how people thought and solved
their daily functional problems, helping build their confidence by
introducing effective coping strategies, making homes safer and
improving performance.
The six-month intervention consisted of five
contacts by an occupational therapist (four 90-minute visits and one
phone call) and one physical therapy visit for 90 minutes.
For example, if a person was having difficulty
preparing meals, Dr. Gitlins team developed strategies to improve this.
We focused on performance and how individuals thought about an
activity, she explains, and helped people problem solve.
We can teach older people strategies that appear
to have a survivorship benefit, Dr. Gitlin says. These findings are
very important and suggest that occupational therapy and physical
therapy should be integrated in the care of older people who have
functional difficulties and chronic conditions.
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