Low-Tech Devices, Home Adaptations Preserve Independence, Reduce Health-Care Costs For Physically Frail Elderly

by community agencies for the elderly, such as Meals on Wheels, and help with shopping, household chores and personal care.

All participants were contacted by phone once a month to collect information on new problems or services received, and in the treatment group, to find out if they needed new or different assistive devices or home modifications. Participants also received an in-home assessment every six months to determine their functional status, health and costs of care.

Findings showed that individuals in the treatment group had received an average of 14 devices from the study, or a total of 681. The control group averaged about two additional devices per person from usual service providers, for a total of 80. Assistive devices provided by the study were very low-tech for the most part, involving primarily bath benches, meal-preparation aids, canes, walkers and a variety of devices to help with fine-motor skills.

The treatment group received a total of 69 home modifications, while the control group received a total of eight, the findings showed. Most environmental interventions cost less than $500. The most frequent modifications were addition of handrails, lowering shelves and making storage more accessible.

Assessment of the participants' functional change at the end of the 18-month study showed that while all participants lost some ability to function, the control group declined more than the treatment group in all categories, and had spent four times more on health care. Mann said the functional differences appeared to be directly related to the interventions.

"For example, the control group showed significant decline in the FIM walking item, from 5.43 to 4.77, while treatment group participants who received ambulation equipment and instruction did not show a significant decline. Similarly, the dressing item on the FIM instrument indicated there was no significant decline for the tre

Contact: Lois Baker
University at Buffalo

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