Fourth Year Follow-up of Assistive Devices Intervention Study Among the Home-Based Elderly

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Fourth Year Follow-up of Assistive Devices
Intervention Study Among the Home-Based Elderly

• Shin-yi Lin, MS
• Machiko R. Tomita, Ph. D.
• Linda F. Fraas, MA, OTR/L
• Susan M. Nochajski, Ph. D., OTR/L
• Department of Rehabilitation Science
• State University of New York at Buffalo

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Introduction

• AT-EI are common compensatory approaches used by
  occupational therapists to assist elderly people
  to live as independently as possible in their
  home. Mann, Ottenbacher, Fraas, Tomita, and
  Granger (1999) conducted a randomized clinical
  trial study to investigate the effectiveness of
  assistive technology (AT) and environmental
  intervention (EI)1.

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Introduction (contd)

• The results of this study suggest that use of
  AT-EI alleviates functional and cognitive decline
  among the frail elderly living at home1. Besides,
  compared to low users, high users of AT-EI
  demonstrated higher levels of independence and
  function whether or not they received intensive
  intervention2. However, the continued use of
  devices by the elderly and the long-term
  relationship of AT use to the maintenance of
  function were still unknown.

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Purpose

• The purpose of the present study was to conduct a
  follow-up study of the AT-EI intervention study,
  which was conducted by Mann and colleague1,2. The
  current study investigated continued use of AT-EI
  and its effect on maintaining physical and
  cognitive function of the older adults four years
  after the AT-EI intervention.
• The differences of AT-EI use and functional
  performance were compared between participants in
  the treatment group (T) and the control group
  (C), as well as between AT-EI high users (H) and
  low users (L).

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Methods

• Participants During the current follow-up study,
  20 people (T n12 C n8) lived at home and
  agreed to participate.
• Procedures Participants responded to the adapted
  questionnaire for this follow-up study regarding
  their demographic information, current health
  condition, and AT-EI use during home interview.
  The investigator conducted functional evaluations
  to examine each participants physical and
  cognitive performance. High users and low users
  were identified according to the number of
  devices used.

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Results

• Figure 1
• Functional Changes of Participants in the
  Treatment Group (T) and Control Group (C) from
  Baseline of Intervention Study to Follow-up Study

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Figure 1
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Figure 1
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Results (contd)

• Figure 2
• Functional Changes of Participants in High Users
  (H) and Low Users (L) group from the Baseline of
  Intervention Study to Follow-up Study

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Figure 2
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Figure 2
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Results (contd)

• Table 1
• Correlation between Functional Decline,
  Demographic Variables and Number of Illnesses

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Table 1
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Conclusion

1. The results indicated that participants in T
   experienced significant decline in both physical
   and cognitive functioning four years after the
   end of the intervention study, while participants
   in C maintained their functional status. Age and
   number of illnesses may have accounted for these
   functional changes in T.

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Conclusion (contd)

1. Four years after the intervention study, the
   participants in T still owned and used twice as
   many AT devices in total number as those in C.
   However, while participants in C acquired more
   devices after the intervention study, those in T
   decreased the number of AT devices used.

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Conclusion (contd)

1. During the intervention study and four years
   after the study, participants in T consistently
   indicated they had less pain than those in C. The
   use of AT-EI might have some psychological
   effects on the elderly people.

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Conclusion (contd)

1. High users of AD minimized their functional
   decline but low device users had a significant
   decline in functional status over four years.
   This suggests that use of AT is an effective
   means to maintain functional independence and
   enable frail elders to continue living at home
   until cognitive decline becomes eminent.

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Conclusion (contd)

• 5. This study also suggested that education of
  assistive devices are very important so that
  after the study is over, frail elders can acquire
  necessary devices to maintain their functional
  status to live at home.

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References

1. Mann, W. C., Ottenbacher, K. J., Fraas, L.,
   Tomita, M., Granger, C. V. (1999).
   Effectiveness of assistive technology and
   environmental interventions in maintaining
   independence and reducing home care costs for the
   frail elderly A randomized controlled trial.
   Archives of Family Medicine, 8(3), 210-217.
2. Mann, W. C., Ottenbacher, K. J., Fraas, L.,
   Tomita, M. (2000, February). Effectiveness of
   assistive technology and environmental
   interventions in maintaining dependence and
   reducing home care costs for the frail elderly
   Three year follow-up using a randomized trial
   design. Paper presented at the meeting of the
   American Association of Retired Persons (AARP),
   Washington, DC.