Functional Goals and Predictors of their Attainment in Low-Income Community-Dwelling Older Adults

Publication date: Available online 19 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Brian W. Waldersen, Jennifer L. Wolff, Laken Roberts, Allysin E. Bridges, Laura N. Gitlin, Sarah L. Szanton
ObjectiveTo describe functional goals and factors associated with goal attainment among low-income older adults with disabilities living in the community.DesignSecondary analysis from two studies of CAPABLE. Functional goals were coded using the International Classification of Functioning, Disability, and Health (ICF) framework. The percentage of goals attained at five months follow-up was computed within each ICF domain. Multivariate logistic regression was used to identify factors associated with goal attainment.SettingParticipants' homes in Baltimore, MarylandParticipantsCAPABLE participants (n=226)InterventionsA five-month, home-based, person-directed, structured program delivered by an inter-professional team: occupational therapist (OT), registered nurse (RN), and handyman.Main Outcome Measure(s)Process of OT goal setting and attainment at the final OT visit.ResultsParticipants identified 728 functional goals (average of 3.2 per participant), most commonly related to transferring (22.0%, n=160 goals), changing or maintaining body position (21.4%, n=156 goals), and stairclimbing (13.0%, n= 95 goals). Participants attained 73.5% (n=535) of goals. Goal attainment was highest for stairclimbing (86.3%), transferring (85.6%), and self-care (84.6%); walking goals were less likely attained (54.0%). Goal attainment was not associated with age, gender, education, depressive symptoms, function, or health-related quality of life but was less likely among participants who had severe pain compared to those without pain (aOR: 0.38, 95% CI: 0.17, 0.86). When participant readiness to change (RTC) score increases by one point on the four-point scale, goal attainment was 62% more likely (aOR 1.62; 95% CI: 1.14-2.29).ConclusionHome-based collaborative goal-setting between older adults and OTs is feasible and particularly effective when individuals are ready or willing to adopt new strategies to achieve identified goals.



http://ift.tt/2i8QRCU