Aging In Place Flashcards
Aging in place
The ability to live in one’s home and community safely, independently, and comfortably regardless of age, income, or ability level
Aging in place: social connection
Community that older adults live in provides social interactions with others in neighborhood and fosters social connections which create attachment to neighborhood
Aging in place: sense of security and familiarity
Prefer familiarity of their home and people around them
Aging in place: sense of I and autonomy
Value their ability to make own decisions, which remaining in their home allows them to do
Safe at Home Checklist
Assesses the inferior/exterior of home, home safety, accessibility issues, and fall hazards
Home Assessment Profile
Performance based, safety and functional performance in living space, observe mobility in various rooms and specific activities performed in those spaces, scored on perceived level of hazard
Home Safety Assessment Tool (HSSAT)
Checklist to identify and correct hazards in the home that pose a fall risk, pictures to ID hazards, also used as a resource as it provides solutions
Comprehensive Assessment and Solution Process for Aging Residents (CASPAR)
Identify aging in place needs by collecting information used by building professionals and OTs to specify modifications, home environment and client’s ability/preferences and interaction of the 2
Client Clinician Assessment Protocol (C-CAP)
Clients’ self-reported perceptions of their abilities, difficulty and safety of performing activities in the home and community, 22 functional items and OT observation
Falls Behavioral Scale (FaB)
Evaluates behavioral factors that could protect against falling, 30 items
10 behavioral dimensions
1) cognitive adaptations
2) protective mobility
3) avoidance
4) awareness
5) pace
6) practical strategies
7) displacing activities
8) being observant
9) changes in level
10) getting to the phone
Home Environment Assessment Protocol Revised (HEAP-R)
Home based self-reporting and observation assessment to help family caregivers of persons with dementia learn through education, skill building, and environmental strategies
Domains: hazards, adaptations, visual cues, clutter, and comfort in 8 areas of the home
Home Falls and Accidents Screening Tool (HOME Fast)
Identify people at risk of falling because of hazards within the home, dichotomous, mark whether or not a hazard is present, higher score higher the fall risk
Non OT Home Fast for nonclinical caregivers
In-Home Occupational Performance Evaluation (I-HOPE)
Targets activities performed in the home essential for aging in place, abilities vs environment, person-environment misfit
Before and after home mod, client’s perspective and satisfaction
Subscores: activity, performance, satisfaction, total battier severity
IHOPE Assist used by informal caregivers
Safety Assessment of function and Environment for rehabilitation health outcome measurement and Evaluation (SAFER-HOME)
Assesses person’s ability to safely carry out functional activities in the home, can be used to measure effectiveness of intervention, interview, and observation
Westmead Home snd Safety Assessment (WeHSA)
Targets fall risks, systematic and extensive list to identify potential hazards in/around the home organized by section
Check for Safety: A home fall prevention checklist for older adults
Used by individuals/family, identify and eliminate fall hazards, organized by areas in the home
Homefit Guide (AARP)
Used by individuals/families help people stay in their home, DIY fixes
Remodeling Today guide: design ideas for kitchen and bathroom
Used by individuals/families, ideas/solutions to incorporate into universal design
Home modifications
Adding lighting, lights on sensors to turn with movement, hallway, and near bathroom
Add ramp to enter, stair lift, handrails
Bathroom modifications: grab bars, removing step over tubs, tub transfer bench, extended shower head, raised toilet
Outcomes for Home Modifications
Functional performance
Improve caregiving outcomes
Fall reduction
Strong evidence it reduces falls, moderate with dementia
Home technology increases cognitive function and independent living
Factors improved by Home Modifications
Accessibility
Adaptability
Universal design
Factors improved by Home Modifications: accessibility
Making doorways wider, clearing space for wheelchair, lowering countertops, installing grab bars, placing switches at easily reached level
Factors improved by Home Modifications: adaptibility
Changes that can be made quickly to accommodate needs of client, installing grab bars, moveable caninets
Factors improved by Home Modifications: Universal Design
Features built into home when blueprints are drawn-appliances, fixtures, and floor plans for all people to use easily
5 best home modifications
1) widening doorways
2) install ramps including indoor threshold ramp
3) kitchens mods
4) bathroom mods
5) flooring modifications, remove/place carpet, tape throw rug
Aging in place: Caregiver education
During education, think of needs of caregiver as well, depression is common as well as emotional exhaustion, burnout
Caregiver support group delays placement
OT role is to emphasize positive aspect of care and shift attitudes of care practice
Social determinant of health effect
On aging in place
Educational and financial considerations
HS or higher education levels are 30% more likely to make home modifications
Lower income rent making it more difficult to complete home modifications
Not everyone can afford home mods be aware of financial barriers
Most Adverse Events in SNF/IRF
Pressure ulcers, delirium, and medication errors
Adverse events in SNF interventions
Fall preventions
Infection management
Techniques to address feeding/swallowing
Medication management
Self management of existing conditions (DM)
Fall prevention intervention: exercise
3x/week for 30-40 minutes
Resistance, balance, and aerobic exercises lead to decreased falls
Fall prevention intervention: education
Risk screening, types of falls, mechanisms of falls, preventative ideas and goal setting reduces risk of falls, moderate evidence for 1:1 education in IRF
Fall interventions: multi-factorial interventions
Fall risk cards with info (nursing), strengthening (PT), education (OT), and hip protectors (OT, PT,Nursing)
Moderate evidence for multicomponent and discipline in home health and IRF
Assessment areas for fall risk in community dwelling adults
Balance, gait, strength, vision, medication, cognitive health, orthostatic hypotension, and environmental hazards
Assessment areas for fall risk in community dwelling adults
Balance, gait, strength, vision, medication, cognitive health, orthostatic hypotension, and environmental hazards
30 second chair stand
repetitive sit to stands from chair without arms for 30 seconds to assess leg strength and endurance in adults at risk for falls