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Home-Based Program Extends Seniors' Lives
Date:4/7/2009

Combo of physical therapy, household changes added 3.5 years on average, study found

TUESDAY, April 7 (HealthDay News) -- A home-based program for seniors that includes occupational and physical therapy, as well as some minor home modifications, can help people live longer, new research found.

In fact, people who received this intervention gained an average 3.5 years of lifespan compared to those who didn't, according to researchers at Thomas Jefferson University in Philadelphia.

"This is an extremely promising intervention," said study author Laura Gitlin, director of the Jefferson Center for Applied Research on Aging and Health, and a professor in the department of Occupational Therapy at the university.

Gitlin said the researchers were somewhat surprised by the study's findings because they initially hadn't hypothesized that the intervention would provide any sort of survival benefit.

"This is what we call a serendipitous finding," she said. "When we looked at people who had been hospitalized before the study, we noted an incredible survivorship -- 0 percent had died in the intervention group compared to 21 percent in the control group. We were startled to see this difference emerge, and we wanted to see if it lasted."

Results of the new study came from following the participants for four years after the intervention began. The work was funded by the U.S. National Institute on Aging, and the results were published in the March issue of the Journal of the American Geriatrics Society.

The study group included 319 people with an average age of 79 who were still living at home but were just beginning to encounter some functional challenges. Gitlin said the challenges could be minor, such as having trouble bending to pick something up or difficulty opening jars, to more significant problems, such as not being able to get in and out of the tub, or to button clothing anymore.

Half of the volunteers were randomly placed into the intervention group, and the other half served as a control group and received no additional treatment.

The intervention group met with an occupational therapist five times, including at home and by telephone. The therapist went through the house with the study volunteers ("clients"), and discussed their needs. The therapist also noted what home modifications needed to be made. Then the therapist taught the seniors how to do tasks differently and ways they could conserve energy during tasks.

"Our approach is client-centered and helps people accomplish their daily goals. We can teach older people, at any age, new ways of performing valued activities," Gitlin said.

Everyone in the intervention group also had at least one visit with a physical therapist to evaluate their balance and their fear of falling. All were taught how to fall safely, and how to recover from a fall.

The average cost of the whole intervention, according to Gitlin, averaged $942.

In a previous article, Gitlin and her colleagues reported that those in the intervention group had fewer troubles with daily living activities and reported a higher quality of life. And the survival benefits kicked in at one year.

The new report focused on long-term survival benefits, and they found that at two years, the mortality rate in the intervention group was 5.6 percent versus 13.2 percent for the control group. The benefit continued for 3.5 years, but wasn't statistically significant after three years, according to the study.

Gitlin said she believes the intervention provided "physical, social and psychological benefits," and that, anecdotally, she's heard people say the program "gave them back their life and made them feel they had a sense of control."

One expert agreed. "This study shows that there are solutions out there to help you maintain your independence," said Dr. Karin Ouchida, co-director of the Montefiore Geriatric Home Visiting Program in New York City. "And as someone who works in geriatrics, it was nice to see these positive results reinforcing what we already do."

More information

Learn more about keeping your home safe and preventing falls from the American Academy of Orthopaedic Surgeons.

Falls Don't Have to Happen

When it comes to preventing a fall, Dr. Karin Ouchida, medical director of the Montefiore Medical Center's Home Health Agency, said that "simple things can make a big difference." Some changes that can help, she said, include:

  • Removing throw rugs from areas where you walk.
  • Improving lighting throughout the house.
  • Installing grab bars in the bathroom.
  • Having an occupational therapist recommend energy-saving devices, such as a grabber that can help you put your clothes on, or pick up something that's fallen.



SOURCES: Laura N. Gitlin, Ph.D., director, Jefferson Center for Applied Research on Aging and Health, and professor, Department of Occupational Therapy, Thomas Jefferson University, Philadelphia; Karin Ouchida, M.D., clinical instructor, medicine, division of geriatrics, Montefiore Medical Center and Albert Einstein College of Medicine, and co-director, Montefiore Geriatric Home Visiting Program, and medical director, Montefiore Home Health Agency, New York City; March 2009 Journal of the American Geriatrics Society


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