AOTA Poster Summary

The OAA is a program I believe can significantly enhance the lives of our elder population; however, it needs work to become more effective. The OAA was passed as part of President Lyndon Johnson’s “Great Society” reforms. It recognized the importance of elder care through community-based Non-Goverment Organizations (NGOs). (Bookman & Kimbrel). This program has had mixed success. Providers have been able to manage the daily practical needs of elders; however, when it comes to emergencies, significant health issues, or impairment, the program is not as successful. (Bookman & Kimbrel). The emphasis of these programs is the knowledge gained from studies that show elders respond better to in-home care. (Bookman &

Mr. Henry and his wife need medical care coordinated throughout the health care system to receive proper treatment and prevent health complications, encouraging their independence by remaining in the same setting. Marek and Rantz highlight that by providing care coordination and health care services for older adults residing in specially designed senior apartments, older adults will not have to move from one level of care delivery to another as their health care needs increase; and they will have the opportunity to “age in place” (Marek & Rantz, 2000). Care coordination starts with a comprehensive assessment of each of Henry and Ertha individual needs for health and social support, and by developing an individualized plan of care for each of them. “Patients should be evaluated, and care plans should be designed and implemented according to the individual needs of each patient (American Geriatrics Society, 2012, p. 1966). As Mr. Henry and his wife health care needs increase, they can receive periodical physical examinations to monitor their underlying health problems, and for early detection of complications remaining in their apartment. This will prevent negative outcomes associated with relocation, and medications and treatment noncompliance.

The widespread falls among the geriatric population reduce their quality of life and take away their functional independence. Lee et al (2013) state that falls leads to the rise in mortality rates and morbidity complications such as fractures and disabilities,1 out of 3 elderly persons in a community setting falls in a year. About 87% of all fractures in the elderly are due to falls. Several of the risk factors that are associated with falls are visual impairments, cognitive impairments, and health-related problems: arthritis, orthostatic, back pains, lack of balance-weakening muscles, previous falls, polypharmacy or psychoactive drugs (Lee et al, 2013).

In DC, community based fall prevention programs have been rising to address falls but fall related incident, injuries and the cost has continuously been rising among elderly people (Costello & Edelstein, 2008). In the study conducted by Berland et al. (2012), showed that in home health, not viewing patient safety as primary prevention, lack of investigation causing fall and frailty of elderly adult have been some factors contributing to falls in home health. Falls negatively impacts an individual living in their home by causing them physical, emotional problem, giving rise to additional cost by losing workdays and income.

More and more people will need care in old age, and if they are disabled. Millions of Americans suffer from a chronic illness, or some kind of disability, and many of these people will have limits in their daily activities. Some people experience

Falls among any individual can cause significant trauma, often leading to an increase in mortality. According to the Centers for Disease Control and Prevention (2012), one in every three adults over the age of 65 falls each year. Long-term care facilities account for many of these falls, with an average of 1.5 falls occurring per nursing home bed annually (Vu, Weintraub, & Rubenstein, 2004). In 2001, the American Geriatric Society, British Geriatric Society, and the American Academy of Orthopaedic Surgeons Panel on Falls Prevention published specific guidelines to prevent falls in long-term

This substantial increase in population of those living longer with chronic illness supports that interventions need to be recognized early to decrease loss of independence. The Louisiana Community Choices Waiver provides ancillary support, such as physical, occupational, respiratory and speech therapy to qualifying residents. These services provide functional support while providing socialization in the home environment. This promotion of increased physical mobility and prevention can assist residents to maintain or increase their independence in the home. The expected growth of the elderly population in the next decade demonstrates a critical need for additional measures to support the efforts of individuals desiring to stay in their homes.

Since falls are a frequent obstruction to independent living among elderly persons, there has been a growing consciousness of the incidence of falls which has led to the development of a lot of community-based fall prevention programs for older adults. Yet, the potential impact of these programs is reduced by the lack of research on factors that may influence older persons' decisions to accept or reject fall prevention behaviors. In an exploratory descriptive study done by Aminzadeh & Edwards, (1998) a focus group approach was used to draw out qualitative data on seniors' views on the use of assistive devices in fall prevention. Four focus group interviews were carried out with a convenience sample of thirty community-living older adults in Ottawa, Canada. "The interviews documented

ADHC’s are known as a health/medical model of care (Pratt, 2010). This type of long-term care service provides care for low income, frail senior citizens and other young adults with disabling chronic conditions, which prevent them from being fully independent in their homes. The individuals that attend these facilities need help with their activities of daily living (ADL’s); however, they do not need 24-hour care within an institutionalized setting

The CDC (2013) defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level” (Healthy places terminology). The idea of aging in place has received growing attention from many entities over the past decade. According to AARP (2014), one in three Americans is now 50 or older, and by 2030, one in five Americans will be 65 and older. Moreover, evidence exists that home evaluation and home modification interventions are effective in promoting home safety, positively influencing task performance, and reducing falls in the older adult population. Regarding health care practitioners and older adults, a variety of major public health problems exist

Caring for the elderly and disabled has always been a relevant issue among American’s; however, not until recently has it become a significant issue within society. Change has occurred in the past couple decade as the workforce dynamics have transitioned from the family based farm living to the inner city, college educated worker who follows opportunity. Decades ago it was common place to have an aging relative live with the family in a multi-generational home; however, that is no longer a practical option in many cases. Although this transitioning of society has created a new issue and that is providing care to those elderly or disabled members of society who cannot rely on the support of family

Although older adults fall more frequently than younger people, falls are not considered as a normal part of aging. Falls and fall related injuries among older adults are major Public Health concern and represent significant reasons of mortality and morbidity in older populations. Koski et al., (1998) defines “fall” as a sudden, unintended loss of balance leaving the individual in contact with the floor or another surface such as a step or chair. Each year, approximately 1 in 3 persons aged 65 years or older fall and more than 1.6 million older U.S. adults go to emergency departments for fall-related injuries (Hyuma et al., 2013). Injuries related to fall are associated with significant disability, reduced independence and mobility, and increased risk of injury deaths. According to National Center for Injury Prevention and Control (2008), the major primary

“What the state and nation should do is provide services that allow our growing population of seniors to live independently in the community and the home,” explains Stuart Kaplan. Another point Kaplan and Deutsch made was that there are an increasing array of seniors in the world. With people living longer, the needs of a 65 year-old senior can greatly vary from someone over 100 years-old. “There needs to be an investment in elder care,” Kaplan stated. Because of this need, Selfhelp developed a range of services to reach even a bed-restricted senior.

The literature review was comprehensive, since the author evaluated many sources relevant to her area of research. This helped me to get an overall sense of what older studies explored and concluded. For instance, one study identified how excellent communication where health care workers are able to discover the problems older adults face at home can lead to older individuals living successfully at home. Although, there was extensive literature on this topic little still exists of how hospital staff decide the most appropriate discharge setting, or make recommendations for what to do if no appropriate discharge destination was available (Popejoy, 2008). As a result, I had a clearer understanding of why the research

As the life expectancy in the United States rises, the number of elderly in the population has also expanded. These increases have led to the oldest-old (people aged 90 and older) to become the fastest growing age group in the country. The oldest-old face many unique challenges because of their age, one of which is disability. Disability in the elderly has major impact upon society 1 and will continue will be a growing burden in years to come.