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

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.

Introduction (cont’d) The results of this study suggest that use of AT-EI alleviates functional and cognitive decline among the frail elderly living at home 1. Besides, compared to low users, high users of AT-EI demonstrated higher levels of independence and function whether or not they received intensive intervention 2. 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.

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 colleague 1,2. 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).

Methods Participants: During the current follow-up study, 20 people (T: n=12; C: n=8) 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 participant’s physical and cognitive performance. High users and low users were identified according to the number of devices used.

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

Figure 1

Results (cont’d) 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

Figure 2

Results (cont’d) Table 1: Correlation between Functional Decline, Demographic Variables and Number of Illnesses

Table 1

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.

Conclusion (cont’d) 2.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.

Conclusion (cont’d) 3.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.

Conclusion (cont’d) 4.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.

Conclusion (cont’d) 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.

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), 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.