Abstract
Frailty can increase the likelihood of hospital readmission and the transition from home to assisted care, decrease life satisfaction, and reduce lifespan. This small study examined how perceptions of frailty of older adults changed when they participated in a six-part OT-led community education program. The repeated-measures analysis revealed a reduction in frailty-risk identification, improvement in walking speed, and increased grip strength for occupational engagement.
Primary Author and Speaker: Susan Blair
The United States population is aging, and there is a portion of our elderly who become frail or are at risk for growing frail. Frailty can increase the likelihood of hospital readmission, require the transition from home to assisted care, decrease life satisfaction, and reduce lifespan (Greenwald, J., & Jack, B., 2009). This study examined how perceptions of frailty of twenty older adults changed when they participated in a six-part occupational therapy-led community education program. A multi-method research approach was utilized to collect quantitative, qualitative, and descriptive data in the form of pre- and post-intervention measures. Changes in perception of frailty, the impact of frailty on functional performance, and themes of frailty identification were analyzed. Emerging themes were identified including perceptions of frailty in older adults, occupational therapy’s role in promoting successful aging in community, and the use of standardized assessment tools that accurately predict frailty status. Perceptions of how older adults view themselves regarding their degree of frailty were well documented in the literature (Cassidy et al., 2012; Schoenborn et al., 2018; Warmoth et al., 2015; Goll et al., 2015). The study outcomes supported this critical theme by demonstrating a positive change in participants’ perceptions of frailty education as noted in the qualitative and quantitative data analysis. Occupational therapy community education that focused on teaching community-dwelling older adults several critical interventions such as ensuring safety during mobility, understanding frailty factors, targeted exercises, fall prevention, and the role of nutrition were amongst the most successful in promoting knowledge and reducing frailty (Apostolo et al., 2018; Stevens & Phelan, 2013). The study showed that the participants increased strength and functional endurance, decreased frailty risk, improved knowledge of balance and fall prevention strategies, and had a better understanding of nutrition. Use of standardized assessment measures to identify and document an individual’s risk for frailty has been studied in the literature (Dent, Kowal, & Hoogendiijk, 2016; Perna et al., 2017) and three were selected for use in the study; Edmonton Frail Scale, the Timed Up and Go tool, and the grip strength test. The participants reported that with education on fall prevention, home safety, strengthening, and balance building, they felt more confident about navigating their homes and community. OT is uniquely positioned to play a pivotal role in helping older adults age in place successfully. This study was designed to be sustainable, and frailty prevention programs can be developed by OTs to manage and guide older adults through their aging process, monitoring chronic co-morbidities, adapting environments, advocating for supportive care, and facilitating participation in social opportunities. Frailty education can occur in settings like senior centers or churches, primary care centers, and physician offices. Policymakers must recognize and acknowledge that the impending arrival of the “silver tsunami” is inevitable. Insurance providers and physicians have begun to recognize the need for a new roadmap for geriatric rehab that emphasizes proactive education rather than a reactive response to chronic conditions. Finally, OT students can participate in future evidence-based studies to apply the interventions and outcomes of this study to other at-risk populations such as the underserved, disadvantaged minority population who are at higher risk for frailty because of limited access to health education and the prevalence of increased rates of chronic co-morbidities
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