Use of the Home Safety Self-Assessment Tool (HSSAT) within Community Health Education to Improve Home Safety.

This exploratory research examined the benefits of a health education program utilizing the Home Safety Self-Assessment Tool (HSSAT) to increase perceived knowledge of home safety, recognition of unsafe activities, ability to safely perform activities, and develop home safety plans of 47 older adults. Focus groups in two senior centers explored social workers' perspectives on use of the HSSAT in community practice. Results for the health education program found significant differences between reported knowledge of home safety (p = .02), ability to recognize unsafe activities (p = .01), safely perform activities (p = .04), and develop a safety plan (p = .002). Social workers identified home safety as a major concern and the HSSAT a promising assessment tool. Research has implications for reducing environmental fall risks.

Occupational therapy community practice and home assessments: use of the home safety self-assessment tool (HSSAT) to support aging in place.

More than 70 million Americans are expected to be 65 years or older by 2030, with 8.7 million 85 or older. Occupational therapists can provide client and population-centered interventions to promote home safety, functional abilities, and quality of life to support older adults' desires for independence and to age in place. This includes the use of assistive technology, home modifications, and rehabilitation principles, to design real life solutions to support the needs of older adults. Using case study methodology this paper focuses on the development and pilot-testing of the Home Safety Self-Assessment Tool (HSSAT), a new home assessment, designed for use by older individuals to promote home safety and aging in place. The results suggest the tool may assist older adults in identifying environmental factors that are related to falls and facilitate their ability to age in place.

Workforce training and education gaps in gerontology and geriatrics: what we found in New York State.

This article summarizes data from the 2008 Symposium Charting the Future for New York State Workforce Training and Education in Aging: The Stakeholder Perspective and the 2009 report Workforce Training and Education: The Challenge for Academic Institutions. This research is the outcome of a collaborative State Society on Aging of New York and New York State Office for the Aging study on New York State's workforce training and education needs. Eight Listening Sessions were held across New York State to obtain input on topics including training, gerontology education, and credentialing and certification. Individual sessions highlighted the needs of urban, rural, and suburban communities. Key themes identified through content analysis included the need for education about aging in agencies serving older adults, education on human development, positive aspects of aging, disabilities, developmental disabilities, and greater opportunities for training and education for service providers. Lack of incentives was identified as a barrier to credentialing or certification. Education about growing older beginning in grade school was recommended. Lack of funding was identified as a barrier that limited support for employee education/training. Disconnects were identified between employers and academic institutions and state government and providers regarding gerontology/geriatric training and education. Consideration to how these themes may be addressed by the Association of Gerontology in Higher Education is offered.

Intergenerational service learning: to promote active aging, and occupational therapy gerontology practice.

Americans are living longer, and the meaning of age has changed, particularly for Boomers and seniors. These demographic changes have economic and social ramifications with implications for health care, including rehabilitation services, and health science education. Service learning is an experiential learning pedagogy that integrates traditional higher education with structured active learning experiences. This article reports on one intergenerational service learning program spanning 3 years. It was designed to facilitate community dialogue on fall prevention and active aging, and to provide intergenerational educational community-based experiences in occupational therapy professional education. The program additionally sought to promote students' understanding of aging and issues related to aging in place, students' professional development and civic engagement, and to encourage students to consider pursuing a career in occupational therapy gerontology practice.

Pilot study exploring quality of life and barriers to leisure-time physical activity in persons with moderate to severe multiple sclerosis.

BACKGROUND: we sought to assess how impairment (physiological/psychological) and disability (social/environmental) are associated with physical and leisure/recreation activity levels and quality of life (QOL) in people with moderate/severe multiple sclerosis (MS). We conducted a cross-sectional survey at the MS Comprehensive Care Center, Stony Brook University Hospital, Stony Brook, NY, of a convenience sample of 43 people (50 eligible) with MS and Expanded Disability Status Scale scores of 6.0 to 8.0. The main outcome measures were QOL measured by MSQOL-54, physical activity measured by Physical Activity Disability Scale, and leisure/recreation activity measured by Nottingham Leisure Questionnaire. We analyzed the canonical correlations among physical and leisure/recreation activity levels and (1) impairment and (2) QOL. RESULTS: higher levels of physical and leisure/recreation activity were associated with lower levels of apathy and depression and higher levels of cognition, self-efficacy, and QOL (physical and mental). Major barriers reported included fatigue, lack of motivation, and cost. CONCLUSION: impairments and social/environmental disabilities create barriers to physical and leisure/recreation activity. Additional research is needed to determine, for people with MS, what supports might increase participation in physical and leisure/recreation activities and whether this increase yields improved QOL.

Ethical decision-making challenges in clinical practice.

Today's health care environment requires professionals to pay increasing attention to efficiencies and functional outcomes. Today's patients are hospitalized for short stays, and those needing rehabilitation often have multiple diagnoses and goals. Cost effective strategies support fast paced occupational therapy programs and professionals who are adept multi-task specialists and problem solvers. Practitioners have multiple resources and strategies for clinical reasoning and decision-making; however, ethical decision-making requires use of additional resources and strategies. This paper provides strategies to examine everyday ethical problems and dilemmas, including application of The American Occupational Therapy's Code of Ethics, to support ethical decision-making in practice settings (American Occupational Therapy Association, 2000a).

A survey of family care giving to elders in New York State: findings and implications.

It is estimated that there are 734,400 care giver households in New York State (9.6% [+/-] 0.8% of all households). Categorization of all care givers on a 5 level "intensity of care" measure reveals that, on average, care givers provide 22.1 hours of care per week. Highest intensity level 5 care givers (9.2% of all care givers), provide, on average, 88 hours of care per week and account for 36.3% of all care giving. The annualized market contribution of all care givers to the NYS health care system is estimated at between $7.5 and $11.2 billion dollars. The combination of care levels 4 and 5 contributed 70% of all care giving and account for about $5.2 billion in market value. Level 4 and 5 care givers are more likely than other care givers to report difficulties including the recent death of the care-receiver (p < 0.001), financial and employment setbacks (p < 0.001), emotional stress from worrying about the patient's future condition, dealing with cognitively impaired, physically unmanageable, opinionated, virtually immobile patient's, and insufficient support from family members (p < 0.05). Nevertheless, they also report such rewards as feeling grateful for improving the quality of the care receiver's life (43.5%) as well as love (17.2%). Of the nearly 15% of NYS care givers who used adult day care services, all reported that these services met their needs fully or partly. However, of the 85% who did not use the service, 33.5% were negative about it. And while use of adult day care services increases with intensity of care level, there is resistance to adult day care particularly among level 3 care givers, with negative statements from 46.8% of them.