The use of phones by elders with disabilities: problems, interventions, costs.

Recognizing the important role the telephone plays in the life of frail elders, this study sought to gain a better understanding of the problems these elders encounter in using their phones to meet their needs. Starting with a sample of 354 frail elders, it was determined that 35, or just under 10%, were having some difficulty in the use of their phones. Twenty-two of these 35 subjects were randomly selected for an assessment of their impairments and phone setups in their homes. Interventions were provided to 19 of the 22 subjects, with two subjects refusing an intervention. At a 6-week follow-up call, all subjects were satisfied with the new phone or phone-related equipment. At a 6-month follow-up, 95% of subjects expressed satisfaction with the intervention. Phone usage increased by 50% for subjects provided a phone intervention. Average cost of equipment was $70.45; cost of personnel time was significantly higher. Recommendations are made for addressing the phone-related problems of frail elders.

Assistive devices used by home-based elderly persons with arthritis.

OBJECTIVE: This article examines assistive device use by home-based elderly persons with arthritis. METHOD: Sixty-six persons were interviewed for the State University of New York at Buffalo (University at Buffalo) Rehabilitation Engineering Research Center Consumer Assessment Study, which sought information on need for and current use of assistive devices. Subjects were assigned to a moderate or a severe arthritis group according to the impact of arthritis on their activities. RESULTS: Subjects in the severe arthritis group had more chronic diseases, a higher level of pain, and a lower level of independence in self-care activities than subjects in the moderate arthritis group. Similarities between the groups included relatively poor health, high rate of medication use, depression, use of a high number of assistive devices (about 10 per person), and an expressed need for additional devices, such as reachers, magnifiers, grab bars, jar openers, and hearing aids. Generally, there was a high rate of satisfaction with the assistive devices used. Most subjects missed being able to participate in at least one activity; most of these activities were active and many related to leisure time. CONCLUSION: Findings also revealed that subjects had inadequate information on assistive devices, which suggests the importance of more occupational therapy involvement with elderly persons in selecting devices.

Inter-rater agreement and stability of functional assessment in the community-based elderly.

The purpose was to examine the inter-rater agreement and test-retest stability of the Functional Independence Measure (FIM) and the Instrumental Activities of Daily Living Scale (IADL) from the Multidimensional Functional Assessment of Older Adults. These two instruments were administered to 20 older persons living in the community. Two experienced raters administered the assessment instruments over either a short (7-10 days) or long (4 to 6 week) interval. The intraclass correlation (ICC) was used to analyze the data. ICC values were computed for agreement between and within raters and across short and long intervals. ICC values for inter-rater agreement and stability ranged from 0.90 to 0.99. The relation between scores on the FIM and IADL scale was also examined. The analysis produced an r value of 0.85, suggesting a positive statistical relationship among the items assessed. The high ICC values indicate that the Functional Independence Measure Instrument and IADL scale of the Multidimensional Functional Assessment of Older Adults provide consistent information across two experienced raters and over time when used with a sample of elderly persons residing in the community.

The need for information on assistive devices by older persons.

Analyzing the results of the first 110 interviews from the Rehabilitation Engineering Research Center on Aging's Consumer Assessments Project, this study examined subjects' responses to the question, "Can you think of a device you would like to have that you haven't been able to find--a device that may not have yet been developed?" Each response was compared to the results of a Hyper-ABLEDATA search for similar existing products. When asked to propose a new device, 43 subjects (39% of the sample) responded with suggestions. In all instances, however, the respondents suggested devices that are already available. These findings indicate that subjects did not have up-to-date or complete information on the assistive devices that could improve their quality of life.

Comparison of assistive device use and needs of home-based older persons with different impairments.

This paper examined assistive device use by noninstitutionalized older persons with visual, cognitive, and physical impairments. One hundred fifty seven persons over 60 years of age (M = 75.5 years) were interviewed in their homes for the University at Buffalo Rehabilitation Engineering Research Center Consumer Assessments Study. Subjects were assigned to one of seven groups according to types of impairment: minimal, physical, visual, visual and physical, cognitive, cognitive and physical, and cognitive and visual. Group assignments were based on scores on the Sickness Impact Profile (physical), Older Americans Resources and Services Program Multidimensional Functional Assessment Questionnaire (vision), and Mini Mental State Exam (cognitive). Overall, subjects owned a mean of 13.7 devices, used 10.8 devices (79% of the devices they own), and were satisfied with 9.8 devices (72% of the devices they own). There were significant differences among the impairment groups in numbers of devices owned and used, and in satisfaction with devices. Subjects expressed the need for more devices, especially devices for increasing mobility and assisting with balance. Results suggest a stronger role for occupational therapists in the assessment of assistive device needs of older persons, and in recommending devices and training persons in their use.