From 1997 to 2000, researchers at the University of Massachusetts at Boston's Gerontology Institute under the direction of Francis G. Caro, Ph.D., conducted a research and demonstration project with the Massachusetts Executive Office of Elder Affairs to encourage the use of low-cost adaptive equipment (such as jar openers, bath rail/grab bars, elevated toilet seats and reachers) among older adult home care clients.
The project was part of the Robert Wood Johnson Foundation (RWJF) Home Care Research Initiative national program.
Ninety-six clients at West Suburban Elder Services received low-cost adaptive equipment six months before 62 clients at South Shore Elder Services in order to permit evaluation of the program and client outcomes. The Massachusetts Executive Office of Elder Affairs oversaw the demonstration program.
Key Findings: University of Massachusetts researchers evaluated the program's impact, using information from client records, equipment tracking data from the two agencies and client interviews. They reported the following results in Technology and Disability, (vol. 13, no. 1, 2000):
- Clients received an average of four equipment items during the demonstration project.
- Nearly half the equipment items were associated with meal preparation and eating.
- Although the demonstration resulted in only modest changes in the use of assistive equipment, client satisfaction was high.
- There were no measurable differences between the experimental and control groups in terms of perceived difficulty with daily living tasks, although clients from the experimental site reported slight decreases in difficulty with meal preparation.
Key Conclusions: The researchers drew the following conclusions:
- While there was no evidence that the project resulted in favorable implications for clients' performance of daily activities, there was evidence that equipment was beneficial on a task-specific basis, and clients reported high satisfaction.
- It may not be reasonable to expect that low-tech equipment, while providing the potential for sustained independence for some activities, will improve functional ability with daily activities overall, in the face of the increasing frailty and impairment typical of older adult home care clients.
- Several implementation issues must be addressed if home care programs are to be effective vehicles for distribution of assistive equipment: training of case managers, allocation of case manager time and agency systems for ordering and delivering equipment.
Researchers published five articles about the project, made about 10 presentations and developed a project website.
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