Date Presented 03/26/20 This is a randomized controlled trial (N = 37) in which individualized OT interventions were provided for three months to support caregiving challenges faced by caregivers of people with dementia. The interventions included illness education, training for safe transfers, medication and appointment organization, exercise methods, and more. These were effective in decreasing depression and mental fatigue and increasing confidence to provide for the next six months, despite the worsening cognitive status of their care recipients. Primary Author and Speaker: Turquessa Francis Additional Authors and Speakers: Leanna Grandolph Contributing Authors: Machiko Tomita, Kristen Binkewicz, Kelly Dinatale, Victoria Anderson, Leanna Grandolph, Deborah Tse, Sara Vasisko

Date Presented 04/05/19 OT interventions for informal caregivers of people with dementia were effective in improving burden, depression, and confidence to provide care currently and for the next six months. The interventions included illness education, training for transfers, organization, and exercise methods. Primary Author and Speaker: Jillian Meidenbauer Additional Authors and Speakers: Kaylee Lynch, Jennifer Thill, Lauren Gantz Faculty Advisor: Machiko Tomita

OBJECTIVE. We sought to understand how functional status, impairment level, and use of assistive devices change over 3 years for older adults with depressive symptoms. We further explored factors that predict change in severity of depressive symptoms. METHOD. This study used data from the Rehabilitation Engineering Research Center on Aging Consumer Assessment Study, a longitudinal study of coping strategies of elders with disabilities. Seventy-three participants with depressive symptoms were interviewed at baseline and 3 years later. RESULTS. During 3 years, participants experienced increased physical disability (p = .001), a decline in severity of depressive symptoms (p = .03), and an increase in the total number of assistive devices owned. CONCLUSION. A significant number of older adults will experience a decrease in depressive symptoms over 3 years, despite an increase in physical disability. They also will obtain more assistive devices as they age.

OBJECTIVE. Dressing is an important activity of daily living, yet many older adults have difficulty due to impairments. The purpose of this study was to explore the use of assistive devices for dressing by older persons with impairments, and to look at differences among frail elders with no dressing difficulty, upper-extremity-only dressing difficulty, lower-extremity-only dressing difficulty, and both upper- and lower-extremity dressing difficulty. METHOD. We conducted in-home interviews and functional assessments with 1,101 elderly persons with activities of daily living and/or instrumental activities of daily living limitations in Western New York and Northern Florida. Participants were assigned to one of four groups based on Functional Independence Measure™ item scores for upper-extremity dressing and lower-extremity dressing. Descriptive statistics were used to report results. RESULTS. Compared to women, there were relatively more men with lower-extremity dressing difficulty than with upper-extremity dressing difficulty. The group with both upper- and lower-extremity dressing difficulty reported the highest level of pain and scored lowest on all measures of functional status and mental status. The most commonly used dressing devices were associated with lower-extremity dressing. CONCLUSION. There are differences in gender, health status, functional status, and mental status among elderly persons grouped by upper- or lower-extremity dressing difficulty. Results suggest that therapists should consider such differences as gender and type of difficulty (upper- or lower-extremity dressing) in both therapeutic approaches and recommendations for assistive devices. Pain is another important consideration, but it can often be reduced during dressing by using assistive devices.

Objective. This study examined the effectiveness of microwave ovens in assisting elderly persons with disabilities with cooking food. Method. The participants were five elderly persons who had gross motor, fine motor, or vision impairments but no cognitive impairments. Before the study, none of the participants owned or operated a microwave oven. In this single-subject design off our phases (ABAB), training in microwave oven use was provided between the first A (baseline) and first B (intervention) phases. Participants had access to the microwave oven in their homes only during the B phases. Each phase lasted for 3 weeks, for a total of 12 weeks. The frequency of using cooking appliances, the number of food items prepared, and the time spent preparing meals were recorded through daily self-reports. Results. All participants showed an increase in the frequency of using cooking appliances for at least one of the two B phases, although they showed different patterns. The number of food items prepared increased in the B phases, except for two participants who were ill. With the introduction of the microwave oven, time spent preparing meals decreased for all five participants, and their participation in meal preparation increased. Although not measured as a study variable, results suggest that the quality of diet also improved with microwave oven use. Conclusion. Occupational therapy practitioners who serve elderly clients might consider recommending microwave ovens for those who do not have cognitive impairments but who are having difficulty with cooking because of vision impairments or physical disabilities.

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 bearing 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.

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.