Sign In | Create an Account | Welcome, . My Account | Logout | Subscribe | Submit News | Contact Us | Home RSS
 
 
 

Project Keeping Seniors at Home

Initiative makes it possible to stay out of nursing home care

July 8, 2013
By LAURAN NEERGAARD, AP Medical Writer , The Intelligencer / Wheeling News-Register

BALTIMORE - Alberta Hough struggles to feed herself a snack, her arms shaking badly from Parkinson's disease. Days earlier, the 84-year-old fell while eating, sliding off her kitchen chair.

The rest of Hough's day isn't much easier to navigate. She wobbles into a bathtub with no grab bar. Her feet catch on damaged floor tiles. Part of the banister she needs to steady herself on the stairs has pulled out of the wall. At the back door, a rickety wooden ramp no longer supports the scooter that helps her get around.

The environment in which you live can be as disabling as a disease, and too often, older Americans wind up in a nursing home not because they're super-sick but because they can't get through their days safely at home.

Article Photos

AP Photo
This photo taken June 12 shows Alberta Hough, center, who suffers from Parkinson’s disease, assisted by her daughter Gloria Hawks, left, and occupational therapist Ally Evelyn-Gustave, right, as she uses a walker to get to a powered scooter in her home in Baltimore.

Now a major research project will bring handymen, occupational therapists and nurses into the homes of 800 low-income seniors in Baltimore to test if some inexpensive fix-ups and strategies for daily living can keep them independent longer, and save millions in taxpayer dollars spent on nursing home care.

"Very small changes can make a big difference," said Sarah Szanton, a Johns Hopkins University associate nursing professor who leads the project. "We're not saying, 'What's your blood pressure?' We're focusing on function: What do they want to do?"

Losing independence is a leading fear as people age. But a recent poll shows that too few comprehend the changes in lifestyle needed to offset the chronic illnesses and gradual slowdown that hit just about everyone in the 70s, 80s and beyond.

Asked about their choice of living situation when they're older, Americans 40 and over say their top priorities are a one-level home with no stairs, that's close to their children and medical care, according to the poll by the AP-NORC Center for Public Affairs Research.

Chances are, that won't be enough.

For Hough, No. 1 is feeding herself without everything tumbling off the fork.

"I'm shaking all the time," she quietly told Hopkins occupational therapist Allyson Evelyn-Gustave.

Hough's other priority is not falling, and stairs are only one of her home's hazards.

To Hopkins' Szanton, bridging the gap between what older adults are able to do and what their homes allow them to do is key to maintaining independence.

The Capable study aims to prove how. During 10 home visits over four months, the Hopkins team is tailoring interventions - including about $1,100 in home repairs or modifications provided for free - to help low-income seniors who are having trouble caring for themselves.

The Capable project - it stands for Community Aging in Place, Advancing Better Living for Elders - is being closely watched by Medicaid officials in other states as a way to coordinate care and improve the functional problems that lead to pricey, and sometimes preventable nursing home admissions. Today, it's difficult for Medicaid patients to get these services.

With more than $8 million in research money from the National Institutes of Health and the Centers for Medicare and Medicaid Services, the project goes beyond home repair for health. It starts with a full-scale assessment of each participant's needs.

Whether it is the cost or emotional ties, many people grow old in the same home where they spent their younger, more agile years. An AARP survey in 2010 found nearly 90 percent of seniors wanted to remain in their current home for as long as possible.

Yet government figures show nearly 1 in 5 seniors living in the community have trouble with at least one activity of daily living, such as walking or bathing.

The four-month intervention costs about $4,000 per participant, including the home modifications and specialists' salaries. The average cost for nursing home care in the U.S. is $6,700 a month, so even a modest delay could add up fast. Szanton will track participants long term and, based on results from an earlier pilot test of 40 high-risk seniors, hopes to delay nursing home entry by up to a year in this frail population.

For families, perhaps the bigger question is how long the solutions will last. Evelyn-Gustave teaches families to brainstorm options as new challenges crop up.

"We can't be there forever. They need the skill to carry on," she said.

 
 

EZToUse.com

I am looking for: