Effects of Home Modifications on Falls and Participation in PACEJennifer Gardner, OTD, OTR1, Claire Mulry, OTD, OTR1, Holly Hardaway, OTR2, Kimberly Syers1, Kelly Scimeca1,

Christopher Curcio1, Monica Shah1, & Louis Herrera1 1Kean University, Union, NJ; 2Independent Domain, LLC, Franklin Park, NJ

Inclusionary Criteria

• Enrollment in PACE August 2012 – January 2013

• Implementation of home modifications based on recommendations of a home safety assessment

• English speaking• SLUMS exam score in normal

rangeOutcome Measures

• Demographics• Age Range: 58-73• Gender: 3 Female, 2 Male• Race: 100% Caucasian

• Fall Frequency• Home Modifications Implemented• Participation SurveyData Analysis

• Spearman rank correlation of relationship among number of falls and Likert scores related to ability, confidence and number of home modifications.

• 5 participants completed the study

• 4/5 participants reported 0 falls since their home modification

• 100% of the participants reported an increase in their ability to do the things they need and want to do since the home modifications

• 4/5 reported an increase in their confidence to do the things they need and want to do since homemodifications

•No statistically significant correlationswere found between falls and home modifications or falls and participation

Aging in Place•Older adults are the fastest

growing demographic in the United States (U.S. Department of Health and Human

Services, 2012)

•Many older adults wish to reside at home in the community (Wiles,

Leibing, Guberman, Reeve, & Allen, 2012).

•Older adults living at home are at a risk for falls (Center of Disease Control and

Prevention, 2012)

Program of All-inclusive Care for

the Elderly (PACE)• Provides health care for people

55 years or older whose disability level makes them eligible for nursing home care but who choose to reside in the community (Mukanmel & Temkin-Greenerow, 2007)

•Care is provided by an interdisciplinary team that includes: physicians; nurses; occupational, physical and recreational therapists; nutritionists; dentists and social workers (Hansen & Hewitt, 2012)

• Funded by Medicare and found to improve quality of care and access to services (Wieland, Boland, Baskins & Kinosian, 2010)

Home Modification•Defined as any change made to

the home environment (including physical, cultural, social, virtual and/or temporal environments) based on the recommendations of a home safety assessment performed by an occupational therapist.

•Despite no statistically significant correlation between home modifications and falls, all participants reported increased confidence in participation after home modifications were implemented

•The findings demonstrate potential for home modifications to enhance client participation in occupations

• Future researchers should: Use a larger sample size to

allow for greater generalizability

Include a pre and post testInclude those who have a mild

to moderate cognitive deficits

Background

Methods

Results Discussion

References

The purpose of the current study was to examine the relationship between home modifications and their impact on falls and participation in a group of community dwelling PACE participants from LIFE St Francis in Trenton, NJ.

Study Purpose

Centers for Disease Control and Prevention. (2012). Falls among older adults: An overview. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/ Falls/adultfalls.htmlHansen, J. C., & Hewitt, M. (2012). PACE provides a sense of belonging for

elders. Generations, 36(1), 37-43.Mukamel, D., Peterson, D., Temkin-Greener, H., Delavan, R., Gross, D., Kunitz, S., & Williams, T. (2007). Program characteristics and enrollees' outcomes in the Program of All-Inclusive Care for the Elderly (PACE). The Milbank Quarterly, 85(3), 499-531.U. S. Department of Health and Human Services. (2012). Healthy people 2020: Improving the health of Americans. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=31Wiles, J., Leibing, A., Guberman, N., Reeve, J., & Allen, R. (2012). The meaning of "aging in place" to older people. The Gerontologist, 52(3), 357-366.Wieland, D., Boland, R., Baskins, J., & Kinosian, B. (2010). Five-year survival in a program of all-inclusive care for elderly compared with alternative institutional and home- and          

community-based care. Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 65(7), 721-726. doi:10.1093/gerona/glq040

Number of Respondents

Number of Respondents

Number of Respondents

Number of Respondents

Home Modification by Environment

Always

Sometimes

Neutral

Rarely

Never

0 0.5 1 1.5 2 2.5 3 3.5

Since the changes have been made to my home to make it safer, I have been able to do the things that I need to do

Always

Sometimes

Neutral

Rarely

Never

0 0.5 1 1.5 2 2.5 3 3.5

Since the changes have been made to my home to make it safer, I have been able to do the things that I want to do:

A Great Deal

Somewhat

Neutral

Very Little

Not At All

0 0.5 1 1.5 2 2.5 3 3.5

Since the changes have been made to my home to make it safer, my confidence in doing the things that I need to do has increased:

A Great Deal

Somewhat

Neutral

Very Little

Not at all

0 0.5 1 1.5 2 2.5 3 3.5

Since the changes have been made to my home to make it safer, my confidence in doing the things that I want to do has increased: