Managing Activity Difficulties at Home: A Survey of Medicare Beneficiaries
Presented to the American Congress of Rehabilitation Medicine, October 1, 2005, Chicago, IL.
published online 05 June 2008.
Abstract
Dudgeon BJ, Hoffman JM, Ciol MA, Shumway-Cook A, Yorkston KM, Chan L. Managing activity difficulties at home: a survey of Medicare beneficiaries.
Objective
To describe assistance from helpers and use of assistive technology and environmental modification by community-dwelling people with difficulties in activities of daily living (ADLs) and instrumental activities of daily living (IADLs).
Design
Cross-sectional study using the 2004 Medicare Current Beneficiary Survey.
Setting
Community.
Participants
Nationally representative sample of 14,500 Medicare beneficiaries (mean age, 71.5y; 55% female; 49% currently married; 68% living with others; 84% white).
Interventions
Not applicable.
Main Outcome Measures
Self-reported difficulty with ADLs and IADLs; uses of help, assistive technology, and/or environmental modification.
Results
Difficulties were reported most frequently for heavy housework, walking, and shopping; money management, shopping, and light housework were reported as activities most often needing a helper. Walking, bathing, and toileting were activities most often needing uses of assistive technology. Bathroom modifications were the most commonly reported environmental modification. Results from a logistic regression showed that advancing age was the primary factor associated with increasing use of helpers and assistive technology or both for difficult activities.
Conclusions
Uses of helpers, assistive technology, and environmental modification are common but vary by type of ADL and/or IADL and age. Focused studies regarding uses of help and access to assistive technology and environmental modification appear needed to support community living. Public education about methods and types of accommodations appears needed and may substitute for or augment guidance from care providers.
aDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA
bRehabilitation Medicine Department Clincal Research Center, National Institutes of Health, Bethesda, MD.
Reprint requests to Brian J. Dudgeon, PhD, OTR, Rehabilitation Medicine, Box 356490, University of Washington, Seattle, WA 98195-6490
Supported by the Centers for Disease Control and Prevention (grant no. MM-0625-04/04) and the Intramural Research Program, National Institutes of Health Clinical Center.
No commerical party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
ABSTRACT