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New Study Shows Benefits of Person-Directed Care in the Home

A new study shows the positive impact of person-directed care on people who need assistance with activities of daily living.

A randomized clinical trial published in JAMA Internal Medicine recently found that, “The findings suggest that disability may be modifiable through addressing both the person and the environment.”

Let Me Explain

A person-directed approach to care is one in which the decisions belong in the hands of the person receiving the care. The focus is on an individual’s abilities—rather than on their disabilities or what they can no longer do for themselves—and their unique preferences. When using this approach, an individual is encouraged to participate in activities that support their well-being. For example, instead of doing the grocery shopping, cooking the meal, serving it, and cleaning up, a caregiver would find out if the person in need of care and assistance would like to write up the shopping list or be a taste tester in the kitchen during the cooking or other activities in the meal preparation—especially if this is someone who finds joy in this.

Statistics show that 1 in 3 older adults in the United States need help with at least one daily activity. The Family Caregiver Alliance addresses who needs long-term care on their website, citing data from AARP that, “The lifetime probability of becoming disabled in at least two activities of daily living or of being cognitively impaired is 68% for people age 65 and older.”

Details, Details

The study looked at 300 low-income “community-dwelling” adults who are living with a disability, age 65 or older, “cognitively intact,” and who self-reported difficulty with one or more Activities of Daily Living (ADLs) or two or more Instrumental Activities of Daily Living (IADLs) over a four-year period. The majority of study participants were women who have multiple chronic conditions such as heart disease, arthritis, and COPD (chronic obstructive pulmonary disease).

The study applied a program called CAPABLE (Community Aging in Place—Advancing Better Living for Elders) for one group or a choice of sedentary activities for the other group. Those in the CAPABLE group had visits, as needed, from a nurse, a handyman and an occupational therapist depending on the goals of the participant.

Over the course of five months, participants in this part of the study experienced 30% fewer difficulties with ADLs such as showering or bathing, getting dressed, transferring in or out of bed and moving easily around their home.

The reason for this study was, “Disability among older adults is a strong predictor of health outcomes, health service use, and health care costs,” the study author explained in the abstract. “Few interventions have reduced disability among older adults.”

Yet they saw with a person-directed care approach that there was a “substantial decrease in disability” for these people.

The conclusion was, “Disability may be modifiable through addressing both the person and the environment.”

Click here to see our infographic about quality care with tips on “This, Not That” when it comes to person-directed care.

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