CARAH's randomized trial, Project ABLE (Advancing Better Living for Elders), funded by the National Institute on Aging, and published in the May, 2006 issue of the Journal of the American Geriatric Society, was recently featured by Reuters Health service, the world's leading provider of medical and healthcare news.

This study tested a six-month intervention in which people received four 90-minute visits with an occupational therapist, as well as one 20-minute telephone contact, and one 90-minute physical therapy visit and home modifications provided by the Philadelphia Corporation for Aging. Of 319 men and women 70 years of age and older, half were assigned to intervention, and half to a control group receiving educational materials only. The therapists showed participants how to modify their homes to make them safer. Strategies included, for example, putting hand-held showers and railings in the bathroom; instructing in problem solving; and training in how to recover from a fall as well as balance and muscle strength training. An important feature of the intervention was that goals were tailored to individual needs identified by the participants themselves. By six months, participants who received the training reported fewer difficulties with activities of daily living, especially bathing and toileting, compared to those who were not assigned to the intervention. They also reported higher self-efficacy, and less fear of falling, a strong risk factor for falling and functional decline. Most of the benefits were sustained at 12 months.

A clinical implication is that primary care physicians consider a referral to such a program for their patients with functional difficulties or fear of falling. Providing home care that is tailored to the individual's personal needs may help to promote successful aging in place and increased quality of life. A policy consideration is that equipment should be reimbursable under Medicare funding. For additional information on this study and other CARAH projects, please refer to the Publication and Presentation section of the CARAH website.

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