Problems with dressing in the frail elderly.

OBJECTIVE Dressing is an important activity of daily living, yet many older adults have difficulty due to impairments. The purpose of this study was to explore the use of assistive devices for dressing by older persons with impairments, and to look at differences among frail elders with no dressing difficulty, upper-extremity-only dressing difficulty, lower-extremity-only dressing difficulty, and both upper- and lower-extremity dressing difficulty. METHOD We conducted in-home interviews and functional assessments with 1,101 elderly persons with activities of daily living and/or instrumental activities of daily living limitations in Western New York and Northern Florida. Participants were assigned to one of four groups based on Functional Independence Measure item scores for upper-extremity dressing and lower-extremity dressing. Descriptive statistics were used to report results. RESULTS Compared to women, there were relatively more men with lower-extremity dressing difficulty than with upper-extremity dressing difficulty. The group with both upper- and lower-extremity dressing difficulty reported the highest level of pain and scored lowest on all measures of functional status and mental status. The most commonly used dressing devices were associated with lower-extremity dressing. CONCLUSION There are differences in gender, health status, functional status, and mental status among elderly persons grouped by upper- or lower-extremity dressing difficulty. Results suggest that therapists should consider such differences as gender and type of difficulty (upper- or lower-extremity dressing) in both therapeutic approaches and recommendations for assistive devices. Pain is another important consideration, but it can often be reduced during dressing by using assistive devices.

[1]  William C. Mann,et al.  Needs of Home-Based Older Persons for Assistive Devices , 1993 .

[2]  J. Stoecker,et al.  Reliability and validity of the FIM for persons aged 80 years and above from a multilevel continuing care retirement community. , 1996, Archives of physical medicine and rehabilitation.

[3]  G. Fillenbaum,et al.  The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. , 1981, Journal of gerontology.

[4]  M. Bergner,et al.  The Sickness Impact Profile: Development and Final Revision of a Health Status Measure , 1981, Medical care.

[5]  P. Krach,et al.  Functional status of the oldest-old in a home setting. , 1996, Journal of advanced nursing.

[6]  K. Manton,et al.  Changes in the use of personal assistance and special equipment from 1982 to 1989: results from the 1982 and 1989 NLTCS. , 1993, The Gerontologist.

[7]  K. Macleod.  Health of the Elderly , 1956, Statistical bulletin.

[8]  M. Bergner,et al.  The sickness impact profile. Development of an outcome measure of health care. , 1975, American journal of public health.

[9]  The use of technical aids by elderly persons in The Netherlands: an application of the Andersen and Newman model. , 1997, The Gerontologist.

[10]  L. Gitlin,et al.  Factors Predicting Assistive Device Use in the Home by Older People Following Rehabilitation , 1996, Journal of aging and health.

[11]  K. Engedal,et al.  The Mini‐Mental State Examination: Identifying the Most Efficient Variables for Detecting Cognitive Impairment in the Elderly , 1992, Journal of the American Geriatrics Society.

[12]  D. J. Lee.  Society and the Adolescent Self-Image , 1969 .

[13]  J. Booth,et al.  Resampling-Based Multiple Testing. , 1994 .

[14]  M. Thorslund,et al.  The use of technical aids among community-based elderly. , 1991, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[15]  R. L. Dipboye,et al.  Global Self-Esteem as a Correlate of Work-Related Attitudes: A Question of Dimensionality , 1990 .

[16]  H. Williams,et al.  Discriminating Characteristics of Community-Dwelling Elderly at High and Low Risk for Frailty , 2002 .

[17]  C. G. Costello,et al.  Measuring depressive symptoms in illness populations: Psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) Scale , 1988 .

[18]  Yogendra P. Chaubey.  Resampling-Based Multiple Testing: Examples and Methods for p-Value Adjustment , 1993 .

[19]  M. Weissman,et al.  Community surveys of psychiatric disorders , 1989 .

[20]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[21]  Allan Birnbaum,et al.  Combining Independent Tests of Significance , 1954 .

[22]  L. Gitlin,et al.  Emerging concerns of older stroke patients about assistive device use. , 1998, The Gerontologist.

[23]  Cv. Granger,et al.  Guide for the use of the uniform data set for medical rehabilitation , 1986 .

[24]  V. Freedman,et al.  A comparison of assistive technology and personal care in alleviating disability and unmet need. , 2003, The Gerontologist.

[25]  R. Levine,et al.  Adaptive device use by older adults with mixed disabilities. , 1993, Archives of physical medicine and rehabilitation.

[26]  L. Gitlin,et al.  How occupational therapists teach older patients to use bathing and dressing devices in rehabilitation. , 1998, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[27]  D. Wolfe,et al.  Nonparametric Statistical Methods. , 1974 .

[28]  F. Hobbs,et al.  65+ in the United States. , 1996 .

[29]  Chuanchieh Hsu,et al.  Improving Morning Care Routines of Nursing Home Residents with Dementia , 1999, Journal of the American Geriatrics Society.

[30]  M. Rosenberg.  Society and the adolescent self-image , 1966 .

[31]  L. Radloff.  The CES-D Scale , 1977 .