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Many older adults live with chronic conditions that may affect their ability to safely perform their daily occupations. Small decreases in ability of older adults to function independently can have profound effects, possibly leading to hospitalization, institutionalization, or death. However, preventative home-based interventions for older adults typically are not reimbursed by Medicare or other insurance carriers.

This study on intervention effectiveness contributes to a growing body of evidence for providing preventative home-based intervention to older adults to support their abilities to function independently in their communities. This study examined whether a preventative home-based intervention, including occupational therapy and physical therapy, was effective in reducing functional difficulties in older adults with chronic conditions. The researchers found statistically significant reductions in difficulty in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with the greatest improvements in bathing and toileting, and a decrease in home fall hazards, in comparison to a no-intervention control group. The effect sizes for all treatment outcomes were small to medium (ranging from 0.19 to 0.26). The intervention participants also showed less difficulty in functional mobility and transfers and increases in self-efficacy and use of functional strategies, but these differences were not statistically significant.


A product of the American Occupational Therapy Association's Evidence-based Literature Review Project.


Copyright © 2015 American Occupational Therapy Association. All Rights Reserved. Reproduced here with permission.

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Originally published as: Henty-clark, L., Lion, R., Marcelo, N., & Li, K. (2015) Does a multicomponent home intervention reduce functional difficulties in community-dwelling older adults as compared to no intervention? [Critically Appraised paper] Bethesda, MD: American Occupational Therapy Association, Evidence-Based Practice Project.