Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: Kentucky is experiencing a higher-than-national average growth in its elder population. The State's health care and other support services to older adults are inadequate to deal with the basic needs of the older adult population. Many simple, low-cost and non-medical interventions that can be applied to help older adults stay healthy in the community are not systematically and broadly implemented. Sometimes all that is needed to keep older adults healthy in the community is increased physical activity, improved eating habits and taking simple steps to minimize the risk of falling. The Geriatric Evaluation and Self-Management Services Project, a project funded by the Department of Health and Human Services, tested such a support project for older adults, delivered by an interdisciplinary health care team of social workers and physical therapists to community-dwelling older adults living in the community. Methods: Community dwelling older adult clients aged 65 and older were given evidence-based geriatric interdisciplinary assessments, a plan of care, and were randomly assigned to either a control or experimental group. Control group clients were to manage their plan of care on their own until the post test at 12 weeks. In addition to these services, experimental group clients received a self-management support program that included support phone calls and face to face visits. Results: ANCOVA analysis was performed on all outcome variables, where group differences at post test were compared, after controlling for pretest scores. The results clearly indicated that self-management support received from the interdisciplinary team after the care plan was designed, resulted in more self-management behaviors in the form of more exercise for the experimental group (F(2)=8.703; p<0.01) and better communication with physicians (F(2)=6.877; p<0.01). The experimental group perceived their health status to be better in terms of their own self-assessment of health (F(2)=6.180; p<0.01), less social/role activities limitations (F(2)=3.438; p<0.05) and less physical limitations (F(2)=39.583; p<0.01). In terms of physical and functional mobility, the experimental group showed a higher increase in independence of daily living activities (F(2)=46.017; p<0.01), as well as more strength in the Functional Muscle Strength of Hip and Knee Extensors, a test strongly correlated with functional abilities and the risk of falling (F(2)=23.587; p<0.01). The experimental group also showed better nutritional health at posttest (F(2)=5.542; p<0.01). The experimental group showed an increased awareness for health resources that can be used to improve their health (F(2)=18.155; p<0.01). Finally, the experimental group ended after twelve weeks with better family networks (F(2)=10.321; p<0.01) and friend networks (F(2)=13.325; P,0.01). Implications: Results indicate that basic self-management support by an interdisciplinary team of physical therapists and social workers can significantly improve the health and well-being of older adults after they've been made aware of their health through a thorough interdisciplinary assessment. The results show great promise for effective, low-cost, non-medical interventions to keep older adults living independently in the community longer.