Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults.
Brian W Waldersen, Jennifer L Wolff, Laken Roberts and 3 others
PMID 28007445WHAT IT FOUND
Low-income older adults fully attained 73.5% of their home-based functional goals.
Attainment was higher for transferring and stairs, but lower for walking and community tasks. Participants were more likely to succeed if they were ready to change, had severe pain, or had home hazards.
Key findings
01Participants fully attained 535 of 728 identified functional goals (73.5%) at five-month follow-up.
02Each one-point increase in baseline readiness to change was associated with goals being 62% more likely to be attained.
03Goals were less likely to be attained by participants in severe pain, but more likely to be attained by those with bathroom or stairway hazards.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was predominantly African-American, female, and urban, so results may not generalize to other populations. Goal attainment was assessed by the same OT who delivered the intervention, not a blinded third party, which risks bias from social pressure or differing OT skills. The study did not account for the concurrent nursing and handyman components of the CAPABLE program, so it is unclear how these influenced OT-specific goal success. Readiness to change was rated by clinicians, which may introduce subjectivity.
Declared interests
The study was supported by the National Institute on Aging and the Centers for Medicare and Medicaid Services.
The easy way to misread this
Do not assume that the presence of home hazards causes goal attainment. The association suggests that visible problems may motivate change or make needs clearer, but hazards themselves are not a treatment. Also, do not generalize the high success rate to all older adults, as this group was selected for specific eligibility criteria and lived in a single urban area.