Customized routines build healthy habits among the elderly, even months after therapy ends
LOS ANGELES, Jan., 2001--Occupational therapy can help senior citizens stay healthy and live independently, with lasting results even six months after seniors initially work with a therapist, according to a study from the University of Southern California.
Study results, published in the January 2001 issue of the Journal of Gerontology: Psychological Sciences, show that such therapy could help keep seniors in good health--and reduce health care and nursing home costs--as the nation's population ages. The results build on the USC Well Elderly Study, a widely cited, three-year research project published in 1997 that documented the impact of occupational therapy on independent-living senior citizens.
The study spotlighted the key role of occupational lifestyle redesign, in which a therapist helps a client develop and adopt a routine of beneficial daily activities based on the client's individual needs.
"Designing your daily routine so that you can control your lifestyle and stay healthy, happy and productive--rather than it controlling you--can lead to much greater personal satisfaction," said Florence Clark, Ph.D., O.T.R., F.A.O.T.A., chair of the USC Department of Occupational Science and Occupational Therapy and the study's lead author.
For example, an elderly woman who used to get excited about doing hands-on volunteer work in the neighborhood might begin to stay home, instead, because her worsening arthritis makes her frustrated and uncomfortable. But an occupational therapist could talk with the woman and discover the right kind of volunteer work for her, encourage her to build time into the day to keep doing the activity, find ways to accommodate the arthritis and help her adopt exercises to help alleviate it.
"Walking, going shopping, doing the activities of daily life--all of these stretch our capacities," Clark said. "If you don't stretch your capacities, though, they begin to decline."
In the original Well Elderly Study, Clark and a multidisciplinary team of researchers worked extensively with 361 senior citizens in the Los Angeles area. One third of that culturally diverse group received individualized occupational therapy while the remaining two thirds either participated in a variety of activities led by non-therapists (such as dancing, knitting and the like) or had no treatment at all. The one third of seniors who had occupational therapy showed remarkable improvement in quality of life and health measures compared to the remaining two thirds.
Now, the follow-up study shows that most of these gains (90 percent) were sustained six months later. The seniors benefited particularly in the areas of physical functioning, vitality, social functioning, general mental health and similar measures.
"We believe that after working with them for nine months, and enabling them to enact a daily routine maximizing health and well being, we were able to help them adopt and keep healthy habits," Clark said.
She and fellow researchers believe occupational therapy will be crucial to address the needs of the nation's growing senior population. Increased life expectancy is creating record numbers of people aged 65 and older: Currently, about 13 percent of the population fits in this age group--a proportion expected to rise to about 21% of the population in 2030.
"Our research shows that a preventive program can help seniors remain healthy and independent for a greater period of time," Clark said. "This is likely, over the long run, to keep them out of hospitals and nursing homes. The government currently spends about $45 billion on nursing home care. With the therapeutic effects that can result from the services of occupational therapists, it's in everyone's interest to include preventive therapy in our health regimen."