Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-05T12:28:18.771Z Has data issue: false hasContentIssue false

Medical and Everyday Assistive Device Use among Older Adults with Arthritis*

Published online by Cambridge University Press:  31 March 2010

Deborah Sutton
Affiliation:
The University Health Network, Toronto
Monique A.M. Gignac*
Affiliation:
University of Toronto
Cheryl Cott
Affiliation:
University of Toronto
*
Requests for offprints should be sent to: / Les demandes de tirés-a-part doivent être adressées à : Monique A.M. Gignac, Ph.D., The Division of Outcomes & Population Health, Toronto Western Research Institute, Main Pavilion 10–328, 399 Bathurst St, Toronto, ONM5T 2S8. ([email protected])

Abstract

This research compared older adults' use of medical assistive devices (ADs) with their use of everyday ADs as a means of managing chronic physical disability. The study also examined whether predisposing, need, and enabling factors were associated with device use in three domains of activity: personal care / in-home mobility, household activities, and community mobility. Participants were 248 adults, aged 55 years and older, with a wide range of disability levels as a result of osteoarthritis. All participants were administered an in-depth, structured questionnaire, as part of a larger study examining older adults' independence and adaptation to chronic physical illness. The results revealed that respondents actively adapted to their disabilities and used a wide range of medical and everyday devices, with everyday devices being reported more than twice as often as medical ADs and the fewest devices overall being reported for community mobility. In general, medical devices were used when subjective and objective need for ADs was considerable. Everyday devices were reported earlier in the trajectory of the disease, at mild and moderate disability levels, and were associated with a broader pattern of adaptation that included planning to avoid problems, exercise, and pacing activities.

Résumé

Cette recherche offre une comparaison entre l'emploi des aides technologiques fonctionnelles médicales et l'emploi des aides fonctionnelles quotidiennes par les personnes âgées en matière de gérance d'incapacité physique chronique. De plus, l'étude examine si les facteurs de prédisposition, de besoin et d'habilitation sont associés à l'usage des aides propres à trois domaines d'activités : les soins personnels et la mobilité à domicile, les activités ménagères et la mobilité communautaire. Ont participé, quelques 248 individus âgés de 55 ans et plus et souffrant d'une vaste gamme de niveaux d'incapacités causées par l'arthrite par usure. Chacun a reçu un questionnaire exhaustif et structuré faisant partie d'une étude élargie traitant le sujet de l'autonomie et l'adaptation à la maladie physique chronique des personnes âgées. Les résultats suggèrent qu'effectivement, il y a une adaptation de la part des répondants face à leur incapacité. De plus, ceux-ci utilisent une gamme d'aides médicales et quotidiennes. Dans l'ensemble, la mobilité communautaire avait le moins de cas de recours aux aides médicales et quotidiennes. En général, il y a recours aux aides fonctionnelles médicales lorsque le besoin subjectif et objectif de ces aides est considérable. Le recours aux aides quotidiennes est signalé surtout au début de la trajectoire de la maladie, lorsque les niveaux d'incapacité sont bénins ou moyens et associés à un profil plus étendu. Ce profil comprend la planification de contournement de problèmes, l'exercice et les activités d'entraînement.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This research was supported by grant #410970184 from the Social Sciences and Humanities Research Council of Canada and by an Ontario Ministry of Health, Health System-Linked grant to the Arthritis Community Research and Evaluation Unit (ACREU).

References

Agree, E.M. (1999). The influence of personal care and assistive devices on the measurement of disability. Social Science & Medicine, 48, 427443.Google Scholar
Agree, E.M., & Freedman, V.A. (2000). Incorporating assistive devices into community-based long-term care: An analysis of the potential for substitution and supplementation. Journal of Aging and Health, 12, 426450.Google Scholar
Andersen, R., & Newman, J.F. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly Journal, 51, 95124.Google Scholar
Badley, E.M., Rasooly, I., & Webster, G.K. (1994). Relative importance of musculoskeletal disorders as a cause of chronic health problems, disability and health care utilization: Findings from the 1990 Ontario Health Survey. Journal of Rheumatology, 21, 505514.Google Scholar
Baltes, M.M. (1996). The many faces of dependency. Cambridge: Cambridge University Press.Google Scholar
Baltes, P.B., & Baltes, M.M. (1990). Psychological perspectives on successful aging: The model of selective optimization with compensation. In Baltes, P. B. and Baltes, M. M. (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 134). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Barker, D. (2001). Meanings of wheelchair use among elderly stroke survivors: A continuity theory analysis. Unpublished master's thesis, University of Toronto, Toronto, Ontario, Canada.Google Scholar
Batavia, A., & Hammer, G. (1990). Toward the development of consumer-based criteria for the evaluation of assistive devices. Journal of Rehabilitation Research & Development, 27, 425436.CrossRefGoogle ScholarPubMed
Brooks, N.A. (1991). Users' responses to assistive devices for physical disability. Social Science and Medicine, 32, 14171424.Google Scholar
Bynum, H.S., & Rogers, J.C. (1987). The use and effectiveness of assistive devices possessed by patients seen in home care. The Occupational Therapy Journal of Research, 7, 181191.Google Scholar
Center for the Study of Aging and Human Development, Duke University (1978). Multidimensional functional assessment: The OARS methodology (2nd ed.). Durham, NC: Author.Google Scholar
Clark, P.G. (1991). Ethical dimensions of quality of life in aging: Autonomy vs. collectivism in the United States and Canada. The Gerontologist, 31, 631639.Google Scholar
Cook, A.M., & Hussey, S.M. (1995). Assistive technologies: principles and practice. St. Louis, MO: Mosby.Google Scholar
Cott, C., Boyle, J., Fay, J., Sutton, D., Bowring, J., & Lineker, S. (2001). Client-centred rehabilitation. ACREU Working Paper 2001–03.Google Scholar
Cott, C.A., & Gignac, M.A.M. (1999). Independence and dependence for seniors with osteoarthritis and osteoporosis. Canadian Journal on Aging, 18, 125.Google Scholar
de Klerk, M.Y.M., Huijsman, R., & McDonnell, J. (1997). The use of technical aids by elderly persons in the Netherlands: An application of the Andersen and Newman model. The Gerontologist, 37, 365373.Google Scholar
Edwards, N.I., & Jones, D.A. (1998). Ownership and use of assistive devices amongst older people in the community. Age and Ageing, 27, 463468.CrossRefGoogle ScholarPubMed
Forbes, W.F., Hayward, L.M., & Agwani, N. (1993). Factors associated with self-reported use and non-use of assistive devices among impaired elderly residing in the community. Canadian Journal of Public Health, 84, 5357.Google Scholar
Fries, J.J., Spitz, P., Kraines, R.G., & Holman, H.R. (1980). Measurement of patient outcome in arthritis. Arthritis and Rheumatology, 23, 137145.Google Scholar
Gignac, M.A.M., Cott, C., & Badley, E.M. (2000). Adaptation to chronic illness and disability and its relationship to perceptions of independence and dependence. Journals of Gerontology: Psychological Sciences, 55B, P362P372.Google Scholar
Gignac, M.A.M., Cott, C., & Badley, E.M. (2002). Adaptation to disability: Applying selective optimization with compensation to the behaviors of older adults with osteoarthritis. Psychology and Aging, 17, 520524.Google Scholar
Gitlin, L.N. (1995). Why older people accept or reject assistive technology. Generations, 19, 4146.Google Scholar
Gitlin, L.N., Miller, K.S., & Boyce, A. (1999). Bathroom modifications for frail elderly renters: Outcomes of a community-based program. Technology & Disability, 10, 141149.Google Scholar
Gitlin, L.N., Schemm, R.L., Landsberg, L., & Burgh, D. (1996). Factors predicting assistive device use in the home by older people following rehabilitation. Journal of Aging and Health, 8, 554575.Google Scholar
Hartke, R. J., Prohaska, T. R., & Furner, S. E. (1998). Older adults and assistive devices. Use, multiple-device use, and need. Journal of Aging and Health, 10, 99116.Google Scholar
Mack, R., Salmoni, A., Viverais-Dressler, G., Porter, E., & Garg, R. (1997). Perceived risks to independent living: The views of older community-dwelling adults. The Gerontologist, 37, 729736.Google Scholar
Mann, W. C., Hurren, D., & Tomita, M. (1995). Assistive devices used by home-based elderly persons with arthritis. The American Journal of Occupational Therapy, 49, 810820.Google Scholar
McWilliam, C.L., Diehl-Jones, W.L., Jutai, J., & Tadrissi, S. (2000). Care delivery approaches and senior's independence. Canadian Journal on Aging, 19 (Suppl 1), 99124.Google Scholar
National Advisory Council on Aging (NACA) (1992). Senior's independence: Whose responsibility? (Forum collection). Ottawa: Minister of Supply and Services.Google Scholar
Penning, M.J., & Strain, L.A. (1994). Gender differences in disability, assistance, and subjective well-being in later life. Journal of Gerontology: Social Sciences, 49, S202S208.Google Scholar
Pippin, K., & Fernie, G.R. (1997). Designing devices that are acceptable to the frail elderly: A new understanding based upon how older people perceive a walker. Technology and Disability, 7, 93102.CrossRefGoogle Scholar
Pirkl, J. (1994). Transgenerational design: Products for an aging population. Hong Kong: Van Nostrand Reinhold.Google Scholar
Rogers, J.C., & Holm, M.B. (1992). Assistive technology device use in patients with rheumatic disease: A literature review. The American Journal of Occupational Therapy, 46, 120127.Google Scholar
Rush, K.L., & Ouellet, L.L. (1997). Mobility aids and the elderly client. Journal of Gerontological Nursing, 23, 715.Google Scholar
Scherer, M.J. (1996). Outcomes of assistive technology use on quality of life. Disability and Rehabilitation, 18, 439448.Google Scholar
Tabachnick, B.G., & Fidell, L.S. (1996). Using Multivariate Statistics (3rd ed.). New York: HarperCollins.Google Scholar
Tech Act 29 USC Sec. 2201. (1988). U.S. Technology Related Assistance for Individuals with Disabilities Act of 1988.Google Scholar
Verbrugge, L.M., Rennert, C., & Madans, J.H. (1997). The great efficacy of personal and equipment assistance in reducing disability. American Journal of Public Health, 87, 384392.Google Scholar
Zimmer, Z., & Chappell, N.L. (1999). Receptivity to new technology among older adults. Disability and Rehabilitation, 21, 222230.Google Scholar
Zimmer, Z., & Chappell, N.L. (1994). Mobility restriction and the use of devices among seniors. Journal of Aging and Health, 6, 185208.Google Scholar