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Identifies factors associated with exercise participation and adherence in a sample of sedentary, functionally limited, community-dwelling adults ages 60 to 94 who participated in a home-based resistance training program (N=102). Results show that psychological factors were most important to adherence to the home-based program. (Author/MKA)

Background and Objectives To better understand the disablement process among older adults, improved measures of activity limitations are needed. Traditional population-level measures lack the ability to distinguish precise gradations of activity limitation and are unable to detect degrees of differences over a wide range of ability levels. Therefore, we used contemporary measurement methods to improve upon current methodologies for characterizing activity limitations within the National Health and Aging Trends Study (NHATS). Research Design and Methods We used the NHATS Round 1 cohort to assess the feasibility of constructing an Activity Limitations scale using Rasch item response theory methods. Factor analysis was used to develop the scale from a set of existing items in the NHATS Mobility, Self-Care, and Household Activity domains. Psychometric properties of the scale were evaluated and the scale was used to examine change in activity limitations among the sample from 2011 to 2015. Results Results supported an 18-item scale (N = 7,609). Rasch infit and outfit statistics were within acceptable range for all items (Cronbach's alpha = 0.95; sample score reliability = 0.83). From 2011 to 2015, 5.88% older adults demonstrated increase in function, 15% showed decrease in function, and 78% of the sample showed no change (did not exceed ± MDC90). Discussion and Implications Findings demonstrate that a unidimensional, interval scale of activity limitations can be constructed using traditional survey measures nested within the NHATS. Results revealed concerns regarding ceiling effects within the current self-report items of activity limitations suggesting future work is needed to expand the range of ability currently represented in the NHATS Activity Limitation items. [ABSTRACT FROM AUTHOR]

Describes a diversified approach to delivering home care to vulnerable older people. This pilot program, funded by the Massachusetts Department of Elder Affairs, attempted to reduce the demand for scarce homemaker services. Results suggest homecare diversification did not alter consumer satisfaction but increased manager time. (Author/JAC)

Over 80 percent of a sample of community-living elderly were self-sufficient in performing basic activities of daily living (ADL); only 18 percent were self-sufficient in performing instrumental ADL. Most elders who use long-term care assistance relied solely on the informal support network in both instrumental (86 percent) and basic (50 percent) ADL. (Author/RC)

Purpose: We describe the results of the dissemination of an efficacious, home-based exercise program called Strong for Life as it was implemented in a nationwide, volunteer caregiving program called Faith in Action, including training of volunteers who implemented the program, recruitment of older adult participants, exercise adherence, and attitudes and perceptions of program staff and participants. Design and Methods: Frail, homebound older adults (N = 105) were recruited from 10 Faith in Action sites to participate in the Strong for Life exercise program. Volunteer trainers (n = 103) were trained by physical therapists to assist the older adults with the program. Surveys were conducted with older adults, volunteer trainers, and Faith in Action sites at baseline and after the older adults had been engaged in the program for 4 months. Results: Satisfaction with program components was very high: At follow-up, 100% of volunteers and 98.6% of older adults rated the program positively. Participants reported engaging in exercise on average 2.2 times per week, with 53% of the participants exercising at least 2 to 4 times per week. Participants also had significant improvements in the Short Form-20 social functioning scale. There were no serious adverse events reported. Implications: Dissemination of the Strong for Life program in a community setting using trained lay volunteers was feasible, acceptable, and safe. Existing volunteer caregiving organizations such as Faith in Action offer a feasible and safe means of disseminating late-life exercise programs to the frail older population. [ABSTRACT FROM AUTHOR]

Presents a study which described a conceptual framework for the dissemination and utilization of information, along with examples of its use by the Boston University Roybal Center for Enhancement of Late Life Function in Massachusetts. Design and methods; Results; Implications.

Focuses on several important aspects of previous knowledge about predictors of home-based exercise by older adults. Reference to a 1996 study by S.N. Blair, documenting the scientific literature of the benefits of physical activity by older adults; Role of psychological factors in exercise adherence; Association of physical characteristics with adherence in nonclinical samples of adults.

Examines whether activity curtailment among old people who were afraid of falling was solely a manifestation of the level of fear of falling or it was associated with other factors. Nature of the fear of falling; Discussion on activity curtailment among the aged who were afraid of falling; Characteristics that distinguish people who are afraid of falling from those who are not.

Investigates the prevalence of quality care deficiencies in 4,324 Medicare-reimbursed episodes of aged home care provided by 47 home health agencies. Absence of quality problems in 56.8 percent of home health agencies; Potential for adverse impact for the patient of quality deficiencies; Concerns regarding the process-oriented quality of care method.

Over 80% of a sample of community-living elderly in Massachusetts aged 71 years or older are self-sufficient in performing basic activities of daily living (ADL); only 18% are self-sufficient in performing instrumental ADL. Most elders who use long-term care assistance rely solely on the informal support network in both instrumental (86%) and basic (50%) ADL. Increasing physical disability is the key predictor of the amount of informal assistance elders use. An elder's living situation is the only informal support network characteristic consistently related to use of informal services. [ABSTRACT FROM PUBLISHER]

Facing a demand for homemaker services that exceeded the supply, the Massachusetts Department of Elder Affairs funded a demonstration to evaluate a diversified approach to delivering, to vulnerable elders, home care which reduced the demand for scarce homemakers. This pilot investigation suggests that homecare service diversification does not alter consumer satisfaction but leads to a modest increase in case manager time needed to coordinate and supervise service delivery. [ABSTRACT FROM PUBLISHER]