6 results on '"Gitlin, Laura N."'
Search Results
2. Community Aging in Place, Advancing Better Living for Elders: A Bio-Behavioral-Environmental Intervention to Improve Function and Health-Related Quality of Life in Disabled Older Adults.
- Author
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Szanton, Sarah L., Thorpe, Roland J., Boyd, Cynthia, Tanner, Elizabeth K., Leff, Bruce, Agree, Emily, Xue, Qian-Li, Allen, Jerilyn K., Seplaki, Christopher L., Weiss, Carlos O., Guralnik, Jack M., and Gitlin, Laura N.
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ACCIDENTAL fall prevention ,PAIN management ,GERIATRIC assessment ,ATTENTION ,BLACK people ,CHI-squared test ,DRUGS ,HEALTH facility design & construction ,HOME care services ,LIFE skills ,LONGITUDINAL method ,NEUROPSYCHOLOGICAL tests ,MOVEMENT disorders ,NURSING practice ,OCCUPATIONAL therapy ,PATIENT compliance ,PEOPLE with disabilities ,GENERAL practitioners ,POVERTY ,QUALITY of life ,RESEARCH funding ,SCALES (Weighing instruments) ,T-test (Statistics) ,PILOT projects ,DISABILITIES ,ACTIVITIES of daily living ,HOME environment ,SOCIOECONOMIC factors ,SENIOR housing ,EFFECT sizes (Statistics) ,RANDOMIZED controlled trials ,CONTROL groups ,BLIND experiment ,DATA analysis software ,DESCRIPTIVE statistics ,OLD age - Abstract
Objectives To determine effect size and acceptability of a multicomponent behavior and home repair intervention for low-income disabled older adults. Design Prospective randomized controlled pilot trial. Setting Participants' homes. Participants Forty low-income older adults with difficulties in one or more activities of daily living ( ADLs) or two or more instrumental activities of daily living ( IADLs). Intervention The Community Aging in Place, Advancing Better Living for Elders ( CAPABLE), coordinated occupational therapy, nursing, and handyman visits, was compared with attention-control visits. The intervention consisted of up to six visits with an occupational therapist, up to four visits with a nurse, and an average of $1,300 in handyman repairs and modifications. Each intervention participant received all components of the intervention clinically individualized to risk profile and goals. Each attention-control participant received the same number of visits as the intervention participants, involving sedentary activities of their choice. Measurement Primary outcome: difficulty in performing ADLs and IADLs. Secondary outcomes: health-related quality of life and falls efficacy. Results Thirty-five of 40 adults (87%) completed the 6-month trial, and 93% and 100% of the control and intervention group, respectively, stated that the study benefited them. The intervention group improved on all outcomes. When comparing mean change in the intervention group with mean change in the control group from baseline to follow-up, the CAPABLE intervention had effect sizes of 0.63 for reducing difficulty in ADLs, 0.62 for reducing difficulty in IADLs, 0.89 for quality of life, and 0.55 for falls efficacy. Conclusion The CAPABLE intervention was acceptable to participants and feasible to provide and showed promising results, suggesting that this multicomponent intervention to reduce disability should be evaluated in a larger trial. [ABSTRACT FROM AUTHOR]
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- 2011
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3. Home-Based Care Program Reduces Disability And Promotes Aging In Place.
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Szanton, Sarah L., Leff, Bruce, Wolff, Jennifer L., Roberts, Laken, and Gitlin, Laura N.
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ELDER care , *GERIATRIC assessment , *CHRONIC diseases , *MENTAL depression , *HEALTH care teams , *HOME accident prevention , *HOME care services , *LIFE skills , *MEDICAID , *EVALUATION of medical care , *MEDICAL care costs , *MEDICARE , *NURSES , *OCCUPATIONAL therapists , *HEALTH outcome assessment , *QUALITY assurance , *RESEARCH funding , *SCALE analysis (Psychology) , *HEALTH self-care , *ASSISTIVE technology , *T-test (Statistics) , *HOUSEKEEPING , *PROFESSIONAL practice , *ACTIVITIES of daily living , *HOME environment , *MULTIPLE regression analysis , *EVALUATION of human services programs , *DESCRIPTIVE statistics - Abstract
The Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program, funded by the Center for Medicare and Medicaid Innovation, aims to reduce the impact of disability among low-income older adults by addressing individual capacities and the home environment. The program, described in this innovation profile, uses an interprofessional team (an occupational therapist, a registered nurse, and a handyman) to help participants achieve goals they set. For example, it provides assistive devices and makes home repairs and modifications that enable participants to navigate their homes more easily and safely. In the period 2012-15, a demonstration project enrolled 281 adults ages sixty-five and older who were dually eligible for Medicare and Medicaid and who had difficulty performing activities of daily living (ADLs). After completing the five-month program, 75 percent of participants had improved their performance of ADLs. Participants had difficulty with an average of 3.9 out of 8.0 ADLs at baseline, compared to 2.0 after five months. Symptoms of depression and the ability to perform instrumental ADLs such as shopping and managing medications also improved. Health systems are testing CAPABLE on a larger scale. The program has the potential to improve older adults' ability to age in place. [ABSTRACT FROM AUTHOR]
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- 2016
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4. A longitudinal evaluation of family caregivers' willingness to pay for an in-home nonpharmacologic intervention for people living with dementia: results from a randomized trial.
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Jutkowitz E, Pizzi LT, Popp J, Prioli KK, Scerpella D, Marx K, Samus Q, Piersol CV, and Gitlin LN
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- Aged, 80 and over, Behavioral Symptoms, District of Columbia, Female, Humans, Independent Living economics, Longitudinal Studies, Male, Maryland, Middle Aged, Caregivers economics, Caregivers psychology, Dementia economics, Dementia therapy, Family Health economics
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Objective: To determine the willingness-to-pay (WTP) of family caregivers to learn care strategies for persons living with dementia (PLwD)., Design: Randomized clinical trial., Setting: Community-dwelling PLwD and their caregivers (dyads) in Maryland and Washington, DC., Participants: 250 dyads., Intervention: Tailored Activity Program (TAP) compared to attention control. TAP provides activities tailored to the PLwD and instructs caregivers in their use., Measurement: At baseline, 3 and 6 months, caregivers were asked their WTP per session for an 8-session 3-month in-home nonpharmacologic intervention to address behavioral symptoms and functional dependence., Results: At baseline, 3 and 6 months, caregivers assigned to TAP were willing to pay $26.10/session (95%CI:$20.42, $33.00), $28.70 (95%CI:$19.73, $39.30), and $22.79 (95%CI: $16.64, $30.09), respectively; attention control caregivers were willing to pay $37.90/session (95%CI: $27.10, $52.02), $30.92 (95%CI: $23.44, $40.94), $27.44 (95%CI: $20.82, $35.34), respectively. The difference in baseline to 3 and 6 months change in WTP between TAP and the attention control was $9.58 (95%CI: -$5.00, $25.47) and $7.15 (95%CI: -$5.72, $21.81). The difference between TAP and attention control in change in the proportion of caregivers willing to pay something from baseline to 3 and 6 months was -12% (95%CI: -28%, -5%) and -7% (95%CI:-25%, -11%), respectively. The difference in change in WTP, among caregivers willing to pay something, between TAP and attention control from baseline to 3 and 6 months was $17.93 (95%CI: $0.22, $38.30) and $11.81 (95%CI: -$2.57, $28.17)., Conclusions: Family caregivers are willing to pay more for an intervention immediately following participation in a program similar to which they were asked to value.
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- 2021
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5. Locations, Circumstances, and Outcomes of Falls in Patients With Glaucoma.
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Sotimehin AE, Yonge AV, Mihailovic A, West SK, Friedman DS, Gitlin LN, and Ramulu PY
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- Aged, Aged, 80 and over, Exfoliation Syndrome complications, Female, Glaucoma, Angle-Closure physiopathology, Glaucoma, Open-Angle physiopathology, Humans, Intraocular Pressure physiology, Male, Maryland epidemiology, Middle Aged, Prospective Studies, Quality of Life, Sickness Impact Profile, Surveys and Questionnaires, Vision Disorders physiopathology, Visual Acuity physiology, Visual Field Tests, Visual Fields physiology, Wounds and Injuries etiology, Accidental Falls statistics & numerical data, Glaucoma, Angle-Closure complications, Glaucoma, Open-Angle complications
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Purpose: To characterize the locations, circumstances, and outcomes of falls in patients with varying degrees of glaucoma., Design: Prospective cohort study., Methods: Patients with suspected or diagnosed glaucoma completed monthly calendars reporting falls. After each fall, a 30-item questionnaire was administered to determine fall location, circumstances, and injury. Mean deviation on visual field (VF) testing was used to categorize glaucoma severity. Main outcome measures were fall locations, circumstances, and outcomes., Results: One-hundred forty-two patients experienced 330 falls. Falls were most likely to occur in/around the home (71%), and this likelihood did not vary significantly with severity of VF damage (P > .2). The most commonly cited fall circumstances were tripping (43.6%), slipping (31.3%), uneven flooring (23.5%), and poor vision (15.9%). The circumstances related to falls did not vary by severity of VF damage (P > .2), except for poor vision, which was more frequently cited in individuals with more advanced VF damage (P = .001). Forty-three percent of falls resulted in some injury; and the likelihood of injury did not vary by severity of VF loss (P = .60) or any other factor except floor type and number of comorbidities (P < .05 for all). Falls in persons with more severe glaucoma were more likely to result in a fracture (9.4%) or an emergency room visit (18.8%), though these associations did not persist in multivariable models (P > .5 for all)., Conclusions: Glaucoma patients fall mostly in/around the home and demonstrate similar fall circumstances across the spectrum of disease severity, suggesting that current fall prevention interventions, particularly those emphasizing home modification, may be an adequate starting point to prevent falls in this high-risk-group., (Published by Elsevier Inc.)
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- 2018
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6. Health Services Utilization in Older Adults with Dementia Receiving Care Coordination: The MIND at Home Trial.
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Amjad H, Wong SK, Roth DL, Huang J, Willink A, Black BS, Johnston D, Rabins PV, Gitlin LN, Lyketsos CG, and Samus QM
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- Aged, Aged, 80 and over, Case Management organization & administration, Community Health Services organization & administration, Continuity of Patient Care organization & administration, Continuity of Patient Care statistics & numerical data, Female, Home Care Services organization & administration, Humans, Male, Maryland, Patient Acceptance of Health Care statistics & numerical data, Patient Care Team, Single-Blind Method, Case Management statistics & numerical data, Community Health Services statistics & numerical data, Dementia epidemiology, Facilities and Services Utilization statistics & numerical data, Home Care Services statistics & numerical data
- Abstract
Objective: To investigate effects of a novel dementia care coordination program on health services utilization., Data Sources/study Setting: A total of 303 community-dwelling adults aged ≥70 with a cognitive disorder in Baltimore, Maryland (2008-2011)., Study Design: Single-blind RCT evaluating efficacy of an 18-month care coordination intervention delivered through community-based nonclinical care coordinators, supported by an interdisciplinary clinical team., Data Collection/extraction Methods: Study partners reported acute care/inpatient, outpatient, and home- and community-based service utilization at baseline, 9, and 18 months., Principal Findings: From baseline to 18 months, there were no significant group differences in acute care/inpatient or total outpatient services use, although intervention participants had significantly increased outpatient dementia/mental health visits from 9 to 18 months (p = .04) relative to controls. Home and community-based support service use significantly increased from baseline to 18 months in the intervention compared to control (p = .005)., Conclusions: While this dementia care coordination program did not impact acute care/inpatient services utilization, it increased use of dementia-related outpatient medical care and nonmedical supportive community services, a combination that may have helped participants remain at home longer. Future care model modifications that emphasize delirium, falls prevention, and behavior management may be needed to influence inpatient service use., (© Health Research and Educational Trust.)
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- 2018
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