Abstract
Rationale & Objective: Older adults with end-stage kidney disease have increased morbidity, fatigue, and decreased physical function, which can inhibit self-care and social engagement. We pilot tested a home-based program to improve physical and social functioning of low socioeconomic status older adults treated with hemodialysis (HD). Study Design: Qualitative study and randomized waitlist control intervention. Setting & Participants: Older adult HD patients in Baltimore, MD. Interventions: We identified functional needs and home environmental barriers to social engagement through focus groups; mapped findings onto aspects of an established program, which includes home visits with an occupational therapist, nurse, and handyman to provide ≤$1,300 worth of repairs, modifications, and devices; and piloted the program (Seniors Optimizing Community Integration to Advance Better Living with ESRD [SOCIABLE])among 12 older adult HD patients. We delivered the services over 5 months in a staggered fashion. Outcomes: Feasibility and acceptability of the intervention and change in disability scores. Results: Focus group themes included fatigue, lack of social support, and desire to live independently. SOCIABLE pilot participants were recruited from 2 dialysis units and all were African American (50% men); mean age was 69 years. At baseline, the mean disability score for activities of daily living (ADLs)was 4.4 and for instrumental ADLs (IADLs)was 6.3 (both out of a possible 16). Among the 9 participants alive at follow-up, there was 100% intervention completion and outcomes assessment. All treated participants improved a mean score of 2.3 for ADL and 2.6 for IADL disability, and social support and social network scores improved by 4.8 and 4.6, respectively. Limitations: Small sample size; all participants were African American. Conclusions: A home-based intervention addressing physical and social functioning of low socioeconomic status older adults on HD therapy was feasible and acceptable.
Original language | English (US) |
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Pages (from-to) | 13-20 |
Number of pages | 8 |
Journal | Kidney Medicine |
Volume | 1 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1 2019 |
Externally published | Yes |
Bibliographical note
Funding Information:This study was funded by grant P30AG048773 from the National Institute on Aging , National Institutes of Health (NIH), Bethesda, MD. Dr Crews was supported by grant K23DK097184 from the National Institute of Diabetes and Digestive and Kidney Diseases , NIH, Bethesda, MD. The funders of this study had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication.
Publisher Copyright:
© 2019 The Author(s)
Keywords
- Disability
- activities of daily living
- dialysis
- home environment
- older adults
- qualitative study
- social engagement
- socioeconomic status