Aging well: a preventive occupational therapy service in naturally occurring retirement communities
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Citation
Abstract
Aging in place is a process, and a choice, where older adults remain in their homes as they age. As the number of retirees rises in the US, the topic of where to live as age related changes occur gains more importance. Naturally Occurring Retirement Communities (NORCs) are buildings or neighborhoods that house a large number of older adults and support them in remaining healthy and in the community (The AP-NORC Center for Public Affairs Research, 2021). Occupational therapy practitioners (OTPs) can play a key role in aging in place at NORCs, as the profession specifically addresses participation in meaningful daily activities (American Occupational Therapy Association [AOTA], 2021).
Understanding community dwelling older adults through the Social Ecological Model (Bronfenbrenner, 1974) facilitates viewing the individual surrounded by a collection on layers that impact the individual at the center, and considers factors such as skills, caregivers and support systems, neighborhoods and laws, and how they affect a person’s life (Cole & Gauvain, 2005). Lack of mobility and balance, home safety, appropriate equipment, functional independence, communal support, and access to care may result in older adults’ need to leave their homes as they age.
A literature review on factors that impact successful aging found that age, chronic conditions, mobility, balance, and functional independence all play a role in balancing the challenges that arise during aging (Jeste et al., 2017; Plys & Kluge, 2016). Receiving healthcare was also found to be a barrier to older community dwellers (Vladeck & Segel, 2010), but there is limited evidence of OTPs’ role in aging in place at NORCs. This gap in the literature highlights the need for occupational therapy (OT) in supporting older adults to successfully age in place at a NORC.
Home safety, including mobility, balance, appropriate equipment, and safe participation in functional tasks has been found to be linked to impact successful aging in the community (DiGennaro Reed et al., 2014; Ozturk et al., 2010; Plys & Kluge, 2016). Interventions that addressed these barriers to community-dwelling were found to be helpful to older adults (Plys & Kluge, 2016). Additionally, wellness, functional independence and social participation were found to positively impact older adults residing in the community, and the use of technology also plays a significant role in aging in place (Lee et al., 2017; Shipee, 2011; Smith et al., 2014).
Aging Well: A preventive occupational therapy service in Naturally Occurring Retirement Communities (Aging Well) proposes the addition of OT services to NORCs to support older adults’ ability to age in place. Providing preventive services will equip NORC residents with the skills and support needed to remain in their homes as they age. The pilot program consists of individual home evaluations and interventions to address mobility and balance concerns, as well as safety during daily functional tasks and use of medical equipment. Group programming will be capped at 10 participants, meet weekly for cycles of six weeks, and focus on skill-development activities, such as digital literacy to promote independence in daily tasks and engagement in healthy habits that promote wellness. The author’s proposed program has potential to increase older adults’ ability to age in place successfully and establish a formal role in an emerging setting for the field of OT. A detailed overview of Aging Well is presented in this doctoral project.