Understanding Key Home and Community Environment Challenges Encountered by Older Adults Undergoing Total Knee or Hip Arthroplasty.


Journal

The Gerontologist
ISSN: 1758-5341
Titre abrégé: Gerontologist
Pays: United States
ID NLM: 0375327

Informations de publication

Date de publication:
13 09 2021
Historique:
received: 14 10 2020
pubmed: 20 2 2021
medline: 29 10 2021
entrez: 19 2 2021
Statut: ppublish

Résumé

Older adults undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) experience significant challenges while navigating their homes after surgery and are at higher risk for falls and injuries. This study explored the specific home and community physical environment challenges faced by community-dwelling older adults while performing daily activities and actions taken to modify their homes before surgery. Using a qualitative descriptive methodology, semistructured interviews were conducted with 22 older adult-care partner dyads pre- and postsurgery to identify key built environment barriers and facilitators in addition to home modifications made pre- and postsurgery. Challenges anticipated by participants to perform daily activities presurgery varied from those experienced postsurgery. Lack of support along stairs or in bathrooms, flooring material, and transitions were significant concerns raised by the participants before surgery. Size and layout of home and ergonomics of resting furniture were recognized as issues postsurgery. Modifications ranged from easy fixes such as rearranging furniture, removing clutter, and installing grab bars to high-cost structural changes such as remodeling critical spaces such as bathrooms. Although participants agreed on the importance of conducting proactive home assessments and modifications before surgery, perceived costs and lack of knowledge or services limit older adults from implementing some changes. Home modifications must be considered proactively before an event such as a THA or TKA. These should be done within the context of the specific needs, abilities, financial capabilities, and social and physical home environments of the individual and the residential caregivers.

Sections du résumé

BACKGROUND AND OBJECTIVES
Older adults undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) experience significant challenges while navigating their homes after surgery and are at higher risk for falls and injuries. This study explored the specific home and community physical environment challenges faced by community-dwelling older adults while performing daily activities and actions taken to modify their homes before surgery.
RESEARCH DESIGN AND METHODS
Using a qualitative descriptive methodology, semistructured interviews were conducted with 22 older adult-care partner dyads pre- and postsurgery to identify key built environment barriers and facilitators in addition to home modifications made pre- and postsurgery.
RESULTS
Challenges anticipated by participants to perform daily activities presurgery varied from those experienced postsurgery. Lack of support along stairs or in bathrooms, flooring material, and transitions were significant concerns raised by the participants before surgery. Size and layout of home and ergonomics of resting furniture were recognized as issues postsurgery. Modifications ranged from easy fixes such as rearranging furniture, removing clutter, and installing grab bars to high-cost structural changes such as remodeling critical spaces such as bathrooms. Although participants agreed on the importance of conducting proactive home assessments and modifications before surgery, perceived costs and lack of knowledge or services limit older adults from implementing some changes.
DISCUSSION AND IMPLICATIONS
Home modifications must be considered proactively before an event such as a THA or TKA. These should be done within the context of the specific needs, abilities, financial capabilities, and social and physical home environments of the individual and the residential caregivers.

Identifiants

pubmed: 33605410
pii: 6144881
doi: 10.1093/geront/gnab025
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1071-1084

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Rutali Joshi (R)

Center for Health Facilities Design and Testing, Clemson University, Clemson, South Carolina, USA.

Anjali Joseph (A)

Center for Health Facilities Design and Testing, Clemson University, Clemson, South Carolina, USA.

Sahar Mihandoust (S)

Center for Health Facilities Design and Testing, Clemson University, Clemson, South Carolina, USA.

Lisa Hoskins (L)

Center for Health Facilities Design and Testing, Clemson University, Clemson, South Carolina, USA.

Susan O'Hara (S)

School of Nursing, Architecture; College of Behavioral, Social and Health Sciences, CUSHR, Clemson University, Clemson, South Carolina, USA.

Cheryl J Dye (CJ)

CU Institute for Engaged Aging, Department of Public Health Sciences, Clemson University, Clemson, South Carolina, USA.

Kapil Chalil Madathil (K)

Departments of Industrial and Civil Engineering, Clemson University, Clemson, South Carolina, USA.

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