After rehabilitation: an 18-month follow-up of elderly inner-city women.
OBJECTIVE
Elderly inner-city women (n = 125) greater than the age of 60 and living alone and who were consecutively admitted to a large, urban, university-based rehabilitation hospital were followed to (a) examine the power of standardized clinical measures to predict who was living alone 18 months after discharge, (b) determine whether live-alone women at 18 months' follow-up were more independent in instrumental activities of daily living (IADL) than women who were not living alone, and (c) investigate whether women who return home to live alone and have low or declining physical function are at risk for subsequent relocation or death.


METHODS
Data from four standardized assessments (physical function, cognition, comorbidity, and depression) and demographic information were gathered during in-patient rehabilitation. Self-report IADL data were collected via telephone interviews at 3, 6, and 18 months' follow-up.


RESULTS
Statistical analysis of results showed that physical function, cognition, and comorbidity were significant and independent predictors of living alone at 18 months' follow-up. Women living alone at 18 months reported significantly greater IADL independence than women who were not living alone. Path analysis confirmed that the relationship between the clinical measures and living situation at 18 months was mediated by self-reported IADL functioning.


CONCLUSIONS
Standard clinical data obtained at discharge are useful to identify who can return home to live alone after rehabilitation, but in-home assessment of IADL remains key to understanding the complex skills required to live alone.
Lysack
Catherine L
CL
Institute of Gerontology, Department of Occupational Therapy, Wayne State University, 87 E. Ferry, 231 Knapp Building, Wayne State University, Detroit, Michigan 48202, USA. c.lysack@wayne.edu
Neufeld
Stewart
S
Mast
Benjamin T
BT
MacNeill
Susan E
SE
Lichtenberg
Peter A
PA
D000203:Activities of Daily Living; D001741:Black or African American / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003863:Depression; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D007902:Length of Stay; D008875:Middle Aged; D010347:Patient Care Planning; D010351:Patient Discharge; D012047:Rehabilitation Centers; D012934:Social Isolation; D012944:Social Support; D014505:Urban Population