title: Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults.
abstract: To describe functional goals and factors associated with goal attainment among low-income older adults with disabilities living in the community.
  
  
  
  Secondary analysis.
  
  
  
  Participants' homes.
  
  
  
  Older adults (N=226) with disability who participated in the Community Aging in Place, Advancing Better Living for Elders trial.
  
  
  
  A 5-month, home-based, person-directed, structured program delivered by an interprofessional team: occupational therapist, registered nurse, and handyman.
  
  
  
  Process of occupational therapist goal setting and attainment at the final occupational therapist visit.
  
  
  
  Participants identified 728 functional goals (mean of 3.2 goals per participant), most commonly related to transferring (22.0%; n=160 goals), changing or maintaining body position (21.4%; n=156 goals), and stair climbing (13.0%; n=95 goals). Participants attained 73.5% (n=535) of goals. Goal attainment was highest for stair climbing (86.3%), transferring (85.6%), and self-care (84.6%); walking goals were less likely attained (54.0%). Goal attainment was not associated with age, sex, education, depressive symptoms, function, or health-related quality of life but was less likely among participants who had severe pain compared with those without pain (adjusted odds ratio, 0.38; 95% confidence interval, 0.17-0.86). When participant readiness to change score increases by 1 point on the 4-point scale, goal attainment was 62% more likely (adjusted odds ratio, 1.62; 95% confidence interval, 1.14-2.29).
  
  
  
  Home-based collaborative goal setting between older adults and occupational therapists is feasible and particularly effective when individuals are ready or willing to adopt new strategies to achieve identified goals.
authors.affiliation: Johns Hopkins School of Medicine and School of Public Health, Baltimore, MD.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Waldersen
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: jwolff@jhsph.edu.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Wolff
authors.affiliation: Johns Hopkins School of Nursing, Baltimore, MD.
authors.forename: Laken
authors.initials: L
authors.lastname: Roberts
authors.affiliation: Johns Hopkins School of Nursing, Baltimore, MD.
authors.forename: Allysin E
authors.initials: AE
authors.lastname: Bridges
authors.affiliation: Johns Hopkins School of Medicine and School of Public Health, Baltimore, MD; Johns Hopkins School of Nursing, Baltimore, MD.
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins School of Nursing, Baltimore, MD.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Szanton
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006040:Goals; D006801:Humans; D057187:Independent Living / Q000523:psychology; D008297:Male; D009788:Occupational Therapy / Q000379:methods*; D010146:Pain / Q000523:psychology / Q000534:rehabilitation*; D011203:Poverty; D011788:Quality of Life; D012648:Self Care; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D016138:Walking
keywords: Frail elderly; Person-centered therapy; Rehabilitation; Self care