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“Instrumental activities of daily living (IADLs) are those activities that allow an individual to live independently in a community. Although not necessary for functional living, the ability to perform IADLs can significantly improve the quality of life.”
—(Guo and Sapra, 2022, p. 1)
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LEARNING OUTCOMES
By the end of this chapter, readers will be able to:
15-1. Describe types of home management activities and their relevance to health and quality-of-life outcomes for older adults.
15-2. Articulate the complexity of physical, environmental, and social factors involved in providing person-centered home management services for older adults.
15-3. Understand relevant theories and frameworks of reference relevant to home management in older adults.
15-4. Identify common assessments that can help occupational therapists assess performance related to home management for older adults.
15-5. Understand common occupational therapy intervention strategies for supporting home management performance in older adults.
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Mini Case Study
Mrs. Wilson is 80 years old, lives alone in a large metropolitan area, and was recently widowed. She is a retired preschool teacher with two adult children, four grandchildren, and two pet cats. Mrs. Wilson is a breast cancer survivor who received surgery and chemotherapy and has been cancer free for 10 years. Her treatment did result in long-term peripheral neuropathy in both of her hands and feet. Mrs. Wilson has hypertension that is appropriately managed by medication; however, she reports the side effects of the medications cause occasional, minor dizziness. She also has arthritis that negatively influences her fine motor skills, mobility, and pain tolerance. Decreased mobility has led to reduced strength and fitness. Many aspects of her comorbidities have resulted in her diminished balance and high risk of falling. Two weeks ago, she had a fall in her home that resulted in a right distal ulnar fracture. After surgical treatment of the fracture, she was referred to occupational therapy due to an inability to independently complete home management tasks (e.g., driving, cooking, home cleaning, laundry).
Mrs. Wilson has lived in her apartment, the first floor of a row house, in a large city for all of her adult life. She has a daughter who lives one block away and has been a major support since the death of Mr. Wilson. However, her daughter is 60 years old and currently undergoing treatment for breast cancer, so she is not able to provide much support at this time. Mrs. Wilson’s son lives out of town and can help financially but not physically. While Mrs. Wilson’s goal is to age in place and remain in her home, there are factors involved that make this more difficult over time. The row house her apartment is in is old and has eight steps to reach the entry to the building. In addition, her neighborhood is not the safe neighborhood with a strong sense of community that it once was, and community support has disappeared due to her neighbors dying or moving ...