Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living with ESRD (SOCIABLE)Study

Deidra C. Crews, Alice M. Delaney, Janiece L. Walker Taylor, Thomas K.M. Cudjoe, Manka Nkimbeng, Laken Roberts, Jessica Savage, Allyson Evelyn-Gustave, Jill Roth, Dingfen Han, La Pricia Lewis Boyér, Roland J. Thorpe, David L. Roth, Laura N. Gitlin, Sarah L. Szanton

Research output: Contribution to journalArticle

Abstract

Rationale & Objective: Older adults with end-stage kidney disease have increased morbidity, fatigue, and decreased physical function, which can inhibit self-care and social engagement. We pilot tested a home-based program to improve physical and social functioning of low socioeconomic status older adults treated with hemodialysis (HD). Study Design: Qualitative study and randomized waitlist control intervention. Setting & Participants: Older adult HD patients in Baltimore, MD. Interventions: We identified functional needs and home environmental barriers to social engagement through focus groups; mapped findings onto aspects of an established program, which includes home visits with an occupational therapist, nurse, and handyman to provide ≤$1,300 worth of repairs, modifications, and devices; and piloted the program (Seniors Optimizing Community Integration to Advance Better Living with ESRD [SOCIABLE])among 12 older adult HD patients. We delivered the services over 5 months in a staggered fashion. Outcomes: Feasibility and acceptability of the intervention and change in disability scores. Results: Focus group themes included fatigue, lack of social support, and desire to live independently. SOCIABLE pilot participants were recruited from 2 dialysis units and all were African American (50% men); mean age was 69 years. At baseline, the mean disability score for activities of daily living (ADLs)was 4.4 and for instrumental ADLs (IADLs)was 6.3 (both out of a possible 16). Among the 9 participants alive at follow-up, there was 100% intervention completion and outcomes assessment. All treated participants improved a mean score of 2.3 for ADL and 2.6 for IADL disability, and social support and social network scores improved by 4.8 and 4.6, respectively. Limitations: Small sample size; all participants were African American. Conclusions: A home-based intervention addressing physical and social functioning of low socioeconomic status older adults on HD therapy was feasible and acceptable.

Original languageEnglish (US)
Pages (from-to)13-20
Number of pages8
JournalKidney Medicine
Volume1
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • Disability
  • activities of daily living
  • dialysis
  • home environment
  • older adults
  • qualitative study
  • social engagement
  • socioeconomic status

ASJC Scopus subject areas

  • Internal Medicine
  • Nephrology

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