WHEN FUNCTIONAL IMPAIRMENT DEVELOPS EARLY: PERSPECTIVES FROM MIDDLE-AGED ADULTS. (11th November 2018)

• Record Type: Journal Article
• Authors: Xu, E; Barrientos, M; Nicosia, F; Steinman, M; Spar, M; Karliner, L; Brown, R
• Is Part Of: Innovation in aging. Volume 2(2018)Supplement 1
• Page Start: 522
• Page End: 522
• Publication Date: 2018-11-11
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igy023.1931
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: Difficulty performing basic activities of daily living (ADLs) is often seen as a problem affecting adults aged 65 and older, especially the oldest old. However, such difficulties also commonly develop among middle-aged adults, and these difficulties can persist and worsen over time. Yet little is known about the experiences and needs of individuals who develop ADL difficulty in middle age. We conducted semi-structured interviews with 40 patients ages 50–64 recruited from four primary care clinics in San Francisco. Patients were eligible if they spoke English or Spanish and were identified by their primary care providers as having developed difficulty performing one or more ADLs during middle age. Interviews focused on patients' daily life, needs, and experiences with the healthcare system. We analyzed transcripts iteratively using a thematic approach. Interviews revealed three main themes: 1) the importance of – and challenges to – developing "systems" to manage ADL impairments, including services, supports, and environmental adaptations; 2) psychosocial challenges related to reconciling ones' identity before and after developing ADL impairment; and 3) difficulty in having ones' needs met within the healthcare system due to its focus on individual diseases and diagnostic tests rather than function and quality of life. Middle-aged adults who develop functional impairment identified several key unmet needs, including psychosocial support and a clinical focus on function. Understanding and addressing these needs will be necessary to deliver optimal care to this population.