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Environmental Press and Adaptation to Disability in Hospitalized Live-Alone Older Adults

^a Institute of Gerontology, Wayne State University, Detroit, MI 48202
^b Sinai Grace Hospital, Detroit, Michigan
^c Institute of Gerontology, Wayne State University, Detroit

Correspondence: Peter A. Lichtenberg, PhD, ABPP, Wayne State University, Institute of Gerontology, 87 E. Ferry Street, Detroit, MI 48202. E-mail: p.lichtenberg{at}wayne.edu.

Laurence G. Branch, PhD

Purpose: This study examined the ability of personal competency variables at the time of hospital discharge to predict primary instrumental activities of daily living (IADLs) and secondary outcomes (living arrangements) in a sample of 194 urban, live-alone, older adults who had a new onset disability. Design and Methods: Consecutively admitted medical rehabilitation patients, 72% women and 85% African American, participated in the study. Using path analysis, three of the four competency variables collected at the time of hospitalization (cognition, medical burden, activities of daily living) predicted IADLs at 3 and 6 months after hospitaliza-tion (e.g., cooking, telephone use, money management). IADLs, in turn, predicted living arrangements at 3 and at 6 months after hospitalization. Results: The findings provided strong support for the importance of assessing a broad range of competency variables when investigating adaptation to disability. Implications: The increased understanding of ad-aptation in live-alone older adults with a new-onset disability is particularly timely given the increase in live-alone older adults and the dire consequences associated with change in living arrangement (i.e., mortality and morbidity) in this group.

Key Words: Activities of daily living • Cognitive functioning • Live-alone elders • Rehabilitation

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