Environmental press and adaptation to disability in hospitalized live-alone older adults

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 s ample 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) pre dicted IADLs at 3 and 6 months after hospitalization (e.g., cooking, teleph one use, money management). IADLs, in turn, predicted living arrangements a t 3 and at 6 months after hospitalization. Results: The findings provided s trong support for the importance of assessing a broad range of competency v ariables when investigating adaptation to disability. Implications: The inc reased understanding of adaptation in live-alone older adults with a new-on set disability is particularly timely given the increase in live-alone olde r adults and the dire consequences associated with change in living arrange ment (i.e., mortality and morbidity) in this group.