Thread by @KidneyMed

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 bit.ly/2Dzz3OE

@DrDeidraCrews @sarah_szanton @tkmcudjoe

This is an innovative pilot tested home based program for older low socioeconomic status adults on hemodialysis aimed at improving physical and social function.

@JanieceLTaylor @lakencroberts @DeanDrexelCNHP @Aging_scholar

Why: Older ESRD patients experience increased morbidity, fatigue and decreased physical function. Multiple studies note improvement in health/functional outcomes with social support however few intervention studies aim at improving this..

How: Patients identified functional and environmental barriers to social engagement through focus groups – this was mapped into a staggered 5 month program.

Barriers/Themes:
Fatigue
Lack of social support/engagement
Unable to live independently
Handyman services

Who: 12 English-speaking, low SES (<$25,000/year) HD patients >60 years old with ADL difficulties

Intervention: 5 month structured program of home visits with OT, nurse and handyman to provide <$1,300 in repairs modifications & devices

Results: At baseline the mean disability score for ADLs was 4.4 and IADLs was 6.3 (out of 16). All treated participants improved a mean of 2.3 ADL and 2.6 IADL disability; and social support and social network scores improved by 4.8 and 4.6, respectively.

Finally, a quote from the paper: “The shift in the [US] toward value-based care has elevated awareness that drivers of health largely fall outside of the bricks-and-mortar facilities of the health care system and can be found in the places where people live, work, and play.”

Check out the editorial accompanying this paper:

Addressing the Need for New Models of Care for Older Adults Receiving Long-Term Dialysis bit.ly/2Cu2aBn

@barrett_bowling @dukegeriatrics @dukekidney #geriatrics #dialysis