Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults.

Objective: To describe functional goals and factors associated with goal attainment among low-income older adults with disabilities living in the community.

Design: Secondary analysis. Setting: Participants' homes. Participants: Older adults (N=226) with disability who participated in the Community Aging in Place, Advancing Better Living for Elders trial. Interventions: A 5-month, home-based, person-directed, structured program delivered by an interprofessional team: occupational therapist, registered nurse, and handyman. Main outcome measures: Process of occupational therapist goal setting and attainment at the final occupational therapist visit.

Results: Participants identified 728 functional goals (mean of 3.2 goals per participant), most commonly related to transferring (22.0%; n=160 goals), changing or maintaining body position (21.4%; n=156 goals), and stair climbing (13.0%; n=95 goals). Participants attained 73.5% (n=535) of goals. Goal attainment was highest for stair climbing (86.3%), transferring (85.6%), and self-care (84.6%); walking goals were less likely attained (54.0%). Goal attainment was not associated with age, sex, education, depressive symptoms, function, or health-related quality of life but was less likely among participants who had severe pain compared with those without pain (adjusted odds ratio, 0.38; 95% confidence interval, 0.17-0.86). When participant readiness to change score increases by 1 point on the 4-point scale, goal attainment was 62% more likely (adjusted odds ratio, 1.62; 95% confidence interval, 1.14-2.29).

Conclusions: Home-based collaborative goal setting between older adults and occupational therapists is feasible and particularly effective when individuals are ready or willing to adopt new strategies to achieve identified goals.