Rehabilitation efforts aimed at improving the physical and emotional well being of frail elderly are often met with resistance. A number of physical, psychological, and social factors have been shown to affect participation. However, absence of an integrated theoretical framework that can be used to explain how these factors operate and interact to influence adherence behavior has limited the usefulness of epidemiological findings in enhancing participation and promoting wellness in the elderly. This study is an attempt to overcome these limitations by explaining response to rehabilitation on the basis of H. Leventhal’s (1980, 1992) “common sense model of self-regulation.” Qualitative and quantitative data collected through observation, interviews, and record review during a falls-prevention physical therapy program for homebound elderly in a long-term health care program in New York City were coded for content of representation (e.g., symptoms and their meaning), coping efforts used to deal with threats posed by both the condition and the “treatment,” appraisals used to test and validate representations, and differences in clients’ “common sense” and treatment provider’s “helping” models. The model of self-regulation explains how attempts by the frail elderly to balance both the fragile physical and psychological experience of their condition affected response to the rehabilitation regimen. Development of a therapeutic alliance, shared representations, and common rehabilitation goals would enhance participation and increase wellness through the ability to monitor and reshape interpretations, coping procedures, and appraisal criteria.
Learning Objectives: Participants in this session will learn the physical and psychological symptoms used by frail elderly in making health decisions and will be able to identify the significance of those decisions in maintaining a fragile balance that may or may not be adaptive in promoting well being. At the conclusion of the session, the participant will be able to use this information to develop treatment programs that are client centered and more likely to be accepted by the frail elderly and successful in promoting adaptive health behaviors.
Keywords: Frail Elderly, Health Behavior
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.