Sunday, November 4, 2007

This presentation is part of : Elderly Care Strategies
Enhancing Home Safety for Frail Elders by Understanding the Meaning of Clutter
Evelyn R. Hayes, PhD, APRN, BC1, Lisa Plowfield, PhD, RN2, Jean Raymond, MSN, APRN1, and Elaine Greggo, MSN, APRN, BC1. (1) School of Nursing, University of Delaware, Newark, DE, USA, (2) College of Nursing, Florida Statre University, Tallahassee, FL, USA
Learning Objective #1: analyze home safety needs of frail elders.
Learning Objective #2: discuss meanings of clutter

The safety of one’s home may influence a frail elder’s ability to remain in his/her home.   Using the Omaha System to collect and analyze the comprehensive needs of 148 community dwelling elders led to an identification of residential safety hazards. A case study analysis approach was used to examine the meaning of clutter for those frail elders who exhibited this environmental need.  Clinician visits, chart documentation, and family informants were the sources of data.  The majority of frail elders resided in their own home or apartment; in one case the frail elder resided in a skilled nursing facility.  Within the dataset, 33% of frail elders had difficulties within their residence.   The most prevalent need leading to hazardous residential living conditions was that of cluttered living space.   One third of those with unsafe residential living had cluttered living spaces.  Preliminary findings indicated that clutter had multiple meanings for frail elders.  Upon in depth assessment and analysis, residential clutter was related to either personal/historical attributes or physical limitations associated with aging.   The meanings of clutter that reflected personal/historical attributes were hoarding behaviors, control over one’s environment, attachment to non-human entities, and memories of years of insufficiency during the U.S. Depression of the 1930s.  The second category of residential clutter reflected the inability to organize, lack of physical capabilities, and cognitive decline resulting in inattentiveness to one’s environment.   Handling clutter can be extremely stressful for the client and his or her family.  An individualized and personal understanding of the meaning of clutter must occur before effective interventions can be developed.