Importance: Adults aging with intellectual and developmental disabilities (IDD) continue to face barriers to participation in meaningful occupation; moreover, the increased life expectancy of adults with IDD intensifies the need for age- and environment-specific support. Objective: To map and categorize transdisciplinary literature on environmental modifications and supports for adults aging with IDD. Data Sources: Studies published between January 1, 2000, and January 1, 2019, identified through PubMed and Scopus. Study Selection and Data Collection: Eleven articles met the inclusion criteria and contained information specific to occupational participation based on environmental modification (e.g., physical space, technology, universal design, type of living setting), social supports (e.g., family members, caretakers, peer groups, health care professionals, policies, organizational infrastructure), or both and adults age ≥35 yr with IDD. Findings: Eleven studies met the criteria for this scoping review. Thematic coding was used to examine the articles within one or more themes: definition of need, environmental risk and assessment, environmental setting, intervention and program planning, use of technology, and bureaucracy. Conclusions and Relevance: This review highlights collective and individual outcomes in the areas of assessment, intervention, and advocacy. Further research is needed within the scope of occupational therapy and disability studies that examines environmental factors and participation outcomes in this population. What This Article Adds: The authors define the interconnectedness of adults aging with IDD and environmental factors, identify barriers to participation, and guide occupational therapy practitioners’ logic on how to positively affect environmental change and supports through intervention.

Falls are a major public health problem for older adults, resulting in injuries and mortality. Screening is recommended to identify the multifactorial fall risks that can be addressed with interventions to prevent future falls. This study examined the utility of using the Rapid Geriatric Assessment (RGA) tool to identify fall risks across multiple settings. RGA data was collected at primary care sites, hospitals, long-term care settings, and community events (n = 8686, 65% female, mean age 77.6). Multinomial logistic regression was used to determine predictors of falls using the RGA. The FRAIL, SARC-F, Rapid Cognitive Screen and SNAQ measures all significantly predicted history of falls. The RGA provides a brief screening that can be used in any setting by multiple providers to identify fall risk.

In the wake of sociopolitical movements to address health inequities and race-based violence in the United States, there have been calls to take up antiracist practices in the occupational therapy profession. This call aligns with Vision 2025 and requires intentional dialogue and instruction on racism and antiracism, beginning in occupational therapy academic programs. Although it is important to engage in discussions on racism and antiracism, it is equally imperative that members of the profession take action to ameliorate the consequences of racism. In this column, we argue for the need for occupational therapy educators to take immediate action. We provide specific recommendations and strategies to broach these topics, examples of classroom activities, and practical approaches for translating these skills to fieldwork settings. Continued work is needed to establish robust policies and practices to ensure that all occupational therapy program graduates enter the workforce prepared to promote health equity through antiracism.

Date Presented 03/28/20 To address the growing number of older adults (≥ 65 years) living with multimorbidity conditions (two or more chronic diseases), OTs will need to utilize evidence-based tools to identify and manage these conditions. In addition to traditional activities of daily living, instrumental activities of daily living, and functional performance measures, the RGA has proven to be a useful assessment tool for OTs, linked to direct intervention planning and functional outcomes. Primary Author and Speaker: Selena Washington Additional Authors and Speakers: Julia Henderson - Kalb

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