1. Messecar, Deborah PhD, MPH, RN, CS

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Well-designed modifications in the homes of older adults, such as grab bars in the bathroom or handrails on stairs, are known to confer important benefits: they can facilitate function, preserve dignity, and improve the quality of life. But many family caregivers are uninformed about the types of modifications available and how they can be obtained and installed. At the School of Nursing at Oregon Health and Science University in Portland in 2000 and 2001, we conducted focus groups, as part of a study titled "Environmental Modification Information for Caregivers," with 43 caregivers of older adults with chronic conditions. The results were surprising. Caregivers were displeased with the three most common ways they obtained information about home modifications: catalogs, television, and the Internet.


Participants identified the following as essential to the information they receive on home modifications:


* a tailored focus-information geared toward the types of problems they are trying to solve


* ready availability-information that's easy to obtain when needed


* credible sources-resources more trustworthy than companies that have a commercial interest in their purchase of a product



Given their lack of confidence in choosing among alternatives, caregivers wanted guidance from skilled professionals (such as nurse case managers and occupational therapists) and more experienced caregivers in selecting appropriate home modifications. Unfortunately, many caregivers reported that they had little access to such professionals.


Clearly, typical strategies for informing caregivers about home improvements aren't adequate. Nurses could fill this gap, but only if they have adequate information on the available resources (Web sites, guides for equipment prescription and ordering, lists of community resources).