Reducing Disability in Older Adult Cancer Survivors

Description

Older adults who are treated for cancer are at risk of developing disabilities due to the symptoms of cancer and the side effects of treatment. Disability occurs when a person has trouble performing the activities he or she needs to do in everyday life. For example, fatigue and pain can make it difficult for an older adult to do housework, leisure, or volunteer activities. Disability makes it harder for older adults to stay active and be productive members of the community, and it can increase the costs of healthcare. Current approaches to cancer rehabilitation focus on using exercise, education, and social support to reduce cancer treatment side effects. These are important strategies to reduce disability, yet some side effects persist despite best efforts to resolve them. To fully reduce disability, people often need to adapt their activities or the environments in which they are performed. The goal of this study is to test an occupational therapy (OT) intervention that teaches explicit problem-solving skills to foster survivors' ability to adapt activities, routines, and environments in order to minimize disability. The project targets adults over the age of 65 who have completed definitive cancer treatment, but are experiencing residual disability. The project has two stages. First, twelve older adult cancer survivors will individually participate in the community-based intervention. After they have completed the program the investigators will revise the intervention to emphasize what they found most effective and helpful, and to eliminate aspects of the intervention that are perceived as unhelpful or redundant. The research question for this first stage of the project is, "To what degree is it feasible for survivors to enroll in the study, complete the six-week intervention, and complete the three outcome assessments?" In the second stage of the project, the investigators will test the revised intervention, comparing it to conventional care. The research question for the second stage of the project is, "Do the people receiving the intervention have better problem-solving skills, lower levels of disability, and better quality of life compared to those people who receive traditional cancer care?" The intervention is appropriate for people who have been diagnosed with any type of cancer. It is designed to focus on whatever activities are most important to each participant. The novelty of the proposed intervention lies in the combination of the OT strategies of activity and environmental adaptation with explicit training in problem-solving to teach survivors to find creative ways to engage in valued activities (e.g., taking care of one's home and family members, and participating in leisure, community, social and work activities). If the intervention is effective in reducing disability, it will give us another tool to reduce the impact of cancer on the daily lives of cancer survivors.

Study Start Date

February 2013

Estimated Completion Date

August 2017

Interventions

  • Other: Usual care
  • Behavioral: PS-OT

Specialties

  • Oncology: Side Effects
  • Hospital Administration: Managed Care

MeSH Terms

  • Carcinoma

Study ID

Dartmouth-Hitchcock Medical Center -- D12110

Status

Unknown

Trial ID

NCT01709344

Study Type

Interventional

Trial Phase

N/A

Enrollment Quota

72

Sponsor

Dartmouth-Hitchcock Medical Center

Inclusion Criteria

  • Age 65 years or older.
  • Diagnosed with any solid or hematological cancer.
  • Completed cancer treatment with curative intent.
  • Evidence of complete response at three months post-treatment
  • maintenance therapy is permitted as long as there is no evidence of disease.
  • Experiencing disability as indicated by a score of > 3 on the Vulnerable Elder Survey.

Exclusion Criteria

  • Moderate or worse cognitive impairment as indicated by a score of 3 or less on the Callahan six-item cognitive screening tool.
  • Medical record documentation of severe mental illness (i.e., schizophrenia or bipolar disorder), active suicidal ideation, or active substance use disorder.

Gender

Both

Ages

65 Years and older

Accepts Healthy Volunteers

No

Study Locations and Contact Information (2)

Study Location Distance Name Phone Email
DartmouthHitchcock Medical Center - Lebanon, New Hampshire 105.5 miles None None None
DartmouthHitchcock Medical Center - Lebanon, New Hampshire 105.5 miles Sheree M McCleary 603-653-9128 Sheree.M.McCleary@hitchcock.org

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