Farrar-Edwards' work on leading edge of examining effects of aging, functional independence

Leadership that Matters

Leadership is not just about the position one holds — it’s about bringing people together to accomplish something collectively. In this issue of Learning Connections, we are putting the spotlight on leadership that brings about change in the evolution of beliefs, values and behaviors.

Leadership that Matters is centered on the efforts of School of Education faculty and staff who are working locally, around the country and across the globe to make a positive difference in real and relevant ways.

Farrar-Edwards’ interdisciplinary work
on leading edge of examining effects of aging, functional independence

UW-Madison’s Dorothy Farrar-Edwards has dedicated much of her academic career to research that examines the effects of aging on one’s ability to live independently.

Summer 2018 Learning Connections CoverShe first started studying the reliability of performance-based assessments, designed to predict whether or not older adults possess the skills to live on their own, while earning her Ph.D. in experimental psychology at Washington University in St. Louis in 1980.

More than three decades later, Farrar-Edwards travels around the nation and across the globe working on this and a range of related topics, and sharing her expertise. In late May, she presented at the 2018 World Federation of Occupational Therapists’ Congress in Cape Town, South Africa, about a study looking at whether there is an optimal period when therapy is most useful in helping a patient who has suffered a stroke regain lost arm or hand function.

“The goal of my work is to contribute to the understanding of quality-of-life issues and well-being in older adults,” says Farrar-Edwards, whose research often centers on people dealing with the effects of a stroke, Alzheimer’s or a mild cognitive impairment. She is a Vilas Distinguished Achievement Professor of occupational therapy with the School of Education’s Department of Kinesiology, and leads the Collaborative Center for Health Equity in the School of Medicine and Public Health.

One interdisciplinary project Farrar-Edwards is currently working on is the development of the Menu Task tool, which is in response to the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. Due to this act, the Centers for Medicare and Medicaid Services (CMS) is considering asking healthcare providers to evaluate patients prior to being released from the hospital to see if they have the mental and performance skills necessary for independent living. Identifying people who are unable to live on their own could reduce caregiver burden and costly hospital readmissions.

To make such reform possible, CMS is in need of a screening tool that requires minimal equipment, is easy to learn, quick to administer and simple to score — all while being reliable in determining if one has the skills to live alone. These skills, often referred to as instrumental activities of daily living (IADL), include things like meal preparation, the ability to get around in a community and financial management skills.

Dorothy Farrar-Edwards pull quoteFarrar-Edwards and colleagues Gordon Giles of Samuel Merritt University in Oakland and Timothy Wolf at the University of Missouri in Columbia, have developed and are testing the reliability and validity of the Menu Task tool, which appears to check the boxes in regard to what CMS is looking for.

The test looks like a hospital food menu, and participants are asked to adhere to a set of rules while ordering off the menu — such as “select one meal item for each of the following meals: breakfast, lunch and dinner” and “select two or more Heart Healthy food items,” signified by a heart icon. Those who don’t pass the Menu Task would then undergo a more detailed assessment to determine if they, indeed, don’t possess the skills for independent living.

A team that includes two of Farrar-Edwards’ Ph.D. students, and five UW–Madison students with the Master of Science in Occupational Therapy Program, helped collect data and administer the Menu Task test to more than 200 people 55-andolder around the Madison area during the previous year.

Early results indicate the Menu Task is a reliable tool. Researchers next will be testing it in a hospital setting.

“Dr. Edwards is a renowned expert in rehabilitation science, especially around issues of aging, stroke recovery, measurement and recruitment,” says Wolf, an associate professor and chair of the Department of Occupational Therapy at the University of Missouri. “She is consistently sought out for advice, consultation and collaboration on a range of studies, including some of the largest scale multi-site clinical trials ever conducted in stroke rehabilitation. In addition she is an excellent mentor and a pleasure to work with.”

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