Defining community ambulation from the perspective of the older adult

Background: Little is known regarding destinations and distances necessary for independent community ambulation after enactment of the Americans with Disability Act. Objective: To qualitatively describe community locations visited by older adults and to determine ambulation distance required to visit these locations. Design: Descriptive study. Methods: Nineteen subjects, 65 years or older and who were independent with transportation, ambulation, and basic activities of daily living, were recruited from 4 senior centers in urban areas of central Alabama. The study was divided into 2 phases. In part 1, using qualitative methodology, older adults were interviewed to determine locations they visited in the community. In part 2, we visited the types of locations identified in part 1 and measured distances required to conduct business at each location. Obstacles, if any, to reaching these locations were identified. Results: Subjects had a mean age of 76.6 (5.8) years; 80% were women, and 50% lived alone in the community. Locations visited by subjects were identified and measured. Researchers categorized locations as essential, essential to some people, and nonessential. Essential locations included bank, doctor's office, and either a grocery store, pharmacy, and department store or a "superstore." A minimum of approximately 200 m was required for community ambulation to most locations, although this distance varied significantly among locations. Limitations: Geographic location and urban setting may not reflect distances necessary for rural residents. Conclusions: Physical therapists can use the 200-m distance as a starting point for goal-setting for older adults desiring a return to community independence.