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The hook. The poke. The blade. These words describe not a new surgical technique but the latest kitchen tool, called Open-It, designed by Columbia occupational therapy students and faculty to help seniors grasp a can's pull-tab, poke a hole in a juice box, and slice open a cracker box. And within a month, Citymeals-on-Wheels, a non-profit organization that delivers meals to New York City's seniors, should be ready to distribute Open-It to each of the nearly 20,000 homebound elders Citymeals serves.

While a new kitchen tool might seem trivial, Open-It solves a critical problem for elders. As many as 7 percent of elders in the United States 65 years and older and 12 percent 75 and older need help preparing meals and have increasing physical impairments that prevent them from being able to open food containers. When seniors cannot open food packaging, their nutrition and, ultimately, their overall health suffers.

The idea for the tool was hatched in 1999 during an occupational therapy fieldwork assignment. As part of a required geriatrics and gerontology course, students went to the Burden Center for the Aging, a Manhattan-based social service agency, to look at problems elders have and devise solutions, says Dr. Patricia A. Miller, assistant professor of clinical occupational therapy (in rehabilitation medicine) at P&S, assistant professor of clinical public health (in the Stroud Center) at the Mailman School of Public Health, and one of three faculty leaders of the Open-It project. The students met with Ms. Marlena Vaccaro, the director of Burden's luncheon program, who noted many elders had trouble opening food packages and needed help.

To investigate, the students designed a survey and polled homebound and other elders to understand the difficulties they had in opening food packages. The research confirmed elders had trouble opening the daily food packages they received from city government agencies and from Citymeals, which supplements the government-delivered food with shelf-stable canned goods (which usually have pull tabs) and weekend and emergency food.

The students then applied what they learned about problem-solving and designed a plastic prototype device with a protected blade and poking end. Pilot tested with 53 homebound elders and 11 elders at the Burden center, Open-It was modified and re-tested. Students then drafted a proposal and demonstrated to Citymeals the problems with its packages and how Open-It could open them more easily. The organization subsequently agreed to purchase 20,000, if Columbia could get the tool manufactured.

The next hurdle was finding money to support the tool's development. The Florence V. Burden Foundation stepped in and gave $15,000 to have the mold for the tool made. The occupational therapy program collaborated with Sara Ann Gusik, associate director of Columbia's Science and Technology Ventures, a division of Columbia Innovation Enterprises, to find a manufacturer who would let Columbia retain the mold's rights and to ensure the tool would be made well with good materials. The students and faculty ultimately decided to work with Enabling Devices, a company based in Hastings-on-Hudson, N.Y.

Then, just when the mold was almost ready late last year, donations to Citymeals declined because of the slowing economy, leaving the organization with insufficient resources to buy the tool. Again charities came forward to help fund the effort. The Starr Foundation and the Leo Rosner Foundation contributed what was still needed to pay for the tools.

Now, even as Enabling Devices is filling that first big order, research at Columbia is continuing under the direction of Dr. Miller and her colleagues, Dr. Janet Falk-Kessler, associate professor of occupational therapy (in rehabilitation medicine) and director of the occupational therapy program, and Dr. Jane Bear-Lehman, assistant professor of clinical occupational therapy (in rehabilitation medicine.)

Students and faculty are enhancing the instruction sheet for the tool, replacing much of the text with easier-to-understand photos. More prototypes will be tested to improve the device and the students are assessing the amount of training needed for the device. "We want to make sure the device works," Dr. Miller says. "We don't want the tool to be thrown in a drawer and forgotten about."