There is strong evidence that occupational therapy improves functioning in community-dwelling physically frail older people.

Background Problems with mobility, functioning and social participation make living independently difficult for frail older adults. To continue living independently, therapy adherence is a prerequisite. The causes for non-adherence among older adults are multiple and complex, which is why insight into older adults’ perspectives regarding their functioning is an essential factor to increase therapy adherence. This study investigates the perspectives of older adults on their functioning, social participation and health, and the factors influencing these elements. Methods We conducted a qualitative study on the older adult’s perceived functioning, social participation and health. Fourteen home-dwelling older adults suffering from chronic health issues were purposively selected. Semi-structured interviews were conducted with open-ended questions. Data were analysed following the Basic Logical Model of Abduction and Creswell’s coding method. Results Assistive devices, the older adult’s dwelling and living environment, professional and informal support, and medication are perceived as important determinants for retaining functioning and social participation. Attitude, social influence and personal effectiveness were found to influence whether a person performs or participates in an activity. A person’s attitude is related to the significance the activity has to that person, the activity’s importance, personal wellbeing, the person’s values, and their desire for autonomy. Peers and children have a social influence on the level of activity of the older person. Traditions, in particular religious activities, along with personal effectiveness are motivating factors determining whether a person performs or participates in an activity. Personal effectiveness is linked to the person’s belief in their personal competencies and to the relationship between effort and result. Finally, it appears that the type of coping strategy the older adult adopts, has an influence on their behavior. The participating older adults often used remarkable problem-focused strategies, which had a positive effect on their level of autonomy. Conclusions Older adults have identified barriers and facilitators that influence their level of functioning and social participation. These findings help to create a framework for maintaining and increasing therapy adherence, which may be helpful in facilitating occupational therapists and other healthcare professionals to detect determinants of therapy adherence.

Background This study investigated the perspectives of primary care professionals, in particular general practitioners, registered nurses, physiotherapists and occupational therapists, on inter-professional collaboration, the barriers and the facilitators they perceive in the care of the frail older population. Methods We conducted a qualitative study. In-depth interviews with healthcare professionals were performed, using open-ended questions about their perceptions on the care of frail older adults and inter-professional collaboration. Data was analyzed following the Basic Logical Model of Abduction and Creswell’s coding method. Results Healthcare professionals indicated that when they explored problems complementary to the reasons for older people to contact a healthcare professional, these additional problems often seemed to be the main problem. They also stated that there was too little inter-professional collaboration in the care of complex chronic issues and lack of a shared vision on collaboration. Collaboration is still limited too much to contacting established professions. Health information technology can support both, inter-professional collaboration and working on an evidence-based manner. It can also be a facilitator to inform patients. The availability and use of health information technology differs between the professions. Success factors and barriers for sustainable collaboration were identified on several levels, namely innovation, individual, professional, patient, social context, context of the organization, economic and political context. Conclusions Our study shed light on the willingness and barriers in collaboration of healthcare professionals in primary care for older adults. There is little inter-professional collaboration, despite the willingness of the healthcare professionals to collaborate.

BackgroundProblems with mobility, functioning and social participation makes living independently difficult for frail older adults. Treatment adherence is a prerequisite for successfully continuing to live independently. The cause of non-compliance among older adults are multiple and complex. Insight into older adults’ perspectives regarding their functioning is essential and an important factor for treatment adherence.Objectives This study investigates the perspectives of older adults on their functioning, social participation and health, and the factors influencing these components.Method We conducted a qualitative study about the older adult’s perceived functioning, social participation and health. Fourteen home dwelling older adults suffering from chronic health issues were purposively selected. Semi-structured interviews were conducted with open-ended questions. Data were analysed following the Basic Logical Model of Abduction and the coding method of Creswell.ResultsAssistive devices, their dwelling and living environment, professional and informal support, and medication are perceived as important determinants. Attitude, social influence and personal effectiveness were found to be of influence whether or not a person will perform an activity, or choose to participate. A person’s attitude is related to the significance the activity has to that person, the importance of the activity, personal wellbeing, their values and the desire for autonomy. Peers and children have a social influence on the level of activity of the older person. Traditions and in particular, religious activities, along with personal effectiveness are motivating factors for whether or not to perform an activity or to participate. Personal effectiveness is linked to the belief in their personal competencies and to the relationship between effort and result.Finally, it appears that the type of coping strategy the older adult adopts, has an influence on his or her behavior. The older adults often used remarkable problem-focused strategies, which had a positive effect on their level of autonomy.ConclusionOlder adults have identified barriers and facilitators that influence their level of functioning and social participation. These findings help to create a framework for maintaining and increasing treatment adherence. This conceptual framework may be helpful in facilitating occupational therapists and other healthcare professionals to detect determinants of treatment adherence.