Allocation of Rehabilitation Services for Older Adults in the Ontario Home Care System

Abstract

Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial.

Rehabilitation therapies for older clients of the Ontario home care system: regional variation and client-level predictors of service provision

“…This coincides with research findings that indicate that OT is primarily used for home assessment purposes in the Ontario Home Care System [48]. This finding also corresponds with a recent review of American home care services that found adaptation and environment as the most frequently referenced intervention [49].…”

Perfil de funcionamento do SAD, Serviço de Apoio Domiciliário - caso de Braga, Portugal.

“…Está demonstrado que, quanto mais as pessoas envelhecem, mais cuidados de saúde no domicílio vem associados às suas necessidades individuais de saúde uma prioridade fundamental (Hoeck, et al, 2011). Barbosa A sugestão que é feita no Canadá foca a optimização dos serviços de reabilitação, de forma a fazer chegar estes serviços aos idosos, e a promover que os mesmos sejam cada vez mais úteis para as pessoas e famílias que recorrem ao SAD (Armstrong, Sims-Gould, & Stolee, 2016).…”

Will virtual rehabilitation replace clinicians: a contemporary debate about technological versus human obsolescence

“…Home rehabilitation services help aging adults improve or maintain their quality of life, physical function and independence; in doing so it extends their time in the community and away from hospitals [ 24 , 25 ]. Despite this evidence, many clients who could benefit from home rehabilitation services do not receive them [ 26 ] and virtual rehabilitation can play a key role in this solution. The advantages of virtual rehabilitation discussed here, including cost-effectiveness and provision of care to remote areas not accessible to standard care, can increase health care quality and availability for all and support healthy aging in place.…”