Characteristics of occupational therapy and physiotherapy within the context of reablement in Swedish municipalities: A national survey

Abstract

Reablement is a multidisciplinary, home‐based intervention implemented for people at risk of functional decline and losing independence aiming to optimise functioning and independence in activities of daily living. There is limited knowledge about what characterises the intervention and the role of different professionals. The purpose of this study was to explore the characteristics and differences of occupational therapy and physiotherapy interventions in terms of focus, content and duration within the context of reablement in Swedish municipalities. Web‐based surveys were used to collect data from 43 municipalities representing 25% of the population in Sweden. Data on intervention characteristics were reported for all cases receiving occupational therapy (n = 1,395) and physiotherapy (n = 1,006) over a 15‐week period. Data were presented descriptively, and differences between occupational therapy and physiotherapy were analysed using Chi‐square tests. The results indicated that reablement in Sweden was implemented for adults in all ages (19–103 years, median 81.0 years); 72% had home help. For both professions, a baseline assessment was made in fewer than half of all cases. There were significant differences between occupational therapists and physiotherapists regarding the focus and content as well as the number of contacts and duration of the intervention. For occupational therapists, walking indoors and self‐care were the largest focus areas, whereas for physiotherapists walking indoors and body function were the largest focus areas. For most cases, the intervention was completed within five sessions over a 6‐week period. This study provides the first picture of occupational therapy and physiotherapy within Swedish reablement contexts. In relation to the results, the focus of interventions, how assessments are made and how the intervention is implemented over time are issues that can be further elaborated.

Transitions between levels of dependency among older people receiving social care – a retrospective longitudinal cohort study in a Swedish municipality

“…However, practices such as preventive home visits or health promoting senior meetings were not part of ordinary practices at the time of data collection. In contrast, reablement was, and had been, part of the home health care provided by the municipality under study, as it is in many Swedish municipalities [ 30 ]. Three types of support were applied as exclusion criteria: support to informal caregivers, daily living support, and day centre.…”

Factors associated to functioning and health in relation to home rehabilitation in Sweden: a non-randomized pre-post intervention study

“…These indicate that the amount of training with professionals is a factor that needs to be considered when planning rehabilitation interventions, as it may have an impact on outcomes. Studies in Sweden have however shown that home rehabilitation interventions by occupational therapists and physiotherapists in Sweden consist of an average of five visits during a six-week period, which is a lower intensity than the home rehabilitation program in our study [ 14 ]. Our results would suggest that increasing in the intensity of professional training sessions in home rehabilitation may be necessary in clinical practice.…”

“…Research suggests the inclusion of occupational therapists and physiotherapists [ 38 ], which is supported by our results. Interventions made by occupational therapists such as housing adaptations and provisions of mobility devices may explain why occupational therapy rather than physiotherapy was associated with mobility outcomes in our study [ 14 ]. However, more research is needed regarding outcomes related to specific professions [ 13 , 39 , 40 ].…”

“…Home rehabilitation is not a unitary concept and programs can vary in how they are called, and its organization, content and target group [ 12 ]. In Sweden, occupational therapists and physiotherapists are the core practitioners in municipal home rehabilitation, and they work in close collaboration with home care services for adults of all ages [ 12 – 14 ], especially for older adults [ 14 ]. Different home rehabilitation programs share however common characteristics such as having a limited duration [ 8 , 15 ], and being intensive, multidisciplinary, person-centred and goal-oriented [ 8 , 15 , 16 ].…”

Promotion of Physical Activity Through Reablement for Older Adults: Exploring Healthcare Professionals’ Clinical Reasoning

“…This study was conducted in a Norwegian reablement setting, which likely has similarities as well as differences from other reablement settings around the world. Both PTs and OTs, home care staff, and, to some extent, RNs were included in the reablement settings included in our study, similar to reablement studies from other countries including Australia, 42 Sweden, 43 Denmark, 44 and Japan. 45 In the United Kingdom, however, reablement is provided through social services, and mainly social workers, and, to a lesser degree, OTs are reported to be involved in reablement.…”