Content and acceptability of an Occupational Therapy intervention in HomEcare Re-ablement Services (OTHERS)

Abstract

Introduction: Despite clear compatibilities between the tenets of occupational therapy and re-ablement, there is limited research on occupational therapy in homecare reablement services. This paper describes the content of an occupational therapy intervention that was delivered in homecare re-ablement services as part of a feasibility randomised controlled trial (OTHERS). It also evaluates whether the intervention was acceptable to the participants who received it. Method: There were three phases. 1.) A bespoke pro forma was completed recording the activities undertaken after each therapy visit. 2.) An acceptability questionnaire was sent by post to every intervention participant. 3.) Semi-structured interviews were completed with key informants who received the intervention. Results/Findings: The principal activities undertaken were: assessment; case management; goal setting; advice and support; and practising activities. It was possible to implement a graded programme for participants' main goals in relation to bathing/showering or kitchen activities. Participants particularly valued the advice and support provided, however, there were difficulties due to fluctuations in circumstances and with activities of daily living (ADL) outside the home. Participants also had outdoor mobility goals but there were difficulties working on these within the 6-weeek timescale. Conclusion: An intervention focussing on ADL within the home was acceptable for participants and consistent with their goals and objectives; however, they also had goals beyond personal ADL and the timescale of the re-ablement episode which were not met. Further research should focus on extended ADL at a later stage beyond the time-limited period.

A Qualitative Study of Older Adults’ Experiences of Embedding Physical Activity Within Their Home Care Services in Ireland

“… 25 Other studies have also found poor health to be a barrier to being active. 11 , 26 The weather being a barrier reflected the country where the research was undertaken, with this current study taking place in Ireland, where rain was the perceived barrier, as was the case for another study with home care clients in the United Kingdom, 26 whereas the Australian study 25 reported hot weather in the summer (ie over 30°C for prolonged periods of time) as their barrier to participation.…”

Exploring the experience of reablement: A systematic review and qualitative evidence synthesis of older people's and carers' views

“…Some older people and their carers described the ending of the reablement period as abrupt and suggested a need for a smoother transition at the end of the intervention period. Older people and their carers reported feeling stressed and anxious about their future when services were reduced (Beresford et al, 2019; Bødker et al, 2019; Hjelle, Alvsvag, et al, 2017; Jakobsen et al, 2019; McLeod & Mair, 2009; Östlund et al, 2019; Whitehead et al, 2018).…”

Integration of physical activity in reablement for community dwelling older adults: a systematic scoping review

“…After screening 2,304 unique records, of which 236 were examined in full-text, 43 articles met our eligibility criteria and served as the overall data material for the scoping review (illustrated in Figure 1-Prisma Flow Diagram). Among these studies were 12 intervention studies, including ve RCTs (30)(31)(32)(33)(34), ve non-randomized controlled trials (35)(36)(37)(38)(39) and two non-controlled pre-post study (40,41), in addition to one RCT long-term follow up study (42); four studies with mixed design/other (43)(44)(45)(46); three studies based on quantitative research (47)(48)(49); and 23 qualitative studies, of which 15 focused on HCPs' perspectives (50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64), six on older adults' perspectives (65)(66)(67)(68)(69)(70) and two on family members perspectives (71,72).…”

“…(Add Table 1 here) Q2 -Experiences and barriers for PA Older adults' perspectives Six qualitative studies explored older adults' experiences of participating in reablement (65-70), of which three qualitative studies (two Norwegian and one from the United Kingdom) (67,69,70) and also one mixed method study (45) touched upon themes related to PA, which are summarized in the following. Additionally, one Australian mixed-method study investigated motivators and barriers to being physically active for older people (70+) that previously had received either reablement or usual home care services (43), and one Norwegian quantitative study explored which occupations and rehabilitation goals older people prioritizes in a reablement setting (75).…”

“…In a study from the UK by Wilde et al (2012), service users expressed frustration at the limited access to wider sources of professional expertise (social workers and OTs were involved in that setting), particularly with the aim of maintaining or improving their ability to walk outdoors and manage stairs so that they could participate in social activities (70). Likewise, another UK study reported that outdoor mobility goals were di cult to reach due to uctuations in the users' health or weather conditions (45). Tuntland et al (2019) investigated what types of activities or tasks that older adults that had participated in an Norwegian RCT (33) reported as di cult to perform, and which activities they prioritized as rehabilitation goals (75).…”