Discharge Decision-Making, Enabling Occupations, and Client-Centred Practice

Moats, Gillian

doi:10.1177/000841740707400203

Cited by 28 publications

(36 citation statements)

References 19 publications

(56 reference statements)

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“…A transitional coach and a personal health record made patients feel comfortable and safe (Coleman et al 2004;Parry et al 2008). Home visits revealed the importance of being at home for the elderly patient (Moats 2007), although other patients having COPD felt they were sent home too early (Clarke et al 2010). A practical patientcentered checklist improved patients' and families' preparedness for discharge (Grimmer et al 2006a, b).…”

Section: Discussionmentioning

confidence: 99%

“…Five studies used a quantitative design and were carried out as an intervention (Bull et al 2000;Coleman et al 2004;Jangland et al 2012;Preen et al 2005;Watkins et al 2012). Eight studies had a qualitative approach, using semi-structured interviews (Brooks 2002;Clarke et al 2010;Efraimsson et al 2006;Moats 2007), a combination of semi-structured interviews and focus groups (Griffith et al 2004;Reed and Stanley 2003), observation (Grimmer et al 2006a) and in combination with video-recorded meetings and follow-up interviews (Efraimsson et al 2004). Two studies were performed using both a quantitative and a qualitative approach (Grimmer et al 2006b;Parry et al 2008).…”

Section: Tools To Support Elderly Patients' Participation In Transitimentioning

confidence: 99%

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A review of the literature on patient participation in transitions of the elderly

et al. 2014

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Patient participation is highlighted in healthcare policy documents as an important area to address in order to improve and secure healthcare quality. The literature on healthcare quality and safety furthermore reveals that transitional care carries a risk of adverse events. Elderly persons with co-morbidities are in need of treatment and healthcare from several care professionals and are transferred between different care levels. Patient-centered care, shared decision-making and user involvement are concepts of care that incorporate patient participation and the patients' experiences with care. Even though these care concepts are highlighted in healthcare policy documents, limited knowledge exists about their use in transitions, and therefore points to a need for a review of the existing literature. The purpose of the paper is to give an overview of studies including patient participation as applied in transitional care of the elderly. The methodology used is a literature review searching electronic databases. Results show that participation from elderly in discharge planning and decision-making was low, although patients wanted to participate. Some tools were successfully implemented, but several did not stimulate patient participation. The paper has documented that improvements in quality of transitional care of elderly is called for, but has not been well explored in the research literature and a need for future research is revealed. Clinical practice should take into consideration implementing tools to support patient participation to improve the quality of transitional care of the elderly.

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Section: Discussionmentioning

confidence: 99%

Section: Tools To Support Elderly Patients' Participation In Transitimentioning

confidence: 99%

A review of the literature on patient participation in transitions of the elderly

et al. 2014

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“…Crennan and MacRae (2010) discovered that although occupational therapists with greater clinical experience were more likely to use a client-centered approach during interventions, achieving client-centered occupational therapy practice was inconsistent. In addition, discharge planning decision-making that incorporated client-centered models of care were found to be inadequate for those who were frail or cognitively impaired (Moats, 2006;Moats, 2007).…”

Section: Discharge Planning Differences Between the Novice And Experimentioning

confidence: 99%

Discharge Planning for the Elderly in Acute Care: The Perceptions of Experienced Occupational Therapists

Holm¹,

2012

Physical & Occupational Therapy In Geriatrics

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Providing medical care and making relevant discharge planning recommendations is critical to minimize risks, reduce hospital readmissions, and promote optimal functioning among the elderly population. Occupational therapists have an important role in making discharge recommendations to facilitate ongoing occupational engagement and adaptations. The purpose of this study was to examine the perceptions of the experienced occupational therapist in acute care on the key factors that are considered when making discharge recommendations for the elderly. Interviews with occupational therapists and field notes revealed the following five themes: Looking at the total picture; prioritizing client-centered collaborations; emphasizing cognitive functioning; enhancing occupational engagement; and framing assumptions about elderly discharge planning. Emphasizing a comprehensive, client-centered, and occupation-based assessment process that highlights client's values, self-care status, and cognitive functioning are the foundations of experienced occupational therapy practice with the elderly.

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“…In order to support the older adult who experiences a decline in health affecting function and prefers to remain at home, health and social practitioners need to know how to evaluate risk when the client's safety is a concern. While current research provides information on how practitioners define, identify, perceive, assess and manage such risk, the breadth and inconsistencies in research findings make it difficult for practitioners to apply them in their everyday practice (Clarke, 2000;Gunstone, 2003;MacCourt & Tuokko, 2010;Moats, 2007;Purdy, 2010).…”

Section: Introductionmentioning

confidence: 99%

Risk: ‘I know it when I see it’: how health and social practitioners defined and evaluated living at risk among community-dwelling older adults

MacLeod¹,

Stadnyk

2015

Health, Risk & Society

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Older adults are increasingly choosing to stay and age in their home or other place where they normally live, even when a change in their health reduces their ability to live independently creating concerns about their safety. In this context, community practitioners need to be aware of risk assessment and management strategies as they support their clients' choices when safety is a concern. This requires an understanding of living at risk and an ability to evaluate the client's risk status. This article is based on a qualitative research study in which we interviewed 12 Canadian community practitioners in 2012 and explored how they defined, perceived, assessed and managed risk and how they balanced their client's safety and autonomy. We used a grounded theory methodology to collect and analyse the data. We found that participants tended to define living at risk as a judgement about a client's impairment within an environment that can cause an event that has an increased potential for a negative consequence. We also found practitioners evaluated the client's risk by considering seven factors: the client's capacity and their support, the occurrence, imminency and frequency of the event, the severity of the consequences, and the number of other events co-occurring. In this article, we show that practitioners are comprehensive in their evaluation of the client's risk. Although practitioners saw risk and living at risk from a negative perspective, they were able to acknowledge that it could coexist along a continuum from safe to unsafe.

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Discharge Decision-Making, Enabling Occupations, and Client-Centred Practice

Abstract: Client-defined models of decision-making are insufficient for frail, cognitively- impaired people. A new, client-centred Negotiated Model of Decision-Making is proposed, which facilitates decisions to enable older people with their occupations.

Cited by 28 publications

References 19 publications

A review of the literature on patient participation in transitions of the elderly

A review of the literature on patient participation in transitions of the elderly

Discharge Planning for the Elderly in Acute Care: The Perceptions of Experienced Occupational Therapists

Risk: ‘I know it when I see it’: how health and social practitioners defined and evaluated living at risk among community-dwelling older adults

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