Older adults and carers' perceptions of pre-discharge occupational therapy home visits in acute care

Abstract

the findings suggest that the current model of pre-discharge home visits does not promote health and well being. For some older adults the home visit provoked anxiety, however home visits are important to carers.

Occupational therapy assessments used in acute physical care settings

“…Atwal et al (17) found that home visits in acute care practice were of more value to the carer than the client because of the opportunity to be involved in discharge procedures. For clients, there was a level of anxiety about the home visit related to feeling that it was a test and not knowing the implications because there was inadequate information about procedures.…”

Occupational Therapy Predischarge Home Visits in Acute Hospital Care: A Randomized Trial

“…Immediately after discharge, older people have significantly lower functional status and a higher rate of functional decline, are at significantly greater risk of adverse events, and have more environmental safety problems and more postdischarge mobility and transportation restrictions than younger individuals. For older adults, return to home is fraught with challenges, with risks including loss of independence and control and fear of failure . Health services provide discharge planning interventions during hospital admission in an effort to address these challenges.…”

“…There are no accepted policies or guidelines for discharge planning. Occupational therapy discharge assessment and decision‐making is usually unstructured and is inconsistent in following client‐centered practice, yet it should support multiple factors that are unique to each individual . A Cochrane review found that discharge planning reduced readmission rates, with most benefit coming from interventions that provided support from hospital and in‐home follow‐up, but it is unclear whether this discharge planning intervention should include home visits (a more time‐intensive and therefore costly intervention than in‐hospital discharge planning interventions).…”

Medical Patients' Experiences of Inreach Occupational Therapy: Continuity between Hospital and Home

“…In a review of literature, Harris et al (2008) concluded that understanding a patient's function in both hospital and home environments is crucial to a sustainable discharge home. However, there is limited evidence that identifies the optimum timing of visits to aid transition home, or the psychological effect of predischarge assessment visits on patients (Atwal et al 2008). Literature reviews have questioned the evidence for the cost-effectiveness of predischarge home visits (Harris et al 2008, Provencher et al 2009.…”