CLIENT-CENTRED OCCUPATIONAL THERAPY IN THE HOMES OF ELDERLY CITIZENS IMPROVES THEIR OCCUPATIONAL PERFORMANCE. RESULTS FROM A RANDOMIZED CONTROLLED TRIAL.

Background: In Denmark, community-based rehabilitation services, including occupational therapy, are offered to senior citizens who struggle with performing daily activities. The intention is to improve clients’ level of... [ view full abstract ]

Background:
In Denmark, community-based rehabilitation services, including occupational therapy, are offered to senior citizens who struggle with performing daily activities. The intention is to improve clients’ level of functioning while ensuring that intervention goals are decided through shared decision-making. However, occupational therapists fear that current restorative home care models, that focus mainly on problems addressed by municipal home care services (self-care and domestic chores), may erode their client’s access to meaningful occupation.
Method:
In this randomized controlled study, intensive, client-centred occupational therapy (ICC-OT) was compared to usual non-client-centred practice (usual-care). Performance and satisfaction on the COPM served as primary outcomes.
All participants (N=119) could receive home care, physiotherapy and assistive devices if found to meet the requirements of the municipality.
In addition, the ICC-OT group (n=59) received 11 weeks of home occupational therapy addressing client-chosen performance issues.
The usual-care group (n=60) received no additional services or up to three weeks of restorative home-care.
Results:
The initial results show that the ICC-OT group improved significantly on performance and satisfaction on the COPM compared to the usual-care group. Further analyses are performed in winter 2015/16.
Conclusion:
Outcomes suggest that ICC-OT is more effective in improving performance and satisfaction with client-identified occupational goals than usual-care.
Application to Practice:
This may inspire planners of restorative home care to take a more client-centred perspective when aiming to improve senior citizens’ performance of daily activities.

Financial support by The Tryg Foundation, MarselisborgCentret, VIA University College and
The Danish Association of Occupational Therapists is gratefully acknowledged.