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Evaluation of an agency-based occupational therapy intervention to facilitate aging in place
- Authors:
- SHEFFIELD Chava, SMITH Charles A., BECKER Mary
- Journal article citation:
- Gerontologist, 53(6), 2013, pp.907-918.
- Publisher:
- Oxford University Press
Purpose: The United States faces a growing population of older adults and accompanying functional disabilities, coupled with constrained public resources and diminishing informal supports. A variety of interventions that aim to improve client outcomes have been studied, but to date, there is limited translational research that examines the efficacy of moving such interventions from clinical trials to agency settings. Methods: A randomized controlled trial was conducted to evaluate a restorative occupational therapy intervention relative to “usual care” among community-dwelling older adults. The intervention included a detailed assessment from a person–environment perspective and provision of adaptive equipment and home modifications where appropriate. The intervention (n = 31) and control groups (n = 29) were evaluated at 3 months and assessed for changes in functional status, home safety, falls, health-related quality of life (HRQoL; EQ5D), depression, social support, and fear of falling; a 4 subgroup analysis also examined outcomes by waiting list status. An informal economic evaluation compared the intervention to usual care. Results: Findings indicated improvements in home safety (p < .0005, b = −15.87), HRQoL (p = .03, b = 0.08), and fear of falling (p < .05, b = 2.22). Findings did not show improvement in functional status or reduction in actual falls. The intervention resulted in a 39% reduction in recommended hours of personal care, which if implemented, could result in significant cost savings. Implications: The study adds to the growing literature of occupational therapy interventions for older adults, and the findings support the concept that restorative approaches can be successfully implemented in public agencies. (Publisher abstract)
Workforce planning to achieve person-centred support
- Authors:
- VOLUNTARY ORGANISATIONS DISABILITY GROUP, ENHAM TRUST
- Publisher:
- Voluntary Organisations Disability Group
- Publication year:
- 2013
- Pagination:
- 8
- Place of publication:
- London
Workforce planning to achieve person-centred support’ offers unique insights into the employment challenges facing social care providers. It describes how Voluntary Organisations Disability Group (VODG) member Enham Trust developed a workforce to support personalisation and person-centred care. The steps taken to change the workforce include: comprehensive re-assessment with individuals in relation to their hourly needs for care and support; aggregating the core hours required to deliver safe personal care and analysing how much of the time remaining available could be used “flexibly”; consulting staff about contracts; embedding principles of personalisation, for example, through a series of training workshops; changing job specifications, titles and content, from that of a support worker to a personal assistant; re-interviewing senior care staff to underline the aim of creating major change - not just the same way of working under a different title. Key factors that help make the process successful include strong leadership, the involvement of individuals’ families, and clear communication and targets. The learning shared from Enham’s experience of introducing a personal assistant workforce will be useful for providers and commissioners in shaping a workforce that is equipped to deliver truly personalised care and support. (Edited publisher abstract)