Home-based occupational therapy can improve physical functioning in older adults with declining health

Nielsen TL, Petersen KS, Nielsen CV, et al.  What are the short-term and long-term effects of occupation-focused and occupation-based occupational therapy in the home on older adults' occupational performance? A systematic review  Scandinavian Journal of Occupational Therapy; 2017 Jul;24(4):235-248.

Review question                  

• How effective is home-based occupational therapy in helping older adults improve performance at relevant tasks and activities?

Background

• As adults age, a number of factors can hinder their ability to perform routine tasks and activities. This includes slowly progressive diseases, impaired body function and structure, and environmental and personal factors.
• Previous evidence has shown that older adults want to stay active and independent, but the previously mentioned factors can significantly reduce quality of life.
• Home-based occupational therapy has the potential of allowing older adults to remain active and independent despite the negative impacts of aging. This review was conducted to systematically examine the evidence relating to how effective home-based occupational therapy is in helping older adults stay active and independent.

How the review was done

• A detailed search of seven electronic databases for studies published up to 2015 was conducted. Studies that focused on an examination of the effectiveness of home-based occupational therapy among adults older than 60 with a reduced level of functioning due to health problems were included in the review.
• A total of 995 articles were identified in searches, and eight studies were included in the review after assessments for eligibility.
• The study authors did not mention a source of funding for this review.

What the researchers found

• The commonly identified types of home-based occupational therapy used a mix of cognitive, behavioural and environmental strategies. These strategies were found to significantly improve older adultsÕ ability to remain active and independent, particularly those with physical health problems.
• While the improvements were significant across studies, older adults found it difficult to maintain these improvements in the long term.
• Occupational therapy was found to be effective at improving physical functioning in older adults who had a stroke, ParkinsonÕs disease, or multiple, chronic health problems.

Conclusion

• This review found that home-based occupational therapy is effective at improving physical functioning in home-dwelling older adults who have had their health decline due to a number of conditions. The effects are more pronounced in the short term, and are less significant in the long term. Across studies, maintaining the improvements was difficult.