Starting point: Preventive programs for older adults should focus on promoting aging in their place of residence. A safe household without barriers is one condition for maintaining a high quality of life and supporting self-sufficiency. The occupational therapist plays a key role in evaluating the home environment and supervising follow-up interventions. Aim: This review study aims to clarify the role of occupational therapist interventions in the home environment of older adults and describe the most common and significant risks and subsequent modifications to the environment to create a safe home and prevent falls based on best practices. Methods: This is a review of published literature between 2013 and 2024 using the PRISMA methodology. The electronic databases Web of Science, Scopus, EBSCO, and PubMed were searched. Results: Of the 198 sources, 10 studies met the analysis criteria. Risky areas in older adult homes and possible interventions to increase safety are clearly listed. The areas with the greatest security risk are the bedrooms, bathrooms with toilets, and stairs. Various obstacles, including carpets, objects placed at an inappropriate height, a low toilet, or insufficient lighting, were among the most common causes of falls. Conclusions: Studies point to the importance of promoting self-sufficiency and raising awareness regarding aging modifications to the homes of older adults.
Background: Coordinated rehabilitation plays a crucial role in helping patients with acquired brain injury (ABI) to return to active lives. Cooperation between occupational therapists (OTs) and social workers (SWs) is very important during the hospital-to-home transition. Aim: The primary objective of the project was to map the coordinated rehabilitation of individuals after ABI within their social environment, aiming to help patients reclaim their lives despite the limitations of ABI. The purpose of this article is to identify and describe the impact of medical-social rehabilitation relative to interprofessional cooperation between OTs and SWs in the patient's home environment. The focus is on identifying the critical elements needed to maximize specialist collaboration. Methods: The research was designed as an experimental qualitative study with auxiliary quantitative indicators in 17 case studies. The study included semi-structured interviews. In addition, the FIM system® and WHODAS 2.0 were used to objectify patient status monitored over time in individual cases. Results: Five critical elements of cooperation were identified: (1) Quality of life, (2) Self-sufficiency, (3) Evaluation of the home, physical, and social environment, (4) Indication of aids, barrier-free modifications, and their financing, (5) Connection of health and social areas. After coordinated intervention, patients reported a gradual increase in their quality of life and self-sufficiency. The next continuity of rehabilitation services is very desirable, at least for maintaining the effect. Conclusion: Specialist cooperation prevents patients from getting lost in the complicated systems of health and social services. It maximizes access to and effectiveness of these services, including the availability of financial aid and psychological support.
- MeSH
- ergoterapie * metody MeSH
- kazuistiky jako téma MeSH
- kvalita života MeSH
- lidé MeSH
- mezioborová komunikace MeSH
- samostatný způsob života výchova MeSH
- sociální práce metody MeSH
- traumatické poranění mozku * rehabilitace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovenská republika MeSH
Úvod: Článek poukazuje na důležitost komunitních služeb pro osoby po získaném poškození mozku a na chybějící návaznost rehabilitace při jejich propuštění do domácího prostředí, které je často nevyhovující vzhledem k nastalé disabilitě. Odborné zhodnocení a vedení odborníky z rehabilitace ve spolupráci s rodinou je nezastupitelné. Cíl: Cílem sdělení je předložit výsledky ergoterapeutické intervence v rámci koordinované komunitní rehabilitace. Hlavním cílem je řešení disabilních situací osob po získaném poškození mozku v domácím prostředí, které souvisejí zejména s evaluací bytu a indikací facilitačních prostředků. Metody: Byla použita metodologická triangulace s převahou kvalitativní části v rámci akčního výzkumu 3měsíční koordinované interprofesní rehabilitace v domácím prostředí. Technikami sběru dat jsou rozhovory s klienty a jejich rodinnými příslušníky, pozorování v domácím prostředí, analýza dokumentů a využití standardizovaných testů (FIM, WHODAS 2.0) pro hodnocení vývoje soběstačnosti, funkčního stavu a subjektivního vnímání kvality života probandů. Výsledky: Do finálního zpracování výsledků se zaměřením na ergoterapeutickou intervenci bylo zařazeno celkem 17 osob z Jihočeského kraje a doplňkově 6 osob z oblasti Praha a Středočeský kraj. Celkově převažuje diagnóza cévní mozková příhoda. V rámci identifikace bariér a facilitátorů výrazně zaznívá rodina klienta. Zároveň většina klientů potřebovala menší úpravy či drobné pomůcky indikované ergoterapeutem, tedy zejména finančně méně náročné facilitátory, které jsou ale zásadní z hlediska soběstačnosti a bezpečnosti v provádění běžných denních aktivit. U osob s tetraplegií či těžší hemiparézou byly indikovány zásadnější úpravy jako např. bezbariérový výtah, instalace rampy, plošiny, schodolezu či řešení bezbariérové koupelny se sprchovým koutem. Zde se jeví jako velice žádoucí spolupráce se sociálním pracovníkem ohledně financování. Závěr: Klienti vnímají pozitivní přínos intervence, chybí jim ale další návazná rehabilitace. Ergoterapeut je v týmu nenahraditelný. Z analýzy rozhovorů je patrná potřeba péče rodiny o klienta, ale nelze zanedbávat ani péči o rodinu a její vedení. Obě potřeby by měly být pro odborníky apelem na kvalitní interprofesní přístup, kdy je rodina s klientem plnohodnotnou součástí týmu.
Aim: The aim of the article is to present the results of occupational therapy intervention in the framework of coordinated community rehabilitation. The main aim is to address the disabling situations of people after acquired brain injury in the home setting, which are mainly related to the evaluation of housing and the indication of facilitation resources. Methods: A methodological triangulation was used with a predominantly qualitative component in an action research study of a 3-month coordinated interprofessional rehabilitation in a home setting. The data collection techniques are interviews with clients and their family members, observations in the home environment, document analysis and the use of standardized tests (FIM, WHODAS 2.0) to assess the development of self-sufficiency, functional status and subjective perception of the probands quality of life. Results: A total of 17 people from the South Bohemia region and 6 additional people from the Prague and Central Bohemia region were included in the final processing of the results focusing on occupational therapy intervention. Overall, the predominant diagnosis was stroke. As part of the identification of barriers and facilitators, the client‘s family plays a significant role. Most of the clients needed minor adjustments or minor aids indicated by the occupational therapist after the stroke, i.e. especially financially less demanding facilitators, which are essential in terms of independence and safety in performing normal daily activities. For people with tetraplegia or more severe hemiparesis, more substantial modifications were indicated, such as a wheelchair lift or installation of a ramp, platform, stair lift, or a wheelchair accessible bathroom with shower. Here, cooperation with a social worker regarding funding seems to be highly desirable. Conclusion: Clients perceive the positive benefits of the intervention but lack further follow-up rehabilitation. The occupational therapist is irreplaceable in the team. From the analysis of the interviews, the need for family care for the client is evident, but the care and guidance of the family cannot be neglected. Both needs should be an appeal to professionals for a quality interprofessional approach, where the family and the clients are a full part of the team.
- MeSH
- domácí životní podmínky MeSH
- dospělí MeSH
- ergoterapie * metody MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- poranění mozku * rehabilitace MeSH
- rehabilitace po cévní mozkové příhodě metody MeSH
- rodina MeSH
- samostatný způsob života statistika a číselné údaje MeSH
- sběr dat metody MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
Objectives: The article points out the importance of coordinated rehabilitation in the personal social environment of people with acquired brain injury (ABI) after discharge from the treating medical facility. We compared the client’s/patient’s subjective perception of their quality of life and special needs several years after ABI to those same items immediately after the coordinated rehabilitation period. Methods: The research was designed as a qualitative pilot study with auxiliary quantitative indicators. It was a longitudinal six-year study, concluded in April 2021 with a computer- assisted telephone interview (CATI) to determine the status and needs of participants. There were 17 client/patient participants. Results: Research suggests that if therapy after ABI is not continued, clients/patients often reverse the gains made during 3-month coordinated interventions and, according to WHODAS 2.0, can return to pre-intervention levels within a year. Three or more years after ABI, clients/ patients subjectively perceive that improvement in their condition has stagnated or has only slightly improved, and most reported a deterioration in their quality of life. Conclusion: While participants were coping with their ABI, it was clear that long-term follow-up involving rehabilitation or at least longer-term professional help and support was desperately needed to help clients/patients maintain their initial improvements.
