A profile of practice: The occupational therapy process in community aged care in Australia.

Abstract

Occupational therapists working in community aged care play a key role in service provision because of their expertise in considering the person, their occupations, and environmental context. To further understand occupational therapy practice in community aged care, this study aimed to explore the approaches, models, frames of reference, assessments, interventions, and outcome evaluation methods being used by Australian occupational therapists in aged care. An online questionnaire was developed, piloted, and delivered to occupational therapists working in community aged care in Australia. Responses to closed-ended questions were analysed using descriptive statistics, and a summative approach to content analysis was applied to open-ended questions. Seventy-one occupational therapists employed in community aged care across Australia participated in the questionnaire. Almost half of the respondents were employed in private practice. All respondents used a compensatory approach to practice, whereas just over three-quarters used a restorative approach. The Person-Environment-Occupation (PEO) model was the most frequently used occupation-focused model (n= 45). The biomechanical and rehabilitative frames of reference were each used by over two thirds of respondents. Cognitive assessments were most common, followed by functional and environmental assessments. The interventions of equipment and home modifications were very common followed by remedial therapy. Community aged care occupational therapists show coherence in theory-to-practice application, but there is wide diversity in practice decisions and possibly gaps in practice. Occupational therapists remain firmly client centred but apply compensatory approaches more than reablement approaches. This trend may be due to the influence of aged care funding models and limits on time. In addition to reacting to crisis, there is scope for occupational therapists to have a greater focus on early intervention to support dementia care and prevent falls.