Do occupational therapy pre-discharge home visits affect the longer term outcomes of the discharge process?

Abstract

Background: Pre-discharge occupational therapy home assessments are routinely performed with older adults in Europe, Australia, and North America. Their primary aim is to facilitate a timely and safe discharge. There has been remarkably little research on the impact of pre-discharge occupational therapy home visits upon the subsequent discharge outcomes. Aim: The purpose of this study was to determine whether pre-discharge home visits from an acute care National Health Service hospital enable an older person to remain at home, whether pre-discharge home visit prevents re-admission to hospital and whether occupational therapy recommendations made on the pre-discharge visit were still complied with two years after discharge. Method: Medical notes of 7 older adults were retrospectively analysed in May 2007 two years after their pre-discharge home visits carried out in 2005. A non-standardised pre-designed data collection tool was used in the medical note analysis. Results: The findings from this exploratory study suggest that occupational therapy pre-discharge home visits may have a positive effect in enabling frail older adults to remain living at home, that re-admissions following home visits in the current sample were for medical rather than functional reasons and that not all the recommendations made by occupational therapists were complied with. Conclusion: It is suggested that further research needs to be done to determine whether occupational therapists in acute care services have a wider role in the management of more frail older adults with long term and deteriorating conditions. There needs to be an acknowledgement that the compensatory approach used within pre-discharge home visits may be of benefit to many older clients.