Occupational Therapy Home Assessment Research Articles

A systematic and critical review of the literature: The effectiveness of Occupational Therapy Home Assessment on a range of outcome measures

Aim: To identify, collate and assess the findings of the available literature regarding discharge planning involving occupational therapy home assessments and the identified outcome measures. A systematic critical review of 31 studies of home assessment was completed. Methods: A comprehensive computer‐aided search was conducted of 10 databases. Any searches identifying literature on home assessment and occupational therapy were retained. The McMaster critical appraisal tools were used to determine methodological quality, the McMaster (qualitative and quantitative). Summaries were made of the key features of each study to enable comparison. Results: Two systematic reviews, eight randomised controlled trials, 16 descriptive and five anecdotal studies were found. Twelve papers relating directly to occupational therapy were identified. A wide variety of outcome measures were identified, covering seven major categories of: personnel present, cost, frequency and when a home assessment was completed, readmission to hospital, stakeholder perspective and use of standardised assessments. There was minimal consistency in measuring outcomes. The McMaster critical review format was used to evaluate each paper and denote a score out of 15 for quantitative and 27 for qualitative papers. These forms are written in basic terms that can be understood by researchers as well as clinicians and students. Conclusion: Low numbers of high level (levels 1, 2) or high quality publications directly relevant to the effectiveness of occupational therapy home assessment and discharge planning were identified. It is apparent from the paucity of quality and quantity of studies identified in this current review that considerably more high‐quality research is required prior to definitive recommendations being made regarding the use of occupational therapy home assessments in discharge planning.

Home Assessment Visits within the Acute Setting: a Discussion and Literature Review

The emphasis on the effective and efficient use of finite resources within acute hospitals has led to close attention being paid to the length of patients' hospital stay and the assessment of risk in facilitating timely hospital discharge. Occupational therapy home assessment visits are valued by the multidisciplinary team as a means of assessing a patient's level of function and environmental risk to ensure safe discharge from hospital. Occupational therapists' education and training and experience mean that they are well placed to predict levels of function postdischarge and to anticipate any problems that may occur in activities of daily living. However, for patients the home assessment visit can be a stressful and bewildering experience. The short-term focus on equipment provision combined with limited postdischarge intervention may not meet patient and carer expectations or concerns with longer-term issues. Although there is a body of evidence to support this intervention, the requirement for evidence-based practice means that there is a need for additional research around the areas of optimal timing, selection of patient groups, therapist's rationale, patient and carer perspectives and any effect that home assessments may have on readmission rates. This paper discusses the literature in relation to the practice of home assessment visits from the acute setting.

Occupational Therapy Home Assessments

Aging in place, in one's home and community, is the goal of most older Americans. American society seeks to support independence and quality of life for older persons for humanistic reasons and to minimize health care costs. This is particularly important given growing numbers of the oldest-old, who are at higher risk for functional impairment and disability. Supportive environments, including housing, promote capabilities and independence. Heterogeneity among elders, however, requires interventions sensitive to cultural diversity, individual needs and goals. Client-centered occupational therapy home evaluations and interventions facilitate collaborative strategies for home modifications and adaptations to maximize safety and functional capabilities of frail elders for successful community living.

A survey of predischarge occupational therapy home assessment visits for stroke patients

Home assessment visits are a part of inpatient stroke rehabilitation programmes, but surprisingly little has been written about how often they are used or what they achieve. This study describes the use of home visits in 327 patients in a study of stroke rehabilitation after discharge from hospital. Home visits were noted in 149 (50%). A median of five problems were identified, most commonly involving mobility inside the property and the height of furniture hampering transfers. A median of four solutions were recorded, most commonly the provision of aids and equipment. Representatives of the community social and nursing services were present in a minority of visits. An occupational therapist (OT) from the Social Services was present in half the home visits in addition to the hospital OT. The study concludes that several important problems are identified on home visits and that simple solutions can be found in most cases. Social and health services, in Nottingham at least, should develop more rational working practices for home visits, so that liaison between hospital and community services is improved and duplication of work is avoided.

The occupational therapy home assessment: The home as a therapeutic environment

This article defines the environment's potential to "support competence, provide appropriate stimulation, and promote safety" by using examples and case data. The author fosters a great appreciation of the home as a medium for enhancing functional independence. This information is of vital importance to the home care professional who relates to the geriatric patient in the home setting.