Background and aim

Home rehabilitation is an increasing service in many countries due to the aging population. The body of knowledge in home rehabilitation is growing but results are inconsistent, and there is still lack of knowledge from user perspectives to guide practice and home rehabilitation programs. The purpose of this study was to explore valuable aspects of home rehabilitation experienced by older adults.

Methods

Fourteen older persons (nine older adults and five next of kins) were interviewed about their experiences of receiving rehabilitation in their homes. Nine de-identified interviews were analyzed as secondary data and with qualitative content analysis.

Results

A familiar home environment, inclusive collaboration, and the mastering of everyday life were aspects of value for older adults in home rehabilitation. Creating a tailor-made rehabilitation together with competent staff, building trust, and providing a sense of security in their homes were also considered valuable.

Conclusion

When using the home as an arena for rehabilitation and collaboration, interventions can be planned based on the older adult's unique conditions and the knowledge and skills of the multidisciplinary team, including the older adult and their next of kin. A valuable home rehabilitation can then be achieved that creates motivation, which in the long term probably also generates desired effects for the older adult. More research is needed on older adult's experiences of content in home rehabilitation programs so that practice develops in accordance with citizens' needs, individual resources, and relationships.

BACKGROUND: Home rehabilitation is a growing rehabilitation service in many countries, but scientific knowledge of its components and outcomes is still limited. The aim of this study was to investigate; 1) which changes in functioning and self-rated health could be identified in relation to a home rehabilitation program in a population of community-dwelling citizens, and 2) how socio-demographic factors, health conditions and home rehabilitation interventions were associated to change in functioning and self-rated health after the home rehabilitation program.

METHOD: The sample consisted of participants in a municipal home rehabilitation project in Sweden and consisted of 165 community-dwelling citizens. General Linear Models (ANOVA repeated measures) was used for identifying changes in rehabilitation outcomes. Logistic regressions analysis was used to investigate associations between rehabilitation outcomes and potential factors associated to outcome.

RESULT: Overall improvements in functioning and self-rated health were found after the home rehabilitation program. Higher frequencies of training sessions with occupational therapists, length of home rehabilitation, and orthopaedic conditions of upper extremities and spine as the main health condition, were associated with rehabilitation outcomes.

CONCLUSION: The result indicates that the duration of home rehabilitation interventions and intensity of occupational therapy, as well as the main medical condition may have an impact on the outcomes of home rehabilitation and needs to be considered when planning such programs. However, more research is needed to guide practice and policymaking.

BACKGROUND: Home rehabilitation programmes are increasingly implemented in many countries to promote independent living. Home rehabilitation should include a comprehensive assessment of functioning, but the scientific knowledge about the assessment instruments used in this context is limited. The aim of this study was to explore relationships between standardised tests and a self-reported questionnaire used in a home rehabilitation programme. We specifically studied whether there were gender differences within and between assessments.

METHOD: De-identified data from 302 community-dwelling citizens that participated in a municipal home rehabilitation project in Sweden was analysed. A Mann Whitney test and an independent t-test were used to analyse differences within the following assessment instruments: the Sunnaas Activity of Daily Living Index, the General Motor Function assessment scale and the European Quality of Life Five Dimension Five Level Scale. Spearman's bivariate correlation test was used to analyse relationships between the instruments, and a Fischer's Z test was performed to compare the strengths of the correlation coefficients.

RESULT: Gender differences were found both within and between the assessment instruments. Women were more independent in instrumental activities of daily living than men. The ability to reach down and touch one's toes while performing personal activities of daily living was stronger for men. There was a difference between men's self-reported performance of usual activities that included instrumental activities of daily living and the standardised assessment in performing instrumental activities of daily living. The result also showed an overall difference between the self-reported assessment and the standardised test of motor function for the total group.

CONCLUSION: The results indicate that a comprehensive assessment with the combination of standardised tests, questionnaires and patient-specific instruments should be considered in a home rehabilitation context in order to capture different dimensions of functioning. Assessment instruments that facilitate a person-centred home rehabilitation supporting personally meaningful activities for both men and women should be applied in daily practice. Further research about gender-biased instruments is needed to facilitate agreement on which specific instruments to use at both individual and organisation levels to promote gender-neutral practice.