Authors (including presenting author) :
TSE YWE(1), LOUIE TMF(1)
Affiliation :
(1)Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital
Introduction :
About 20% of community-dwelling elderly aged 65 and above experience fall every year. About 75% of them caused severe injuries such as broken bones and 57% of fall related to environmental risk factors such as slippery floor. An Occupational therapist in Integrated Care Discharge Support Program for elderly patients (ICDS), providing immediate post-discharge services to those frail elderly with frequent admission, conducts home safety intervention including home safety assessment, assistive device prescription and home modification.
Objectives :
To evaluate the effectiveness of home safety intervention provided by occupational therapy of ICDS.
Methodology :
The therapist used the Safety Assessment of Function and the Environment for Rehabilitation – Health Outcome and Measurement and Evaluation, (SAFER-HOME), version 3 to assess the environmental safety, the Modified Barthel Index to the self-care, the Modified Functional Ambulation Classification to assess the mobility and the Hong Kong version of Montreal Cognitive Assessment to assess the cognitive function of all ICDS patients during initial home assessment and the last session. The statistical differences between initial visit and discharge, using paired t- test, were used. At last, the unplanned admission rate of patients due to accidental fall was also recorded.
Result & Outcome :
50 elderly patients (age mean = 83.1, S.D.= 9.3) with chronic disease were recruited from 01 October 2018 to 30 September 2019. Six out of 50 ICDS patients did not complete the whole ICDS program. One patient died suddenly due to acute aortic dissection and one ceased for arranging long term placement. Other four patients ceased due to severe medical problems such as stroke and pneumonia. No one admitted due to accidental fall. For those 44 patients completed the ICDS, basing on findings of SAFER-HOME, the highest fall risk areas were toilets & bath-areas. By paired t-test, it showed statistical differences on SAFER-HOME (p< 0.001) between initial visit and discharge. The environmental risk had significant decreased after home safety intervention. 22 patients (50%) were followed the advice on grab bar installation in their own toilet or bath-area. And 18 patients (41%) were advised to use bath-seats or bath-boards so as to decrease fall risk during bath taking. Moreover, it showed significant improvement on self-care, cognitive function and mobility of the patients (all p< 0.001) after completing ICDS. In conclusion, the home safety intervention of occupational therapy was effective in reducing the environmental risk, improving self-care, cognitive function and mobility of elderly patients. It was also effective to prevent accidental fall at home.
