Who determines the rehabilitation needs of care home residents? An observational survey

Determining the rehabilitation needs is of great importance in long-term care setting, but the perception of rehabilitation needs may vary extensively between service provider and recipients. The purpose of this study was to assess the differences between the self-perceived and carer-evaluated rehabilitation needs among care home residents. Data of Longitudinal Older Veterans (LOVE) study were sorted for study. Overall, this study enrolled 581 (mean age=80.9±5.4 years) male participants. Among them, 539 (92.8%) were physically independent, and 463 (79.7%) were cognitively intact. Of these participants, 367 (63.2%) believed they would be physically improved by certain rehabilitation services, but only 57 (9.8%) residents were considered to have rehabilitation potential by their carers. Over half of physically dependent, but only 16.7% of physically independent residents were considered to have positive rehabilitation potential by their carer. Similarly, carers considered that residents with cognitive deficits were more likely to be improved by rehabilitation (24.6% vs. 6.0%, p<0.001) but cognitively intact residents considered themselves more likely to benefit from rehabilitation (67.6% vs. 45.8%, p<0.001). In conclusion, a significant disagreement in rehabilitation potential was noted between residents' self-perception and carer assessment. Residents with physical dependence and intact cognition may be more likely to receive rehabilitation. An intervention study is needed to develop practice guidelines to provide cost-effective rehabilitation for care home residents.