Occupational Therapy Predischarge Home Visits in Acute Hospital Care: A Randomized Trial

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Occupational Therapy

Background:

• Discharge planning is crucial for older adults transitioning from hospital to home.
• Occupational therapy interventions aim to optimize functional independence and participation.
• The HOME program, an enhanced discharge planning intervention, was compared against usual care.

Purpose of the Study:

• To evaluate the effectiveness of the HOME program, an enhanced occupational therapy discharge planning intervention, against usual care.
• To determine if pre- and post-discharge home visits, goal setting, and follow-up improve outcomes for older adults.

Main Methods:

• A randomized controlled trial was conducted in acute and medical wards.
• Participants included 400 individuals aged 70 and older.
• Primary outcomes measured were activities of daily living (ADLs) and participation in life roles (LLDI).

Main Results:

• The HOME program resulted in significantly more occupational therapist recommendations (892 vs. 329).
• No significant differences were found between groups in ADLs or participation.
• Both groups maintained prehospital functional status, with similar unplanned readmission rates.

Conclusions:

• The HOME program, despite implementing more recommendations, did not show superior benefits over in-hospital consultation alone.
• Routine home visits as part of discharge planning for acutely hospitalized medical patients are not recommended.
• Further research should focus on developing guidelines for high-quality in-hospital consultations.