Implementation and outcomes of a novel occupational therapy service in a nursing home

Occupational therapy plays a vital role in enhancing engagement and quality of life for people living in nursing homes. However, in Australia, funding for occupational therapy in nursing homes is limited, and its scope is restricted. The Enhancing Allied Health for Older People (EAHOP) trial aimed to assess the feasibility and impact of embedding a multidisciplinary allied health model, including occupational therapy, in a nursing home. This paper describes the occupational therapy implementation and outcomes of the EAHOP trial.

A convergent mixed-evaluation was conducted. Twenty-seven residents at an Australian nursing home received occupational therapy by occupational therapists and occupational therapy students. The Canadian Occupational Performance Measure (COPM) was used to set goals and evaluate changes in occupational performance. Data included median therapy minutes per resident and service occasions. Qualitative data were gathered using semi-structured and unstructured interviews and analysed using content analysis.

The EAHOP trial included a Stakeholder Committee that included residents of the nursing home who were participants in the trial. This group advised the research team on all aspects of the intervention throughout the trial.

Residents received a median of 895 minutes of occupational therapy and 203 minutes from allied health assistants for a 1-to-36-week programme where the intervention period varied according to individual need. This equated to a median of 3.9 minutes/resident/day. COPM scores showed clinically meaningful improvements in performance and satisfaction. Interventions addressed diverse occupational performance issues across self-care, productivity, and leisure. Qualitative findings supported these outcomes, highlighting the benefits of the service and identifying barriers and implementation challenges.

Embedding a comprehensive occupational therapy service within a multidisciplinary team model is both feasible and beneficial in a nursing home. The improvements in occupational performance and satisfaction, along with the diversity of interventions required, highlight the important contribution of occupational therapy in a nursing home.