Elderly disabled persons in the home setting : aspects of activities in daily life
Author: Lilja, Margareta
Date: 2000-09-01
Location: MTC, Theorells väg 1
Time: 13.00
Department: Institutionen för klinisk neurovetenskap, arbetsterapi och äldrevårdsforskning (NEUROTEC) / Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research (NEUROTEC)
Abstract
The overall aim of this thesis was to explore and describe elderly
disabled persons' activities in daily life in the home environment from
an occupational perspective and, secondly to describe occupational
therapy interventions provided to elderly disabled persons in their home
setting.
Study I explored and described elderly persons' performance in ADL, and
occupational therapy interventions provided. Most of the participants
wanted to engage in more activities than they were judged to have the
capacity and/or environmental support for. Hobby activities
outside/inside the home, taking a bath or shower, washing clothes, and
cooking were activities presenting significant problems. Participants who
received occupational therapy experienced problems regarding self-care.
Assessment and assistive devices were the most common occupational
therapy interventions provided in the study.
Study II focused on participants from study I that had an elevator in
their housing and their need for mobility support in the environment.
Social contacts in the home and weekly shopping were activities where no
major difference could be seen between those elderly persons who needed
assistance using the elevator and those who managed the elevator alone.
Mobility was not only related to a person's bodily function but also to
social support from the environment.
Study III explored and described occupational therapy intervention
patterns over two periods. Treatment/training, prevention in everyday
activities and information/consultation increased from period I to period
2, while interventions concerning assistive devices decreased.
Treatment/training during both periods concerning leisure/recreation
activities, whilst interventions concerned consultation seemed to be
changing over time from focusing on clients to relatives and home help
staff.
Study IV aimed at uncovering and interpreting elderly disabled persons'
experiences, values and meanings of being engaged in daily occupations.
Themes related to participation against the odds, retreat from
occupation, the need for an invitation from others, and personal meanings
related to capacities for occupations were uncovered. The findings
suggest that for occupational therapy it is important to distinguish
between when a person has made a conscious choice to withdraw from
occupational life and when a person, for example, has to few occupational
choices.
Study V described and evaluated a clinical attempt to change occupational
therapy practice when reporting clients between occupational therapists
in the chain of care. The ADL taxonomy was used as an instrument for
transferring the information. It was seen as useful for this purpose but
there was still a need for reporting clients orally. Aspects of
temporality, structure, professionalism and the instrument's usefulness
overall influenced the transfer of information. Systematic discharge
planning schemes, written and formally structured information, feedback
loop for communication, and collaboration with the clients and their
families in the discharge process are suggested as guidelines for the
transfer of information.
Implications of the studies for occupational therapy for elderly disabled
persons in the home setting are proposed in the discussion section.
List of papers:
I. Borell L, Lilja M, Carlsson-Alm S, Törnquist K, Ståhl E (1995). "Community-based occupational therapy: a study of elderly people with home help in a social-welfare district in Stockholm" Scand J Occup Ther 2: 138-144
II. Lilja M, Borell L (1997). "Elderly people´s daily activities and need for mobility support" Scand J Caring Sci 11(2): 73-80
Pubmed
III. Lilja M, Borell L (2000). "Occupational therapy practice patterns with older Swedish persons at home" Can J Occup Ther (In Print)
IV. Borell L, Lilja M, Anderson-Sviden G, Sadlo G (2000). "Occupations and signs of reduced hope - an explorative study of older adults with functional impairments" Am J Occup Ther (Accepted)
V. Lilja M, Nygård L, Borell L (2000). "The transfer of information about geriatric clients in the occupational therapy chain of care: an intervention study" Scand J Occup Ther (In Print)
I. Borell L, Lilja M, Carlsson-Alm S, Törnquist K, Ståhl E (1995). "Community-based occupational therapy: a study of elderly people with home help in a social-welfare district in Stockholm" Scand J Occup Ther 2: 138-144
II. Lilja M, Borell L (1997). "Elderly people´s daily activities and need for mobility support" Scand J Caring Sci 11(2): 73-80
Pubmed
III. Lilja M, Borell L (2000). "Occupational therapy practice patterns with older Swedish persons at home" Can J Occup Ther (In Print)
IV. Borell L, Lilja M, Anderson-Sviden G, Sadlo G (2000). "Occupations and signs of reduced hope - an explorative study of older adults with functional impairments" Am J Occup Ther (Accepted)
V. Lilja M, Nygård L, Borell L (2000). "The transfer of information about geriatric clients in the occupational therapy chain of care: an intervention study" Scand J Occup Ther (In Print)
Issue date: 2000-08-11
Publication year: 2000
ISBN: 91-628-4244-7
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