title: Reflecting on practice: are home visits prior to discharge worthwhile in geriatric inpatient care?
abstract: The discharge process of elderly clients from inpatient hospital care to their homes has lately received extensive attention but there is a lack of knowledge about the clients' problems as experienced in the home environment and their perceptions of corresponding home interventions prior to discharge. The aim of this clinical study therefore was to illuminate from both clients' and therapists' perspectives, common practice occupational therapy interventions at predischarge home visits in geriatric inpatient care. Home visits were carried out together with 23 clients before discharge during which their problems and the occupational therapy interventions at home were documented. After discharge, a follow-up home visit was carried out and the apprehensions of both parts regarding the interventions undertaken at the previous home visit were documented. In addition, a group interview was held with the nine therapists engaged in the study. The results exhibited a strong focus on physical disability, environmental issues and assistive devices. The clients were in general satisfied with the home visit interventions but their perceptions and responses to problems also differed from those of the therapists. When there was dissatisfaction, it resulted from serious delay in delivery of home modifications or devices, which posed a risk to their safety at home. For multiple reasons, both pre- and postdischarge home visits were found to be very important for the clients' safety.
authors.affiliation: Department of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden. louise.nygard@neurotec.ki.se
authors.forename: Louise
authors.initials: L
authors.lastname: Nygård
authors.forename: Ulrika
authors.initials: U
authors.lastname: Grahn
authors.forename: Anna
authors.initials: A
authors.lastname: Rudenhammar
authors.forename: Susanne
authors.initials: S
authors.lastname: Hydling
mesh_terms: D000203:Activities of Daily Living; D000359:Aftercare / Q000592:standards; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000592:standards; D006699:Home Care Services / Q000592:standards; D006792:House Calls; D006801:Humans; D008297:Male; D020380:Needs Assessment; D009788:Occupational Therapy / Q000523:psychology / Q000592:standards*; D010351:Patient Discharge / Q000592:standards*; D011369:Professional-Patient Relations; D018570:Risk Assessment; D012449:Safety; D013548:Sweden; D013997:Time Factors