Williamson, T. Taylor, J. This presentation presents independent - - PowerPoint PPT Presentation

Darby, J. Edmans, J.A. Logan, P.A. Gladman, JRF. Williamson, T. Taylor, J.

“This presentation presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0407- 10147) The views expressed in this presentation are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.”

Study Aim

To explore older patient and carer perspectives of their everyday activities following discharge from an Acute Medical Unit

Demographic Data (n= 18 patient participants)

Gender: Male n= 8 Female n= 10 Residency status: Lives alone n= 10 Lives with partner n= 7 Lives in care home n= 1 Age range: 74-89 years Mean age: 82 years Admission reasons: collapse/ chest pain/ fall/ swollen leg/ diarrhoea/ S.O.B/ vomiting/ abdo pain/ haematomasis/ back pain/ heart racing Barthel Score: range 3-20 Mean score: 17 Ethnicity: White n= 18 Identification of Seniors at Risk (ISAR) Score: 2-5 Mean score: 3

Demographic Data (n= 6 Informal carer participants)

No: Barthel score Relationship Lives with patient Level of support Home care 2 19 Daughter No Domestic tasks No 7 12 Wife Yes Personal & domestic tasks Yes 10 17 Wife Yes Personal & domestic tasks No 11 3 Son Yes Domestic tasks Yes 17 18 Daughter No Domestic tasks Yes 18 20 Daughter no Personal & domestic tasks No

Findings

Theme: Outstanding needs Sub-theme 2: Unresolved daily living needs Sub-theme 4: Value

• f independence

Sub-theme 3: Impact

• n informal carer

Sub-theme 1: Unresolved health issues

Sub theme 1: Unresolved Health Issues

(JD): And what do you think Diane (daughter), do you think there’s been any change at all in the last six weeks? (Diane): I think that’s Mums probably got less energy, so I, my personal view is that I think things are probably a bit worse than they were, at the moment (pg 16).

Physical Barriers Shortness of breath, exhaustion/ fatigue, reduced mobility, poor balance, pain/ stiffness/ hemiplegia, terrain, requires aid/ adaption Psychological Barriers Loss of confidence Perception of fragility/ageing Embarrassment Fear of falling Social/ Environmental Barriers Need transport to go out No-longer driving Need help from others to go out

Sub-theme 2: Unresolved Daily Living Needs

Expressed problems with DADLs Expressed problems with PADLs Expressed problems with Leisure/social ADLs n= 11 n= 8 n= 10 Washing/dressing problems n= 5 Bath/shower transfer difficulties n= 5 Problems with stairs n= 4 Problems with meal preparation n= 3 Difficulty going out n= 8

Sub-theme 2: Unresolved Daily Living Needs

Sub-theme 2: Unresolved Daily Living Needs

(JD): So tell me how you have been getting

• n since you’ve come home?

(Norman): Well, not my normal self, I’ll not keep

• n about it, not my normal self love,

because I can’t seem to get me normal things done, part from carers coming in and helping me extra you know (pg 7).

(David): I don’t know what to blame it (shortness of breath) on really, but I’m trying anyway, but it’s hard work for my good lady there. It makes it hard work for her, it wears her

• ut a bit, but it is hard work. But she’s
• struggling. She’s getting by aren’t you?

(pg 3).

Sub-theme 3: Impact on Informal Carers

Sub-theme 3: Impact on Informal Carers

(Betty): ... so I say to him (husband) about twenty to seven come on let me get you ready for bed (laughs), so then his ready for bed, so and then I do your (colostomy) bags, do the bags in-between anyway Janet, but it’s a full-time job (pg 2).

Sub-theme 4: Value of Independence

(Annie): When I’m out, personally me self how I feel now, which I was before, I feel better doing things, I don’t want to sit about, I says it’s no good sitting about this is your problem, sit about you don’t do nothing, that half your problems, I says “leave me, let me do what I want to do, I’ll not go too far, I know how far I can go now”, I says “I’m pushing myself”, but I says “let me do these things on me own. Like I used to be. And I find out that if I’m doing jobs I feel better in myself (pg 14).

Key Points

Missed opportunity for occupational therapy assessment and intervention Role of Interface Occupational Therapist on Acute Medical Units Need to identify an appropriate screening tool

Any questions?

janet.darby@nottingham.ac.uk