REVIEW PAPER
A new perspective on the role of the occupational therapist in the home rehabilitation of people with physical disabilities
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Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
Submission date: 2022-07-27
Acceptance date: 2023-03-01
Publication date: 2023-06-22
Physiother Quart. 2023;31(3):30-35
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ABSTRACT
Research shows that housing and health are inextricably linked. People with mobility impairments, whether in wheelchairs or on crutches, face a variety of impediments to urban infrastructure on a daily basis, both within their own home and in their immediate surroundings. The research shows, that disability may be decreased by adapting the environment. The home modifications improve functioning and decrease dependence, impact on general sensation, participation, and higher self-assessment of health. Housing adaptations were identified as one of the ten most promising “preventive interventions” for older people with physical disabilities. Adapting a home to the needs of people with mobility impairments requires an individual approach and comprehensive approach. Interdisciplinary cooperation among specialists from various scientific fields: technical, medical, and social – significantly increases the effectiveness projects. Occupational therapists play a key role in helping patients and their families to plan a safe, functional and comfortable home environment, supporting home healthcare services. Occupational therapists better understand the physical, social, emotional, sensory and cognitive aspects of the person and the relationship between the person, environment and occupation. The aim of the publication was to show the importance of adapting the apartment to the needs of a person with a disability as an important element of supporting the rehabilitation process in the living environment. Particular attention was paid to the role of the occupational therapist as an expert who understands the relationship between the person, the environment and the occupation.
REFERENCES (33)
1.
Nowak E, Budny J, Kowalski K. Mieszkanie dostępne dla osób z dysfunkcją ruchu. Biblioteczka dla Osób Niepełnosprawnych. Warszawa: Integracja. Available 7.08.2022 from:
http://www.niepelnosprawni.pl/....
2.
Stuberg W. Home accessibility and adaptive equipment in Duchenne muscular dystrophy: a case report. Pediatr Phys Ther. 2001;13(4):169–174.
3.
Carnemolla P, Bridge C. Housing design and community care: how home modifications reduce care needs of older people and people with disability. Int J Environ Res Public Health. 2019;16(11):1951; doi: 10.3390/ijerph16111951.
4.
Petersson I, Lilja M, Borell L. To feel safe in everyday life at home – a study of older adults after home modifications. Ageing Soc. 2012;32(5):791–811.
5.
Fänge A, Iwarsson S. Changes in accessibility and usability in housing: an exploration of the housing adaptation process. Occup Ther Int. 2005;12(1):44–59; doi: 10.1002/oti.14.
6.
Boström L, Chiatti C, Thordardottir B, Ekstam L, Fänge AM. Health-related Quality of Life among people applying for housing adaptations: associated factors. Int J Environ Res Public Health. 2018;15(10):2130; doi: 10.3390/ijerph15102130.
7.
Stark S, Keglovits M, Arbesman M, Lieberman D. Effect of home modification interventions on the participation of community-dwelling adults with health conditions: a systematic review. Am J Occup Ther. 2017;71(2): 7102290010p1–7102290010p11; doi: 10.5014/ajot.2017.018887.
8.
Rantakokko M, Iwarsson S, Portegijs E, Viljanen A, Rantanen T. Associations between environmental characteristics and life-space mobility in community-dwelling older people. J Aging Health; 2015;27(4):606–621; doi: 10.1177/0898264314555328.
9.
Resolution adopted by the General Assembly. 61/06 Convention on the Rights of Persons with Disabilities [in Polish]. Available from:
https://www.unic.un.org.pl/dok....
10.
Sochańska-Kawiecka M, Kołakowska-Seroczyńska Z, Zielińska D, Makowska-Belta E, Ziewiec P. Study of the needs of people with disabilities. Final report [in Polish]. PFRON; 2017. Available 7.08.2022 from:
https://www.pfron.org.pl/filea....
11.
Hitch D, Larkin H, Watchorn V, Ang S. Community mobility in the context of universal design: Inter-professional collaboration and education. Aust Occup Ther J. 2012;59(5):375–383; doi: 10.1111/j.1440-1630.2011.00965.x.
12.
World Health Organization. Active ageing-a policy framework. Acontribution of the World Health Organization to the second United Nations world assembly on ageing. Madrid: WHO; 2002.
13.
Granbom M, Iwarsson S, Kylberg M, Pettersson C, Slaug B. A public health perspective to environmental barriers and accessibility problems for senior citizens living in ordinary housing. BMC Public Health. 2016;16:772; doi: 10.1186/s12889-016-3369-2.
14.
Allen K, Glasby J. ‘The billion dollar question’: embedding prevention in older people’s services – 10 ‘high-impact’ changes. Br J Soc Work. 2010;43(5):904–924; doi: 10.1093/bjsw/bcs024.
15.
Keall MD, Pierse N, Howden-Chapman P, Guria J, Cunningham CW, Baker MG. Cost-benefit analysis of fall injuries prevented by a programme of home modifications: a cluster randomised controlled trial. Inj Prev. 2017;23(1):22–26; doi: 10.1136/injuryprev-2015-041947.
16.
Care and Repair England. Home Adaptations for Disabled People. Warwickshire: Orbit Charitable Trust; 2010. Public Health Matters – The Human Cost of Falls.
17.
Keall MD, Pierse N, Howden-Chapman P, Cunningham C, Cunningham M, Guria J, et al. Home modifications to reduce injuries from falls in the home injury prevention intervention (HIPI) study: a cluster-randomised controlled trial. Lancet. 2015;385(9964):231–238; doi: 10.1016/S0140-6736(14)61006-0.
18.
Ekstam L, Carlsson G, Chiatti C, Nilsson MH, Malmgren Fänge A. A research-based strategy for managing housing adaptations: study protocol for a quasi-experimental trial. BMC Health Serv Res. 2014;14:602; doi: 10.1186/s12913-014-0602-5.
19.
Wahl HW, Fänge A, Oswald F, Gitlin LN, Iwarsson S. The home environment and disability-related outcomes in aging individuals: what is the empirical evidence? Gerontologist. 2009;49(3):355–367; doi: 10.1093/geront/gnp056.
20.
Nowakowski P, Charytonowicz J. Selected problems of the quality of the living environment of the disabled [in Polish]. Wrocław: Wydział Architektury Politechniki Wrocławskiej. Available 7.08.2022 from:
http://idn.org.pl/Lodz/Mken/Mk....
21.
Stark S. Removing environmental barriers in the homes of older adults with disabilities improves occupational performance. Occup Ther J Res. 2004:24(1):32–39; doi: 10.1177/153944920402400.
22.
Lord SR, Menz HB, Sherrington C. Home environment risk factors for falls in older people and the efficacy of home modifications. Age Ageing. 2006:35(Suppl 2):ii55–ii59; doi: 10.1093/ageing/afl088.
23.
Cockayne S, Pighills A, Adamson J, Fairhurst C, Drummond A, Hewitt C, et al. Can occupational therapist-led home environmental assessment prevent falls in older people? A modified cohort randomised controlled trial protocol. BMJ Open. 2018;8(9):e022488; doi: 10.1136/bmjopen-2018-022488.
24.
Heywood F. The health outcomes of housing adaptations. Disability Soc. 2004:19(2):129–43; doi.org/10.1080/0968759042000181767.
25.
Gałązka M, Kromka-Szydek M, Disabled accommodation – review of modern solution [in Polish]. Aktual Probl Biomech. 2011;5:41–44.
26.
Whitehead PJ, Golding-Day MR, Belshaw S, Dawson T, James M, Walker MF. Bathing adaptations in the homes of older adults (BATH-OUT): results of a feasibility randomised controlled trial (RCT). BMC Public Health. 2018;18:1293; doi: 10.1186/s12889-018-6200-4.
27.
Golding-Day M, Whitehead P, Radford K, Walker M. Interventions to reduce dependency in bathing in community dwelling older adults: a systematic review. Syst Rev. 2017;6:198; doi: 10.1186/s13643-017-0586-4.
28.
Barras S. A systematic and critical review of the literature: the effectiveness of occupational therapy home assessment on a range of outcome measures. Aust Occup Ther J. 2005;52:326–336; doi: 10.1111/j.1440-1630.2005.00496.x.
29.
Cumming RG, Thomas M, Szonyi G, Salkeld G, O’Neill E, Westbury C, et al. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. J Am Geriatr Soc. 1999;47(12):1397–1402; doi: 10.1111/j.1532-5415.1999.tb01556.x.
30.
Fänge A, Iwarsson S. Changes in ADL dependence and aspects of usability following housing adaptation – a longitudinal perspective. Am J Occup Ther. 2005;59(3):.
31.
296–304; doi: 10.5014/ajot.59.3.296.
32.
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009;2:CD007146; doi: 10.1002/14651858.CD007146.pub3.
33.
Chiatti C, Iwarsson S. Evaluation of housing adaptation interventions: integrating the economic perspective into occupational therapy practice. Scand J Occup Ther. 2014;21(5):323–333; doi: 10.3109/11038128.2014.900109.