Evaluating Reablement for Home-dwelling Elderly in a Norwegian Municipality
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Physical Disability
- Sponsor
- Frode F. Jacobsen
- Enrollment
- 61
- Locations
- 2
- Primary Endpoint
- Canadian Occupational Performance Measure
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
The purpose of this study is to determine whether a special kind of rehabilitation offered to home-dwelling older adults is effective with regards to functional ability and municipal costs.
Detailed Description
Early detection of functional decline among home dwelling older adults and immediate onset of rehabilitation, can improve function, and reduce or delay need for home-based assistance and nursing home placement. Towards year 2050 there will be a significant increase in number of elderly persons in Norway, with an urgent need for new models for early intervention and rehabilitation in order to give service to a larger amount of elderly persons. Reablement is a new and promising rehabilitation model which many Norwegian municipalities are implementing in order to meet current and future needs for municipal home-based services. However, very little research has been conducted regarding the effectiveness of this intervention. This study aims at assessing the effectiveness of reablement in terms of daily functioning and economic costs compared to standard home-based treatment and care. The study will be conducted in the municipality of Voss in Western Norway, a municipality with only 14000 inhabitants. It is a double-blinded, block-randomized controlled intervention trial, recruiting home-dwelling older adults with an initial functional decline in daily activities. The intervention is intensive, multidisciplinary, home-based rehabilitation given by home-trainers, under supervision from an occupational therapist or a physiotherapist. The control intervention is standard home-based treatment and care. Thirty participants will be recruited in each arm of the study. The participants will be assessed at baseline, and at 3-, and 9 months follow-up. Primary outcomes will be participation, activity, and municipal expenditures. Costs are generated by the working hours of the different professions. Hence, there will be a daily registration of the working hours different health care professions spend in the private homes of the participants. Power calculations based on study with a similar target group using the instrument Canadian Occupational Performance Measure, estimate a need for only 21 participants in each group due to the longitudinal design. However, in order to account for possibilities of frailer target group or a large drop out rate (40 %), a total number of 30 participants in each group will be tried recruited. Data analyses will be performed according to intention to treat. The working hour data is panel data and will be analyzed accordingly; a random or a mixed effect regression model will be employed. Also, descriptive statistics and simpler tests will be carried out.
Investigators
Frode F. Jacobsen
Professor
Bergen University College
Eligibility Criteria
Inclusion Criteria
- •Home-dwelling person
- •Applicant of home-based services
- •Above 18 years old
- •Functional decline in at least one activity
- •Able to understand written and oral Norwegian
Exclusion Criteria
- •Cognitive disability
- •Terminal ill
- •Being assessed as needing nursing home placement
- •Being assessed as needing institution-based rehabilitation
Outcomes
Primary Outcomes
Canadian Occupational Performance Measure
Time Frame: 9 months
Activity and participation will be measured using Canadian Occupational Performance Measure (COPM) The COPM is a measure of a client's self-perception of occupational performance in the areas of self-care, productivity and leisure.
Secondary Outcomes
- Expenditure(15 months follow-up)