Occupation

Abstracts
P156
Rehabilitation for outdoor activities and mobility in
care homes: the ROAM study
King A 1,2,3 , Chadborn N 1,2 , Gordon A 1 , Gladman J 1,2 , Logan
P 1 , University of Nottingham 1 , CLAHRC/HEEM East
Midlands 2 , Nottinghamshire Healthcare NHS Foundation
Trust 3
Care home residents should be offered opportunities to
participate in meaningful activities in an environment of
their choice (College of Occupational Therapists 2013).
Whilst outdoor activities and mobility are believed to have
health-related benefits, best practice recommendations are
based on expert consensus. This research aimed to map the
literature, identify evidence gaps and highlight implications for
occupational therapy in UK care homes.
A systematic mapping review was conducted. Ethical approval
was not required. A range of databases were searched.
Articles were categorised using keywords including: outdoor
location outdoor activities barriers to outdoor activities and
health benefits. 1066 abstracts were identified 39 articles were
included. There were 20 pre-post and 19 descriptive studies,
with 2974 resident participants. 312 were from the UK. The
care home garden was the most frequent location (28, 72%). 1
pre-post study evaluated an occupational therapy programme.
Most descriptive studies (13, 68%) were architecture, rather
than therapy-focused. The most frequent outdoor activities
were: walking (14, 74%) socialising (11, 58%) and observing
surroundings (11, 58%). Co-produced research with residents
occurred in only 1 study. Barriers included weather, access
and lack of staff time. Benefits to the physical health, mental
wellbeing and occupational functioning of residents were
reported.
This review is the first to systematically collate data on
outdoor activities and mobility in care homes. There is a lack
of robust evidence in this field. There is a need to incorporate
the involvement and views of residents in further research.
Dementia Care Mapping (Brooker 2005) may be an appropriate
observational tool to use with residents unable to participate
in interviews and focus groups. Occupational therapists are
uniquely placed to explore the potential health benefits to
residents, of tailored activities and mobility programmes in
outdoor environments.
References
College of Occupational Therapists (2013) Living well through
activity in care homes: the toolkit. London: COT. Available at:
www.cot.co.uk/living-well-through-activity-care-homes-toolkit-0
Accessed on 19.09.15.
Brooker D (2005) Dementia Care Mapping: A Review of the
Research Literature. The Gerontologist, 45 (1), 11–18.
Keywords
Older people, Research, Practice – present and future
Contact E-mail Addresses
msxalk@nottingham.ac.uk
Author Biographies
I am a part-time NHS Occupational Therapist working in care
homes for older people. I am also a PhD student at the University
of Nottingham, funded by the Collaboration for Leadership in
Applied Health Research and Care East Midlands (CLAHRC EM)
and Health Education East Midlands (HEEM). I qualified as an OT
from Sheffield Hallam University in 2010 and achieved a Masters
in Research Methods (Health) in 2014. I have worked with
older people since 2010 and I am passionate about facilitating
meaningful activities and outdoor use.
P157
Four walls forever? The impact of microenvironment
living for the older person
Posters
Stuart-Neil L 2 , McClean N 1 , Luton and Dunstable University
Hospital NHS Foundation Trust 1 , UCLPartners 2
With the ever increasing pressures to facilitate a safe and timely
hospital discharge, occupational therapists are faced with the
challenges of discharging patients back to their own home for
ongoing rehabilitation when their full rehabilitation potential has
not been achieved, or the patient is no longer able to increase
their functional independence. Discharge to micro-environments
(i.e. one room living) has become increasingly common, yet
a literature review has shown very little research in this area.
Although some research, such as that by Atwal et al (2008) has
highlighted concerns regarding the quality of life for patients
limited to one level or one room living, there appears to be little
research into the experiences and consequences for patients
and their families. Given this lack of evidence we embarked on a
research project to investigate this.
This poster aims to review the outcomes of our research
conducted with older people who were discharged from hospital
to a micro-environment some where the micro-environment
set-up was expected to be a short-term arrangement and
others where it was expected to be long-term. Semi-structured
interviews were completed to gather perspectives of patients,
families and staff at the time of discharge, with further followup
interviews with patients and families at six and twelve weeks
post-discharge. Themes from the interviews will be explored to
enhance understanding of the benefits and barriers of microenvironment
living. Expectations of both staff and patients
will be considered which will challenge both the hospital and
community therapist to reflect on the journey and outcome of
what actually happened to ‘that patient’?
References
Atwal A, McIntyre A, Craik C & Hunt J (2008) Occupational
therapists’ perceptions of predischarge home assrssments
with older adults in acute care. British Journal of Occupational
Therapy. 71(2): 52–58
Keywords
Older people, Research, Pathways or models of service delivery,
NHS
Contact E-mail Addresses
Nina.Mcclean@ldh.nhs.uk
Author Biographies
Nina McClean qualified in 2004 and has held various posts in
elderly care. She currently works as the specialist occupational
therapist for the Department of Medicine for the Elderly at Luton
and Dunstable University Hospital NHS Foundation Trust. She has
a special interest in dementia, equipment provision and falls.
Laura Stuart-Neil qualified as an occupational therapist in 1998.
She specialised in stroke and care of the elderly and previous
posts include clinical lead OT for elderly at Kings College
Hospital. She joined UCLPartners in 2013 where she leads
a number of projects focussed on the care of older people.
She also continues to work clinically as a Bank Occupational
Therapist.
Laura was chair of the COT Scottish Board from 2005–2007
and has an MSc in Applied Professional Studies (leadership and
organisational development) from the University of Dundee.
144