None listed
Conditions
Brief summary
Leaving hospital and getting back home after a hip fracture can be challenging and involve some adjustments. Participating in some form of rehabilitation has been shown to help. As part of this rehabilitation, occupational therapists are trained to assist people to overcome various problems in order to live more independent lives. They may assist with the return to home life through the development of new skills for daily living, such as household tasks and personal care. They may also make or facilitate changes to the home environment to make life easier and safer. The hospital environment can be very different to home and sometimes occupational therapists take people on a visit from hospital to their home to help to plan for discharge. These visits may have benefits such as preventing falls at home or improved ability to complete activities around the home but these home visits can be time consuming and tiring for some patients. The aim of this study is to find out if going home from hospital for a short visit with an occupational therapist prior to being discharged provides benefits for people following hip fracture compared with hospital- based discharge planning. The results will help guide health professionals to prescribe treatments to support patients to return home after a hip fracture and to make sure that these treatments are targeted to patients who will get the most benefit.
Interventions
The participants will receive a hospital-based initial interview by the occupational therapist on admission to hospital, consistent with usual care. The duration of the interview may be approximately 30 to 60 minutes depending on the participant and their occupational, social and environmental status. The interview will be part of the hospital-based discharge planning and will focus on developing rapport, gathering information about the participant's occupational performance and their home envir
The participants will receive a hospital-based initial interview by the occupational therapist on admission to hospital, consistent with usual care. The duration of the interview may be approximately 30 to 60 minutes depending on the participant and their occupational, social and environmental status. The interview will be part of the hospital-based discharge planning and will focus on developing rapport, gathering information about the participant's occupational performance and their home environment. The participants will then receive a single home visit, in which an occupational therapist will accompany the participant on a short visit prior to discharge from hospital. The home assessment will be conducted between 1 and 5 days prior to expected discharge date or whenever the participant has recovered sufficiently to be able to participate, or within 24 hours post discharge for patients discharged directly from acute settings with insufficient notice to arrange a home visit. The home assessment visit takes approximately 1 hour and provides an opportunity for the participant to practise activities of daily living and includes the provision of education, advice and recommendations on equipment, home adaptations and available community services. The home assessment visit will be completed using a home assessment report form and recommendations and actions will be recorded on a home assessment summary form. The occupational therapist will assist in organising the hire of equipment or referral to community services that are identified as being required as a result of the home assessment visit and the discharge planning process.
Sponsors
Professor Nicholas Taylor
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
People will be invited to participate provided they meet the following inclusion criteria:- a) Admitted as an inpatient to an Eastern Health hospital b) Adults greater than or equal to 50 years of age because from 50 years of age risk of falling and incidence rates of hip fracture rise dramatically c) Primary diagnosis of hip fracture as determined by the International Classification of Diseases, 10th edition codes S72.00 - S72.11 d) Living in a private residence in the community prior to the hip fracture e) Not demonstrating risk factors at admission that would suggest a length of stay greater than 28 days (eg. Particularly complex social situation or extensive co-morbidities)
Exclusion criteria
Participants will be excluded if they are: a) Admitted from a residential care facility because this population would not be expected to receive a home assessment visit b) Patients who fracture their hip during an inpatient admission because this would not be a primary diagnosis c) Assessed as having impaired cognition and do not have a carer or responsible person who can give informed consent d) Planned to be discharged to a residential aged care facility because a home visit would not normally be considered as a component of the discharge plan for these patients e) Living in a location more than 1 hour by car from the hospital because it would not be practical to complete a home assessment visit due to distance
Outcome results
None listed