None listed
Conditions
Brief summary
A hip fracture can have a serious impact on an older person’s everyday life. Recovery is complex and extends well beyond discharge from hospital with the transition home presenting significant challenges for older people and their carers. Planning for discharge home enables health professionals and older people to work together to identify any needs and organise support after discharge. This study aims to examine the feasibility and effectiveness of using telerehabilitation via a smartphone, tablet or computer to deliver a pre-discharge home safety intervention in a sample of 40 older adults recovering in hospital after hip fracture. Feasibility will be considered in relation to demand, acceptability, practicality and limited efficacy with a view to applying telerehabilitation home safety assessments to older people recovering in hospital after hip fracture who are planning to return to community living.
Interventions
The intervention is a therapy/ treatment intervention. Participants hospitalised for hip fracture and allocated to the intervention group will receive usual care by a multidisciplinary team during their hospital stay, as provided to the control group including a standardised initial occupational therapy assessment and completion of the Home Falls and Accidents Screening Tool (Home Fast) to gather information about the home environment and identify participants at risk of falling because of hazar
The intervention is a therapy/ treatment intervention. Participants hospitalised for hip fracture and allocated to the intervention group will receive usual care by a multidisciplinary team during their hospital stay, as provided to the control group including a standardised initial occupational therapy assessment and completion of the Home Falls and Accidents Screening Tool (Home Fast) to gather information about the home environment and identify participants at risk of falling because of hazards at home. In addition, they will participate in a single technology-enabled 'real-time' remote assessment of the home environment which is anticipated to take approximately 1-hour. The home safety assessment will be conducted between 1 and 5 days prior to the 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 the telerehabilitation home safety assessment. The occupational therapist will sit with the participant in the hospital linked via a video connection to a family member/carer at the participant’s home. The remote home safety assessment will be completed using a standardised home assessment report form taking into consideration the participant's functional capacity and potential environmental hazards. The occupational therapist will provide advice and recommendations and plan targeted interventions to be completed in hospital in preparation for discharge home. The aim is to involve the participant/ family in collaborative decision-making to maximise functional capacity and confidence in returning home. The occupational therapist will work with the participant and their family to provide education about the safe use of adaptive equipment to assist in the home, simulation and practice of activities of daily living within the hospital setting, provision of information about available community services and external referrals where required. Recommendations from the home assessment will be recorded on a standardised home assessment summary form and a copy will be given to the participant.
Sponsors
La Trobe University
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
Patients will be eligible for inclusion if they: • Have been admitted to Eastern Health with a primary diagnosis of hip fracture • Are aged 50 years and older • Are expected to return to a private residence on discharge from hospital • Have a family member who is willing to participate and has access to the technology by which Eastern Health’s telehealth portal can be reached Occupational therapists who work with participants enrolled in the study will be invited to participate in a focus group to discuss their perceptions of the telerehabilitation home safety intervention.
Exclusion criteria
Patients will be excluded if they: • Have been admitted from a residential care facility • Fracture their hip during an admission to hospital because this would not be a primary diagnosis • Have an extended non-weight bearing period • Have advanced cancer • Are refusing to participate in therapy • Are displaying aggressive behaviour • Have cognitive impairment (greater than 2 errors on the Short Portable Mental Status Questionnaire) and no carer who is able to give informed consent to be involved in the study • Are identified by the occupational therapist as requiring an in-person home-based assessment prior to discharge from hospital.
Outcome results
None listed