Intensive multidisciplinary home rehabilitation for older people with severe conditions

• Published in: International journal of integrated care 2017-10, Vol.17 (5), p.176
• Main Authors: Kiselev, Joern, Steinert, Anika, Schindler, Wencke, Haesner, Marten, Mueller-Werdan, Ursula
• Format: Article
• Language: English
• Subjects: Geriatrics; Hearing loss; Integrated delivery systems; Multidisciplinary teams; Older people; Rehabilitation
• ISSN: 1568-4156; 1568-4156
• DOI: 10.5334/ijic.3484

Introduction: Older people often demonstrate multiple physical and functional problems simultaneously. For this reason, geriatric rehabilitation (GR) is often organized as integrated care with a multidisciplinary team providing a structured care plan to alleviate or reduce the consequences of the patients’ conditions. However, some of those in need of GR have difficulties to adapt to the hospital settings and therefore do not profit from the intense multidisciplinary care provision in such a setting as would be desirable. These patients are often finishing their rehabilitation without being able to walk independently, or manage their daily life.Practice change implemented: Since 2007, the German health care system offers a home-based GR for geriatric patients, called Mobile Rehabilitation (MR), within the same framework as the standard GR in a hospital setting, providing an intensive and multidisciplinary rehabilitation program over 6 to 8 weeks.Aim and theory: There is good evidence on the effectiveness of rehabilitation and home care concepts in general. However, several risk factors such as the presence of cognitive or psychological disorders, or seeing and hearing impairments, among others, lead to unsatisfactory result of a rehabilitation program. that can be attributed to problems of a geriatric patient to adapt to the requirements of a rehabilitation program. Possible reasons are the presence of cognitive or psychological disorders, or seeing and hearing impairments, among others. Such patients can, in theory, largely profit from MR in their accustomed environment.Intervention program and timeline: The MR program consists of, on average, 40 sessions of physiotherapy, occupational therapy, speech therapy or nursing care with 6 sessions each week. Regular multidisciplinary team meetings are under the leadership of a geriatrician.Highlights: First publications on this program demonstrate its general effectiveness. Additionally, results from the project MORECARE, a German-based, national research project aiming at identifying and overcoming organizational and managerial barriers in providing home-based GR in Germany will be presented.Comments on sustainability and transferability: In 2016, the concept of MR has been broadened and includes now several additional conditions associated with a decreased adaptability to conventional rehabilitation settings. This decision was based on the first evidence on it’s effectiveness. This presentation will enable sta