Intensive client-centred occupational therapy in the home improves older adults’ occupational performance. Results from a Danish randomized controlled trial

Abstract

Background: There is growing interest in enabling older adults’ occupational performance. We tested whether 11 weeks of intensive client-centred occupational therapy (ICC-OT) was superior to usual practice in improving the occupational performance of home-dwelling older adults.

Methods: An assessor-masked randomized controlled trial among adults 60 + with chronic health issues, who received or applied for homecare services. Recruitment took place September 2012 to April 2014. All participants received practical and personal assistance and meal delivery as needed. In addition, they were randomized to receive either a maximum 22 sessions of occupation-based ICC-OT (N = 59) or to receive usual practice with a maximum three sessions of occupational therapy (N = 60). The primary outcome was self-rated occupational performance assessed with the Canadian Occupational Performance Measure (COPM).

Results: No important adverse events occurred. ICC-OT was accepted by 46 participants (88%), usual practice by 60 (100%). After 3 months, the ICC-OT-group had improved 1.86 points on COPM performance; the Usual-Practice group had improved 0.61 points. The between-group difference was statistically significant (95% confidence interval 0.50 to 2.02), t-test: p = 0.001.

Conclusions: ICC-OT improved older adults’ occupational performance more effectively than usual practice. This result may benefit older adults and support programmatic changes.

Keywords:

• Client-centred
• home
• occupation-based
• occupational therapy
• occupational performance
• older adults

Acknowledgements

The occupational therapists Karen Andersen, Anette Bjerring, Dorte Sølund Hansen, Karin Breiner Henriksen, Lene Ifversen, Jytte Jakobsen, Birgitte Krogh Jespersen, Zita Jespersgaard, Louise Møldrup Nielsen, Hanne Pedersen, Helle Søndergaard Thomsen, senior consultant Nils Høgel, and the steering committee from The Municipality of Randers and VIA University College are greatly acknowledged for their participation and support.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The study has received financial, material and other support from The Tryg Foundation (Grant number J.nr.7-11-1343); The Municipality of Randers; VIA University College; Aarhus University, Department of Public Health; The Danish Association of Occupational Therapists (Grant number FF 1 13 - 10); and DEFACTUM, Central Denmark Region. The funders had no influence on the design or the results of the study.