Occupational Therapy in Care Homes (OTCH)

Background:

We are inviting care homes to participate in the OTCH trial which is assessing the value of occupational therapy for people who have had a stroke (including small strokes) living in care homes.  The study is funded by a section of the NHS called the National Institute for Health Research. We hope that the NHS will improve its provision of therapy to care homes as a result.Care homes will be identified via the Quality Health Care Commission public listings.  Half of the homes will receive the services of an Occupational Therapist for two to three months. The therapist will work with individual residents (with their informed consent), practicing activities, supplying aids and equipment and will also provide some staff training.Half of the homes will continue with their normal levels of care. Residents with stroke in these homes will be interviewed at regular intervals. When the study period is complete the occupational therapists will also provide 2 sessions of staff training at the end of the study and some teaching aids.

What happens if the care home participates?

We will ask you to:

• Identify all residents in the care home who have or may have a diagnosis of a stroke or TIA.
• Distribute trial invitation letters to eligible residents and explain the trial to them
• Liaise with residents who consent to participate and trial team members to arrange assessment meetings
• Provide access for trial team members, i.e. the assessor and occupational therapists
• Provide the trial team members with access to the residents’ notes so they are able to collect information on demographics and medication for the trial.
• Care home staff (in the control arm) will receive group education sessions on facilitating independence and mobility and the use of adaptive equipment.

If you would like to know more please contact Katie Stant

Tel: 0121 414 6510
Email: k.e.stant@bham.ac.uk

What is the purpose of the study?

This 4 year-long study is being carried out to assess the value of providing a targeted course of occupational therapy to people living in a residential or nursing home after stroke. This service has been found to be of value to people living in their own homes, and to people after a stroke. It has been found to be helpful in terms of improving their independence, their ability to take part in every day activities, and their mobility. However, occupational therapy is less readily available to people living in residential or nursing homes.

What would happen to me if I take part?

All the homes that participate in the study will either receive the service of an occupational therapist or not for a three month period (on top of any services the home currently receives). However, the computer will randomly decide, as if by the toss of a coin, whether your home receives the therapy.

What do I have to do and what does the therapist do?

If you decide to take part, you will be assessed 4 times-at 0 months, 3 months, 6 months and finally at 12 months. You may be seen by an occupational therapist, who will deliver therapy according to your needs. The assessments will ask you various questions about your day-to day activities. The initial assessments will also include looking at your speech (an aphasia screening test) and at psychological functioning.

The therapists providing the service will ask you about your ability to take part in day to day activities and if the therapist feels that she can help you to keep your mobility and or prevent you from loosing your independence she will suggest one of a number of things to help you such as;

• Provide a piece of equipment or adapt something (such as raising the height of your chair).
• Provide some advice
• Provide some activities, which he/she will practice with you and ask you to continue to practice between visits.
• Provide some exercises for you to practice.

The therapists will arrange a time that is convenient for you and this would not restrict your lifestyle in any way. The therapists providing the therapy would be visiting your place of residence for about 3 months, but as an individual you may only be seen a few times (depending on your needs). 

If you would like to know more please contact Katie Stant

Tel: 0121 414 6510

Email: k.e.stant@bham.ac.uk

Background:

We are inviting care homes and their residents to participate in the OTCH trial which is assessing the value of occupational therapy for people who have had a stroke (including small strokes) living in care homes. The trial is funded by a section of the NHS called the National Institute for Health Research. We hope that the NHS will improve its provision of therapy to care homes as a result.

In this trial, we are proposing to provide access to occupational therapy for the eligible residents. Following an individual assessment, the therapist will be able to work with the resident to provide training and practice activities. The therapist may also supply some equipment to help the person such as adapted cutlery or they may provide small adaptations to the home that may help the residents improve their independence and mobility. For example, the therapist may raise the height of the chair to make it easier to stand up and provide a grab rail in the toilet. The content of therapy is NOT experimental and is in keeping with current occupational therapy practice, as delivered in domiciliary settings. The study is evaluating a standard intervention when delivered in a care home setting. This is because the organisation, environment and personal characteristics of the people living in this type of setting differ from those of people living in their own homes, which may affect the value of the intervention and economics of the intervention.

Clearly the care home staff will need to be able to understand how to use the equipment given to residents and how to encourage practice. Therefore staff training and education will be part of the intervention.

Half of the homes will receive the intervention and half will not, then the whole group will be compared on assessments that specifically measure day to day activity and mobility. 

If you would like to know more please contact Katie Stant

Tel: 0121 414 6510

Email: k.e.stant@bham.ac.uk