OBJECTIVE: To determine the impact of a restorative model of home care on social support and physical function among community-dwelling older people. DESIGN: Cluster randomized controlled trial SETTING: Home care in urban New Zealand. PARTICIPANTS: 205 participants (mean age 79.1 years, 71.3% female, 81.5% New Zealand European (NZE) and 50.8% residing in areas of the highest levels of social deprivation (intervention group) and 76.9 years with 60.8% female, 73.2% NZE and 53.5% in the highest levels of social deprivation (usual care group). INTERVENTION: Participants randomized to the intervention group completed a goal facilitation tool with a Needs Assessor to determine their needs and to establish the aims for the episode of care. Services were structured according to the principles of restorative home care (independence focussed with individually tailored activity programs). Usual care participants received a standard needs assessment that informed the delivery of home care services. MAIN OUTCOME MEASURES: Short Physical Performance Battery, Dukes Social Support Index. RESULTS: There was greater change over time in physical function (measured by Short Physical Performance Battery (F = 8.30, p = 0.003)) but no associated increase in social support (as determined by Dukes Social Support Index (F = 2.58, p = 0.09)). CONCLUSIONS: Significant improvements in physical function were observed following a period of restorative home care services. The absence of an associated change in social support may have been the result of a combination of factors, including: the threshold of physical function required for community ambulation; the low rate of allied health service provision; and the time required to re-establish social ties. The findings contribute to greater understanding of factors necessary to refocus home based services to emphasise improvements in physical function and independence.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher