Addressing the Gap: Occupational Therapy in Hospice Care.

Patients receiving hospice care have a host of occupational challenges, though few are being seen in occupational therapy for treatment. Occupational therapy can help those receiving hospice care live with dignity before death. Data retrieved from the National Home and Hospice Care Survey were analyzed using independent t-tests, Wilcoxon rank-sum tests, Chi-square tests and logistic regressions. Only 10.6% of the participants received occupational therapy. Patients who received occupational therapy were significantly older and had shorter lengths of hospice care service compared to their counterparts. Over 85% of the patients needed assistance with at least one task of activity of daily living (ADL). Findings suggested a need to increase occupational therapy workforce in hospice care and advocate the value of occupational therapy services in hospice settings.

Is Referral to Home Health Rehabilitation After Inpatient Rehabilitation Facility Associated With 90-Day Hospital Readmission for Adult Patients With Stroke?

OBJECTIVE: We examined the association between home health rehabilitation referral and 90-day risk-adjusted hospital readmission after discharge from inpatient rehabilitation facilities among adult patients recovering from stroke (N = 1219). DESIGN: A secondary data analysis of the 2005-2006 Stroke Recovery in Underserved Population database. A logistic regression model, multilevel model, and the propensity score inverse probability weighting model were used to evaluate the risk of 90-day rehospitalization between patients with stroke who received a referral for home health rehabilitation and those who did not receive a home health rehabilitation referral at inpatient rehabilitation facility discharge. RESULTS: The regression, multilevel, and propensity score inverse probability weighting models indicated that inpatient rehabilitation facility patients with stroke who received home health rehabilitation referral had substantially lower odds of 90-day rehospitalization after inpatient rehabilitation facility discharge compared with those who were not referred to home health (odds ratio = 0.325, 95% confidence interval = 0.138-0.764; odds ratio = 0.340, 95% confidence interval = 0.139-0.832; odds ratio = 0.407, 95% confidence interval = 0.183-0.906, respectively). CONCLUSIONS: Our findings suggest the importance of continuation of care (home health) after hospitalization and intense inpatient rehabilitation for stroke. Additional research is needed to establish appropriate use criteria and explore potential underuse of home health services as well as the benefits for follow-up outpatient services for those who do not qualify for home health at inpatient rehabilitation facility discharge.

Comparisons of the Association of Family and Social Factors With Functional Limitations Across the United States, Mexico, and South Korea: Findings From the HRS Family of Surveys.

Objective: The association of family and social factors with the level of functional limitations was examined across the United States, Mexico, and Korea. Method: Participants included adults from the 2012 Health and Retirement Study (n = 10,017), Mexican Health and Aging Study (n = 6,367), and Korean Longitudinal Study of Aging (n = 4,134). A common functional limitation scale was created based on Rasch analysis with a higher score indicating better physical function. Results: The American older adults (3.65 logits) had better physical function compared with Mexican (2.81 logits) and Korean older adults (1.92 logits). There were different associations of family and social factors with functional limitations across the three countries. Discussion: The American older adults demonstrated less functional limitation compared with Mexican and Korean older adults at the population level. The findings indicate the need to interpret carefully the individual family and social factors associated with functional limitations within the unique context of each country.