Assessing the impact of a restorative home care service in New Zealand: a cluster randomised controlled trial

Abstract

Due to the ageing population, there is an increased demand for home care services. Restorative care is one approach to improving home care services, although there is little evidence to support its use in the community setting. The objective of this trial was to evaluate the impact of a restorative home care service for community-dwelling older people. The study was a cluster randomised controlled trial undertaken at a home care agency in New Zealand. The study period was from December 2005 to May 2007. Older people were interviewed face-to-face at baseline, four and 7 months. A total of 186 older people who received assistance from a home care agency participated in the study, 93 received restorative home care and 93 older people received usual home care. The primary outcome measure was change in health-related quality of life (measured by the Short Form 36 [SF36] Health Survey). Secondary outcomes were the physical, mental, and social well-being of older people (Nottingham Extended Activities of Daily Living, Timed Up and Go, Mastery scale, Duke Social Support Index). Findings revealed that compared with usual care, the intervention demonstrated a statistically significant benefit in health-related quality of life (SF36) at 7 months for older people (mean difference 3.8, 95% CI -0.0 to 7.7, P = 0.05). There were no changes in other scale measurements for older people in either group over time. There was a statistically significant difference in the number of older people in the intervention group identified for reduced hours or discharge (29%) compared with the control group (0%) (P < 0.001). In conclusion, a restorative home care service may be of benefit to older people, and improves home care service efficacy.

A review of self-rated generic quality of life instruments used among older patients receiving home care nursing

“…) and restorative home care service (King et al . ). The other two assessed responsiveness of different QOL instruments (Zhang et al .…”

A systematic review of the evidence on home care reablement services

“… reablement intervention does not meet the systematic review 'intervention' criteria'(1 study) 39 .…”

Home care: An opportunity for physiotherapy?

“…Such delegation is dependent on having suitably trained support worker staff and a level of trust by the physiotherapist in the ability of the support worker to deliver the programme and respond effectively to changes in the client over time. Within the New Zealand context this is only possible as a component of a system wide quality improvement initiative that comprises robust communication between the support worker, coordinator and physiotherapist (King et al 2012, King et al 2011 to enable responsive communication of progress and the required adjustments to the intervention.…”