Exploring how occupational therapists and physiotherapists evaluate rehabilitation potential of older people in acute care.
Gemma Bradley, Katherine Baker, Catherine Bailey
PMID 40337082WHAT IT FOUND
Therapists judged older patients' rehab potential by comparing current function with pre-admission baseline, treating acute problems first, then watching response to therapy.
Pathway choices often depended on bed and service availability more than clear criteria.
Key findings
01A four-stage reasoning process was identified when therapists evaluated rehabilitation potential.
02Baseline information was central, but clinical records often showed gaps, question marks and inconsistent entries about previous function.
03Therapists waited to see progress before making confident judgements, and pathway decisions were influenced by bed and service availability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study took place on one ward in one UK hospital, so the reasoning may not transfer to other settings. It included only five patient cases and a small number of therapists, with three occupational therapists and three physiotherapists observed and three occupational therapists and two physiotherapists interviewed. It focused on occupational therapists and physiotherapists, so patients, families and other professionals were not fully represented. All observations and interviews were done by one researcher, although other analysts checked the data. The four-stage process is descriptive, not a validated tool, and the authors say it is not best practice. Data were collected in 2016 and 2017, before changes described in COVID-19 discharge guidance, so language and practice may have evolved.
Declared interests
The authors declared no potential conflicts of interest and received no financial support.
The easy way to misread this
Do not use the four-stage process as a validated tool for deciding who should get rehabilitation. It describes reasoning on one ward, with a small number of patients and therapists, and the authors state it is not a decision-making tool or best practice.