Transferring Occupational Therapy Knowledge to Village Health Volunteers to Enhance Activities of Daily Living Among Older Adults in Community-Based Elder Care: A Qualitative Study.
Autchariya Punyakaew, Suchitporn Lersilp, Napalai Chaimaha and 2 others
Practical strategies across six ADL domains—seated dressing to cut fall risk, oval-lipped cups for stroke patients, bamboo grab bars—emerged from ten experienced OTs in Chiang Mai, alongside a hands-on training model for village health volunteers using simple language and local materials.
Key findings
1Ten OTs organised their recommendations into six ADL domains (feeding, grooming, dressing, bathing, toileting, mobility), each with specific strategies spanning adaptive techniques, environmental modifications, caregiver education, and cultural adaptation.
2A four-part framework for training village health volunteers was proposed: use plain everyday language instead of clinical terms, equip VHVs with a structured referral prompt ('What I saw… What I tried… What I need'), deliver short hands-on workshops with role-play and real community photos, and anchor everything in locally available materials.
3Cultural fit was treated as central, not decorative: Western-style adaptive clothing (Velcro fasteners) was often resisted in favour of front-opening shirts or loose-fitting Thai garments; bamboo, PVC pipe, and rope were recommended over imported equipment; and temple grounds or community pavilions were suggested as walking-practice spaces.
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How it was doneWhat they foundWhat it means for OTs
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What it does not show
All ten OTs work in one city (Chiang Mai), so the recommendations reflect that specific healthcare context and may not transfer to other regions or countries. The village health volunteers themselves were not interviewed; we only hear the OTs' view of what volunteers need, not the volunteers' own experience, challenges, or training gaps. No one tested whether these guidelines actually improve ADL performance when VHVs use them. These are structured expert recommendations, not a tested intervention with measured outcomes. The sample of 10 OTs, while adequate for thematic saturation in qualitative work, means the range of practice settings and patient populations is narrow.
Declared interests
Funded by the Faculty of Associated Medical Sciences, Chiang Mai University (Project No. R67IN00001). The authors declare no conflicts of interest.
The easy way to misread this
Do not read these as evidence that the guidelines improve ADL outcomes. Ten OTs described what they do and what they think would work for community volunteers; no intervention was delivered to older adults, no outcomes were measured, and no follow-up was conducted. The recommendations are expert opinion organised into themes, not a tested programme, and the cultural specificity (Thai garments, bamboo, temple grounds) means they are not a generic ADL toolkit you can drop into another setting unchanged.
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