Intensity of Occupational Therapy Utilization in Nursing Home Residents: The Role of Sensory Impairments.

OBJECTIVES: Unaddressed functional limitations in nursing home (NH) residents can lead to unnecessary, excess disability that negatively affects residents' quality of life. In order to enhance functioning, NH residents can receive rehabilitation such as occupational therapy (OT). However, little is known about factors that may aid or hinder full therapy utilization in NH residents. Hence, our study investigated sensory impairments (vision and hearing) and other important health-related variables (eg, cognitive functioning) as predictors of intensity of OT utilization.

DESIGN: Retrospective study with data extraction from electronic medical records (EMRs).

SETTING: Skilled nursing facility.

PARTICIPANTS: A sample of newly admitted NH residents (N = 121).

MEASUREMENTS: Single items for sociodemographic variables and clinician-rated extent of sensory difficulties (hearing and vision) as well as pain presence based on Minimum Data Set (MDS 3.0) assessments in EMRs. MDS 3.0 scales assess cognitive functioning, depressive symptoms, and functional dependency. Total hours of OT received during 90 days postadmission to the NH were extracted from the EMRs.

RESULTS: A regression analysis demonstrated that better admission hearing and cognitive functioning, fewer admission depressive symptoms, and higher admission functional dependence were associated with more intense OT utilization-more hours used-over a 90-day period.

CONCLUSION: This study emphasizes the importance of assessing and addressing hearing difficulties and depression in NH residents in order to optimize utilization of beneficial OT services and to promote most optimal independent functioning and quality of life.