What are the short-term and long-term effects of occupation-focused and occupation-based occupational therapy in the home on older adults' occupational performance? A systematic review.

BACKGROUND: There is a lack of evidence-based knowledge about the effectiveness of home-based OT for older adults aimed at improving occupational performance by practicing activities and tasks.

AIM: This review synthesizes and discusses evidence for the effectiveness of occupation-focused and occupation-based OT for older adults at home.

MATERIAL AND METHODS: Peer-reviewed quantitative papers were included.

PARTICIPANTS:  ≥ 60-year-old adults with functional limitations.

INTERVENTION: OT aiming at improving occupational performance, primarily through the practice of activities and tasks.

OUTCOME: Occupational performance.

CONTEXT: Home. Three reviewers critically appraised 13 of 995 detected papers. Extracted data were presented and summarized descriptively.

RESULTS: Eight high-quality papers showed that occupation-focused and occupation-based OT using cognitive, behavioral and environmental strategies may significantly improve occupational performance in older, home-dwelling adults with physical health problems. Maintaining achieved improvements was a consistent challenge.

CONCLUSIONS AND SIGNIFICANCE: Evidence suggests that older adults' occupational performance can be significantly improved through low-intensity occupation-focused and occupation-based intervention. It is recommended to develop and test high-intensity OT programs and maintenance programs.