02962nas a2200457 4500000000100000008004100001653001100042653001100053653000900064653000900073653002200082653001700104653002000121653002200141653001600163653002200179653003100201653006600232653001800298653002500316653003300341653002300374653005200397653003200449653002300481653005500504653005600559100001300615700001300628700001400641700001400655700001200669700001900681700001500700245012500715250001500840300001100855490000700866520158000873020005102453 2014 d10aFemale10aHumans10aAged10aMale10aTreatment Outcome10aRisk Factors10aRisk Assessment10aAged, 80 and over10aNew Zealand10aSurvival Analysis10aActivities of Daily Living10aDelivery of Health Care/methods/organization & administration10aFrail Elderly10aGeriatric Assessment10aHealth Services for the Aged10aHome Care Services10aIndependent Living/ statistics & numerical data10aPatient Discharge/standards10aProgram Evaluation10aRehabilitation/methods/statistics & numerical data10aResidential Facilities/ statistics & numerical data1 aKerse N.1 aHoorn S.1 aJacobs S.1 aSenior H.1 aChen M.1 aAnderson Craig1 aParsons M.00aPromoting independence in frail older people: a randomised controlled trial of a restorative care service in New Zealand a2014/03/07 a418-240 v433 a

BACKGROUND: frail older people often require tailored rehabilitation in order to remain at home, especially following a period of hospitalisation. Restorative care services aim to enhance an older person's ability to remain improve physical functioning, either at home or in residential care but evidence of their effectiveness is limited. OBJECTIVE: to evaluate the effectiveness of a restorative care service on institutional-free survival and health outcomes in frail older people referred for needs assessment in New Zealand. METHODS: a randomised controlled trial of restorative care or usual care in 105 older people at risk of permanent residential who were follow-up over 24 months. The restorative care service was delivered in short-stay residential care facilities and at participants' residences with the aim of reducing the requirement for permanent residential care. It included a comprehensive geriatric assessment and care plan developed and delivered, initially by a multi-disciplinary team and subsequently by home care assistants. RESULTS: compared with usual care, there was a non-significant absolute risk reduction of 14.3% for death or permanent residential care (8.8% for residential care and 7.2% for death alone) for the restorative care approach. There was no difference in levels of burden among caregivers. CONCLUSIONS: restorative care models that utilise case management and multi-disciplinary care may positively impact on institutional-free survival for frail older people without adversely impacting on the health of caregivers.

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