Page 184 - HA Convention 2015

Service Priorities and Programmes Free Papers

SPP6.7 Managing Service Demands 10:45 Room 221

How Domiciliary Occupational Therapy Fill the Gap of Existing Community Services for Frail Elderly —
a Retrospective Review
Lam R, Ng S, Ng B
Occupational Therapy Department, Kowloon Hospital, Hong Kong

Introduction

Enhancing community and primary care is one of the Hospital Authority’s (HA) strategic directions to meet the caring
demand of the growing population of frail elderly. Despite the establishment of various new services, e.g. Integrated Care
and Discharge Support for Elderly Patients Programme and improvement of existing services (such as enhancement of
Community Geriatric Assessment Service, Geriatric Day Hospitals, etc.) The demand is still not met. In previous years,
Occupational Therapy Department of Kowloon Hospital still received referrals for Domiciliary Service. The study intended to
review our domiciliary referrals and services provided in 2014 in order to describe potential service gaps. We hope that such
information can facilitate concerned stakeholders to devise healthcare plans in future.

Tuesday, 19 May Objectives

Describe basic demographics, sources of referral, occupational therapy interventions in order to estimate potential service
gaps of community care.

Methodology

Case records of all domiciliary occupational therapy (DOT) referrals from January to December 2014 were retrieved for
review. Additional clinical data of related cases were downloaded from Clinical Data Analysis and Reporting System for
analysis. Descriptive statistics were mainly used.

Results

The majority of the 294 cases being referred for DOT in 2014 were elderly; 89.90% of clients were older than 65 years old,
who suffered from chronic disabling diseases, such as cardiopulmonary diseases, fracture and dementia. There were still
10.10% of patients aged below 60, their conditions included stroke and spinal problems etc. 58.80% of referrals were directly
related to post-discharge support from the hospital. These patients were excluded from ICDS but the clinicians or caregivers
concerned about “safe” discharge or their age were out of range. In case there were community support service arranged,
the appointment might be shortened after discharge. Services provided for this group of patients included: home safety
assessment and follow-up (28.96%), aids prescriptions (22.40%), home oxygen follow-up (19.13%) and on-site carer training
(13.11%) and Activity in Daily Livings training (7.92%). There were 31.97% of referrals from outpatient clinics and most of
these cases suffered from dementia and/or depression. This might suggest that the provision of community care for elderly
with purely psychological problems were still scarce. The remaining referrals were from HA community teams (9.18%), which
indicated that due to long waiting time for long term care services provided by social welfare department could not address
the urgent needs of this group of patients. This review will describe areas that our healthcare system may address in planning
our service.

HOSPITAL AUTHORITY CONVENTION 2015

182