Dilemmas in rehabilitation and patient strategies in an intensive home intervention: a follow-up study

Abstract

Background The original project, where older persons received reablement performed by an interprofessional team showed success factors for IHR. However, since there is a lack of knowledge about why some persons do not recover despite receiving IHR, this study follows up patients’ experiences of IHR. Aim To describe older persons’ perceived dilemmas in the reablement process within the framework of IHR. Method 11 CIT interviews with participants who have previously received IHR, were analysed, interpreted and categorized according to CIT. The study was approved by the Swedish Ethical Review Authority. Results The results showed disease-related dilemmas, fatigue or pain so that participants could not cope with the prescribed exercises. New diseases appeared, as well as medication side effects made exercising difficult, and painkillers became a prerequisite for coping with IHR. Low self-motivation and mistrust towards the staff emerged like lack of trust due to otherness such as sex, cultural background, or language also became critical. Conclusions Interventions that consider individual- and contextual dilemmas are very important. By recognizing critical situations, this study can work as a basis of evidence to further develop interventions for older people living in their own homes and to ensure them to stay there.

Keywords

• active ageing
• follow-up
• home rehabilitation
• interprofessional team
• municipal care
• recovery
• reablement