Authors: (including presenting author): :
Lau CM (1), Cheng KN (1), Jim CH (1), Ho CM (1)
Affiliation: :
(1) Occupational Therapy Department, Tai Po Hospital
Keyword 1: :
occupational therapy
Keyword 2: :
caregiver self-efficacy
Keyword 3: :
discharge planning
Keyword 4: :
home modification
Keyword 5: :
readmission prevention
Keyword 6: :
psychogeriatric
Introduction: :
Psychogeriatric patients and their caregivers often experience unmet environmental needs, insufficient caregiver preparedness and inadequate post-discharge support, contributing to high risks of re-admission, caregiver burnout, and reduced quality of life. Occupational therapists play a critical role in addressing these challenges by assessing the multifaceted needs of clients and their families. The Enhanced Elderly Discharge Program is designed to address these gaps by providing comprehensive pre-discharge home assessments, caregiver training, and community resource linkage to facilitate safe and sustainable transitions from hospital to home.
Objectives: :
To evaluate the effectiveness of EEDP provided by Occupational Therapist for Psychogeriatric Patients in in-patient setting.
Methodology: :
A single-group pretest-posttest design with one-month follow-up was employed from June to December 2025 at the Occupational Therapy Department of Tai Po Hospital. Fifteen psychogeriatric inpatients with functional impairment in ADL/IADL, fall or suicidal risk, environmental barriers, available caregivers, and planned discharge to home were recruited. The EEDP consisted of (1) pre-discharge home assessment and modification recommendations with assistive device prescription, (2) caregiver education on ADL/IADL assistance, behavioural and psychological symptoms of dementia (BPSD) management, and communication strategies, and (3) linkage to community resources. Primary outcome was caregiver confidence and competence measured by the Revised Scale for Caregiving Self-Efficacy (RSCSE; score 0–100) at baseline, immediately after post-intervention, and one month after discharge. Secondary outcomes included satisfaction survey (0-10 point scale), and 30-day psychiatric readmission rate.
Result & Outcome: :
Fifteen participants completed the EEDP (M=75.0 years, SD=7.79; 47% mood disorder, 47% dementia, 7% schizophrenia). According to the Wilcoxon Signed Ranks Test, RSCSE scores significantly improved (Z=-2.323, p=0.020) from baseline (M=48.6, SD=26.3) to post-intervention (M=61.9, SD=26.7). For the seven participants who completed the post-discharge follow-up, no significant difference was found in RSCSE scores (Z=-1.521, p=0.128) immediately after post-intervention (M=61.1, SD=26.8) compared to one-month after discharge (M=75.6, SD=24.2), indicating the maintenance effect of the EEDP on caregiver confidence and competence. Caregivers showed increased knowledge in home safety (Z=-1.952, p=0.050; M=6.27, SD=1.35 at baseline vs. M=7.19, SD=1.22 post-intervention) and community services (Z=-2.00, p=0.045; M=5.50, SD=1.95 at baseline vs. M=6.79, SD=1.60 post-intervention). Program satisfaction was high (M=8.3, SD=1.43). None of the seven participants with post-discharge follow-up were re-admitted to the hospital within 30 days after discharge. To conclude, the EEDP significantly improved caregiver self-efficacy, with effects sustained at one-month follow-up, and showed promising results in preventing early psychiatric readmission. These findings support the integration of structured discharge planning into routine psychogeriatric occupational therapy practice.
