Amstelring

International organizations have called for the development of programs to strengthen global health resilience. This poster describes the development of an international research collaborative to examine whole-person health and resilience using the web-based application MyStrengths+MyHealth (MSMH). MSMH enables individuals to self-report strengths (resilience), challenges, and needs using simplified terms that have been community validated and at the fourth grade US reading level.

In general older adults, even the oldest old are community dwelling and vital. However, vulnerability can silently or suddenly exist. Multidisciplinary assessment of health problems and disabilities is necessary to compose a comprehensive intervention program. In the Netherlands, a team specialised in elderly care accomplishes home-based assessments. In 2009 we conducted a case study aiming to describe the characteristics of the patients and the reasons for consultation. A total of 84 records were analysed. 60% of the clients were 85 years or older, 32% were living independently and 61% were residents in homes for elderly people. The majority of clients was female and living alone (widowed). Most clients had multiple issues and were referred for cognitive evaluation. During the process of assessment many underlying behavioural, emotional and social problems became manifest. These findings support that symptoms and complaints of frail elderly are complex. A systematic multidisciplinary approach enhances the dialogue with patients and caregivers to discuss their needs and their attitude towards care. More research, however, is necessary to evaluate the effectiveness of this intervention.

Occupational therapy might play an important role in maintaining independent living for community dwelling elderly people. The aim of this systematic review is to determine whether occupational therapy improves outcome for people who are >/=60 years and are living independently. An extensive search in MEDLINE, CINAHL, EMBASE, AMED and SCISEARCH until July 2002 was performed. Studies with controlled and uncontrolled designs were included. Six intervention categories were distinguished and individually analysed using a best-evidence synthesis, based on the type of design, the methodological quality, type of outcome measures and statistical significance of findings. 17 studies were included, ten of which were randomised clinical trials. Six randomised clinical trials had a high methodological quality. Strong evidence is present for the efficacy of advising on assistive devices as part of a home hazards assessment on functional ability. There is some evidence for the efficacy of training of skills combined with a home hazard assessment in decreasing the incidence of falls in elderly people at high risk of falling. Some evidence is available for the efficacy of comprehensive occupational therapy on functional ability, social participation and quality of life. Insufficient evidence is present for the efficacy of counselling the primary caregiver of dementia patients about maintaining the patient's functional abilities. This review shows that occupational therapy interventions for community dwelling elderly people results in positive outcomes. Future research in the efficacy of occupational therapy in elderly patient groups such as people with dementia is recommended. Furthermore, research into tailoring interventions to the needs of elderly patients is recommended.