Limited research exists on the experiences of older adults participating in community rehabilitation. Our longitudinal, collective case study explored older adults’ experiences while they engaged in community rehabilitation and home care services, as well as family caregivers’ concurrent experiences. Drawing on interpretive description, we inductively analysed interview data gathered at three points over 3–6 months from six family dyads. Questions focused on activities of daily living, instrumental activities of daily living and other meaningful activities affected by changes in the older adult’s health. From our thematic analysis, three themes emerged: (a) Centring community rehabilitation and home care services around the older adult and family; (b) Understanding the intricate interface of formal and informal supports; and (c) Supporting the meaningful aspects of life. Our findings suggest a metaphor of re-braiding, a reconfiguration of activities that requires increased integration of formal and informal supports within home care and community rehabilitation.

Social re-entry in the criminal justice system cannot be avoided since virtually all prisoners are released sooner or later. These initiatives are the outcome of a restorative justice approach which aims to reduce future offences by bringing back offenders to normal life by rehabilitation and restoration. Prisoners’ lives in prisons were very difficult in the Indian context till the last decade. Different rehabilitative approaches have been introduced inside prisons but, after release, the number of social re-entry initiatives is much less. The released face many psycho-social and economic issues which may destroy a person’s ability to adjust with the services provided. The national prison policy of India recommends aftercare services for the rehabilitation of released prisoners. The labelling and social stigma due to the crime hinders prisoners’ ability to re-enter society after release. In this context, the present paper explored the issues and challenges faced by the released prisoners during their social re-entry and came up with rehabilitative initiatives for a better restoration process in the Indian context.

To better understand and improve the rehabilitation process of older adults with sensory losses in both hearing and vision or dual sensory impairment (DSI), this study explored the perspectives of health care professionals who work with this population. Thirteen individuals, with varied professional backgrounds, were interviewed about their experiences in working with older adults with DSI. We transcribed and coded the interviews, then conducted content analysis. Regardless of their professional backgrounds, the participants reported additional roles that they perceived they fulfilled: (a) counsellor, (b) navigator, and (c) trainer and re-trainer. These roles involved helping individuals with DSI, and their family, with depression, acceptance, repeat consultations, and way-finding through the health system. From the professionals’ perspective, these additional roles increase workload and place them in situations they were not trained for. They suggest education for all professionals and for family members working with people with DSI; moreover, they suggest a multidisciplinary team rehabilitation approach.

Residents in long-term care (LTC) often require physical rehabilitation (PR) to maintain/improve physical function. This scoping review described the breadth of literature regarding PR in LTC to date, synthesizing PR interventions that have been evaluated, outcomes used, and tools for determining service eligibility. A structured search, conducted in six licensed databases and grey literature, identified 381 articles for inclusion. Most interventions were delivered and evaluated at the resident level and typically were multicomponent exercise programs. Performance-based measures, activities of daily living, and mood were the most frequently reported outcomes. A key knowledge gap was PR in relation to goals, such as quality of life. Future studies should reflect medically complex residents who live in LTC, and length of residents’ stay should be differentiated. Intervention studies should also explore realistic delivery methods; moreover, tool development for determining service eligibility is necessary to ensure equality in rehabilitative care across the LTC sector.

This study examined a population-based profile of older adults with acquired brain injury, and their functional outcomes, in in-patient rehabilitation. Older adults aged 65 and older admitted to in-patient rehabilitation from acute care with traumatic brain injury (TBI) (n = 1214) or non-traumatic brain injury (nTBI) (n = 1,530) from 2003/04 to 2009/10 in Ontario were identified. Demographic and clinical characteristics and the total function score from the FIM(TM) Instrument were examined. The Discharge Abstract Database and National Rehabilitation Reporting System were used. Results indicated that older adults with TBI had significantly higher total function scores than those with nTBI at admission and at discharge (p < .001). However, both groups made significant (p < .001) and similar gains (p > .05) in total function scores. We conclude that older adults with TBI and nTBI make similar in-patient rehabilitation gains. Lower initial functional ability of nTBI patients on admission and patients’ different clinical profiles have implications for clinical care and resources.

This study investigated the relationships among several aspects of cognitive functioning and the outcome of self-medication training in hospitalized elderly patients. Data from 53 geriatric patients who received rehabilitation treatment at the SCO Hospital in Ottawa, Canada between 1992 and 1997 were collected, on an archival basis. Patients began a graduated self-medication program after undergoing a neuropsychological evaluation. Performance scores from five different aspects of cognition were regressed on the self-medication training outcome measures. Findings revealed that aspects of cognitive functioning were significantly related to the outcome of self-medication training. Thus, psychometric measures of cognition can be useful in predicting which patients are most likely to benefit from a self-medication program, or alternatively, those who would require a modified program to be able to learn. The clinical implications of these results are discussed.

The Functional Independence Measure (FIM) was developed to assess the burden of care of persons receiving rehabilitation services in regard to self-care activities and social and cognitive skills. Until now, no study has evaluated the validity of the FIM with the elderly without distinction of diagnosis. The purpose of this study was to examine the MIF's factorial structure using a principal components analysis. As a secondary goal, the predictive validity and the internal consistency of the instrument were also examined. Data collected from 120 subjects generated a solution consisting of three factors accounting for 67.6 per cent of the total variance. The first factor (46.6%) represents the handicap concept, the second factor (14.7%) measures disability and the third factor (6.3%) represents disability with a major component of physical involvement of lower extremities. The results of this analysis confirm the multidimensional structure of the FIM and reveal the possibility of a third factor for the elderly. With this population, internal consistency of the instrument, obtained from admission and discharge data, is estimated at 0.92 and 0.96 with Cronbach's alpha. Total FIM score at discharge as well as items related to the handicap factor as measured on admission allow us to correctly predict place of discharge in a proportion of 72.9 per cent of the cases. These results indicate that the FIM bears an interesting potential for measuring rehabilitation outcomes for the elderly.

This study compared the changes in some bio-psychosocial variables (functional independence, nutritional risk, pain, balance and walking, grip strength, general well-being, psychiatric profile, perception of social support, leisure satisfaction, and caregivers' feeling of burden) in four categories of clients during their program at a geriatric day hospital (GDH). The study also evaluated whether or not improvements, if any, were maintained 3 months after discharge. One-hundred-and-fifty-one people, categorized by primary reason for admission, were assessed at the GDH with reliable and valid tools, at admission and at discharge. Three months after discharge, they were reassessed with the same tools. Overall, two categories of clients, stroke / neurological diseases and musculoskeletal disorders / amputations, improved the most. For the gait disorders and falls group, only the functional independence score improved, but not at a clinically significant level. Finally, clients in the cognitive function disorders / psychopathologies group improved the most on their well-being scores and caregivers' burden decreased the most. All gains were maintained up to 3 months after discharge, except for leisure satisfaction. With the exception of clients who attended the GDH because of gait disorders and falls, the improvements and maintenance achieved in each category occurred in the domains where improvement had been hoped for, because of the particular disabilities in question and because of the nature of the GDH services offered.