Switching from “one size fits all” to a personalised approach based on free open source kitchen design software could dramatically slash the annual cost of adapting the homes of elderly patients on their discharge from hospital.
Research from occupational therapy and computer science academics from Brunel University London shows that more than half of the costly equipment from shower chairs to grab rails installed in their homes for such patients is ever actually used.
The Brunel solution could also speed up the whole process of pre-discharge home visits by occupational therapists (OTs) relieving hospitals of “bed-blocking” elderly patients who are healthy enough to go home at a further cost of more than £500 a night.
Explained Dr Arthur Money, who led the team: “Pre-discharge home visits are routinely carried out to make sure the transfer from hospital to home is safe for the patient.
“But there are issues not only with the speed of the process but the lack of shared decision making which leads to more than half of assistive equipment installed not having been used when OTs make follow-up visits.”
He added: “While some adaptations may fall into the not-needed-yet-but-will-be-category, many patients end up with equipment they don’t understand how to use or is useless because it is installed at the wrong height.
“And many patients find the home visit itself demoralising, daunting and anxiety provoking. Our software turns the home visit into a collaboration between patient and OT.”
OT lecturer Dr Anita Atwal says the software also helps bridge the information gap where elderly people are not quite sure what a piece of equipment is or does but are reluctant to show their ignorance to an expert.
“As OTs one of the most striking lessons from the research is when older people were placing items of what to us is part of our everyday work in the wrong places – quite clearly not understanding what the equipment was for.”
Fellow Brunel OT lecturer Lesley Wilson added: “It also became clear that while the hacked interior design software is a great tool for both patient and OT it needs to be used in a partnership approach.
“Older people using it hands-on in our study were very clear they saw it as a great tool but one to be used together with their OT. And many have already encountered versions on the High Street from estate agents to kitchen design outlets.”
The team plans further developments to the software in the next phase of the research including the ability to introduce the patient into their adapted virtual home by building accurate to real-life scale avatars.
Said Dr Money: “Just in the same way as different people want a different kitchen counter height items such as grab and hand rails need to be installed at a comfortable height for the patient. Introducing avatars will help OTs get that aspect right.”
A copy of their paper is available for download here