Goldies2Home Project Update

 Enhancing Optimal Aging: Working Together with Goldies2Home: A Project Update- Fall 2017

Funded by the Labarge Optimal Aging Fund, Enhancing Optimal Aging: An Examination of a Unique Adult Day Service Model for Older Adults, is led by Dr. Vanina Dal Bello Haas, Assistant Dean (Physiotherapy), School of Rehabilitation Science, and Dr. Sharon Kaasalainen, Associate Professor, School of Nursing.

Our research, comprised of two (2) phases, aims to better understand how a unique adult day, slow stream rehabilitation program, using Goldies2Home (G2H, Shalom Village, Hamilton, Ontario) as a model of care, targets the needs of older adults transitioning from hospital to home.

Phase 1
Phase 1 of our research involved examining historical records, retrospective data and document mapping. Focus group and interviews were then conducted to get a better sense of what the past participants, their caregivers, G2H staff and administrators thought were the benefits and areas of improvement for the G2H program and outcome measures of importance. Transcripts were analyzed using qualitative thematic analysis.

Phase 2
Phase 2 involved creating participant assessments consisting of physical, psychological, cognitive and social questionnaires and measures, recording therapy and exercise prescription, and exercise(s) and activities completed.  These outcome tests and measures were approved by the Goldies2Home staff and implemented on participants of Goldies2Home. Assessments were conducted at baseline (start of the program), discharge (completion of the program after 4 weeks), 3-month post discharge, and 6-month discharge. Sixty-four participants were involved in Phase 2 assessments. Participants were also observed during the program by research assistants who logged activities and measured rate of perceived exertion during the exercise and fitness sessions.

The research team has completed enrolment and all data collection. Preliminary analysis of Phase 2 assessments are now being completed. Focus groups and interviews with participants who completed the program in Phase 2 were also conducted and analysis is underway.

The Results
Preliminary results indicate that participants benefit socially and have significant improvements in physical function and mobility related measures in the short term. However, healthcare system challenges such as funding and capacity can be improved, and responding to the identified challenges to enhance the model of care is warranted. To what extent physical related improvements are sufficient and can be sustained to maintain safe independent living post G2H discharge, as well as long term benefits, have yet to be determined.

Next Step: Goldies2Home 2.0
Goldies2Home 2.0 is a new project funded by the Hamilton Community Foundation. This is the next step for our current study and will focus on identifying key evaluation outcomes considered important during the future program implementation phase, exploring how and why different factors support or impede program implementation and impact study outcomes, and examining potential resource impact of the program model and related implications.

Goldies2Home 2.0 will involve conducting a literature review to identify the current evidence-base and best practices related to community-based, slow-stream rehabilitation models of care and programs, as well as conducting focus groups and interviews. Recruitment for focus groups will include current and past participants, family members of participants, staff, managers and administrators (Shalom Village), LHIN stakeholders, community agencies serving older adults, and older adults who are on the G2H waitlist. Questions will be asked about experiences, needs, strengths, concerns and challenges with current services, and a participatory action approval will be used to develop an enhanced model of care. The Goldies2Home 2.0 project begins this month.

Future Impact
Unique community-based adult day, slow stream programs, such as Goldies2Home, have the potential to increase older adults' quality of life, health and well-being, and satisfaction with transitional care. They could also provide a key role for mitigating risk and maximizing mobility and resilience in older adults through the provision of primary care services and chronic disease management, while ensuring optimal aging at home. Ultimately, our main goal for this research is to develop an enhanced community-based, slow-stream rehabilitation, hospital-to-home transition model of care for older adults, building on the current G2H program.

Acknowledgements
We would like to thank the staff and community of Shalom Village for their continued support and participation in our research.

For more information, please contact our study coordinator, Olivia Virag at viragoe@mcmaster.ca

General Information

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School of Rehabilitation Sciences
Faculty of Health Sciences, McMaster University
Institute of Applied Health Sciences,
Room 403, 1400 Main St. W. Hamilton, ON L8S 1C7

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