How occupational therapists teach older patients to use bathing and dressing devices in rehabilitation.

OBJECTIVE This article describes the methods occupational therapists use to teach bathing and dressing device use to older patients in rehabilitation programs. The relationship of three patient characteristics to five aspects of assistive device instruction was examined. METHOD The study sample included 86 patients and 19 occupational therapists who provided the assistive device training. Patients were 55 years of age or older and in rehabilitation for an orthopedic deficit, cerebrovascular accident, or lower limb amputation. Therapists recorded information on teaching methods, perceptions of patient knowledge, and expectations for future device use after each treatment session. RESULTS Patients received an average of three dressing and two bathing devices for home use. Therapists devoted an average of two and a half sessions (10 min average duration) to teach dressing device use and an average of one session (9 min average duration) to teach bathing device use. Teaching occurred mostly in the clinic setting through oral instruction and demonstration. At discharge, patients who evaluated devices positively and were evaluated as having a positive affect were perceived by the therapists as "having greater knowledge of device use." More time was spent teaching those patients with lower Functional Independence Measure scores, less positive evaluations of devices, and lower affect scores. Family caregivers were involved in one or more dressing sessions for 26% of patients and one or more bathing sessions for 36% of patients. CONCLUSION Assistive device training in rehabilitation centers consists largely of simulated sessions in the occupational therapy clinic, and patients in the study described the instruction they received as "satisfactory." More research is needed to study the long-term effectiveness of assistive device training after patients return home.