Enhancing Physical Activity Recommendations to Support Cognition in Homecare: A Quality Improvement Project

Abstract

Background: Physical activity is a safe, evidence-based self-management strategy for older adults (aged 65+) with cognitive impairment. Although homecare occupational therapists (OTs) and physiotherapists (PTs) are well positioned to support the growing number of older adults living at home with cognitive impairment, physical activity is rarely recommended as a strategy to manage cognition. Objective: To increase OTs’ and PTs’ knowledge of physical activity recommendations, as well as increase the range of physical activity recommendations for older adults living at home with cognitive impairment. Methods: This quality improvement project used a pre-post intervention approach. Data was collected through a pre-post clinician survey and pre-post chart audit to evaluate the impact of a multimodal education intervention on OT and PT knowledge and practice. The intervention included educational sessions and the development of four client handouts. Results: Post-intervention, OT and PT survey results showed a non-significant improvement in knowledge, and a greater range of physical activity recommendations. The PT chart audit demonstrated a statistically significant increase in PTs providing education about the role of physical activity in relation to cognitive impairment. For OTs, there was a non-significant increase in physical activity recommendations. Conclusions: This multimodal education resulted in non-significant improvements in knowledge for OTs and PTs, however there were significant practice changes for PTs when providing education to patients about the impact of physical activity on cognition. Future research could refine the targeting of this intervention to better meet the needs of OTs and incorporate an evaluation of patient outcomes.