Therapy intensity from the care pathways
cognitive (dis)abilities, pain
APPENDIX, MALNUTRITION
Six GR facilities indicated that, apart from the specialized nursing staff, GR pivots on three main healthcare professionals: the medical team, the occupational therapist, and the physiotherapist. Appendix A shows the therapy intensity as described per care pathway per healthcare professional per week. Four of the six GR facilities registered a combination of individual as well as group therapy. The remaining two GR facilities distinguished between individual and group therapy provided by the physiotherapist. Unfortunately, the frequency of group therapy was not specified. To avoid the possibility that the calculated individual and group therapy were outliers in these two GR facilities, only physiotherapy on an individual basis was considered in the analysis. Healthcare professionals such as psychologists, dieticians, speech therapists, and social workers were available on a consultation basis and were not standard in the care pathways. Five GR facilities described they had multidisciplinary consultation meetings to evaluate progression and adjust the rehabilitation where and if necessary. In addition to the intensity of therapy GR facility A, D, E and F described the content of therapy based on assessment and screening tools. The tools selected by the facilities varied. GR facility A, D, and F applied the Utrecht Scale for Evaluation of Clinical Rehabilitation (USER) for the evaluation of cognitive (dis)abilities, pain, mobility, and Activity of Daily Living (ADL), as well as the Canadian Occupational Performance Measure (COPM) for the evaluation of problems with ADL, participation, and goal setting. Next to the USER, the additional assessment tools for mobility in GR A and D were Time Up and Go (TUG), 10-m walk test (10MWT) and Functional Ambulation Categories (FAC). Risk inventory and evaluation was incorporated in GR facilities A, D and F, using the Visual Analogue Scale (VAS) for screening of pain and Short Nutritional Assessment Questionnaire (SNAQ) to screen for malnutrition. GR facility D additionally screened for polypharmacy and falls. GR facilities D and E centered on caregiver involvement by adapting the caregiver scan or caregiver strain index (CSI) (see Appendix B).