The Complexity of Geriatric Rehabilitation. A One-Year Follow-Up of Client, Caregiver, and Administration Perceptions

Abstract: The overarching aim of this thesis was to report changes in the quality of geriatric rehabilitation as perceived by administration, caregivers, and clients during a one-year period of a Swedish governmental venture of development in geriatric rehabilitation. Further aims were to describe changes in clients’ prevalence of symptoms, ADL dependence, subjective well-being in a one-year follow-up and to generate knowledge for further develop-ment of quality of geriatric rehabilitation. Study-specific questionnaires, the ADL-Staircase, and the Göteborg Quality of Life instrument were used. The results indicate that the national venture positively influenced the development of geriatric rehabilitation, at different levels of care. Increased collabora-tion in administration was shown and among caregivers the proportion who used rehabilitation knowledge in daily work changed positively. The clients’ high preva-lence of symptoms and high dependence in ADL demonstrated the frailty of the group, but in spite of this, decreased dependence was shown, and the clients perceived their subjective well-being as good. Client contentment with rehabilitation and training decreased during the evaluation period. The absence of official goals for rehabilitation and the different opinions on rehabilitation content demonstrated possibly influenced the result. Hence, further efforts are needed to develop the content of geriatric rehabilitation. The different aspects of geriatric rehabilitation quality development and the difficulties inherent in designing evaluation and interpreting the results elucidated demonstrate the complexity of geriatric rehabilitation. Study limitations are highlighted, but still this thesis contributes with knowledge useful for future evaluation efforts and geriatric rehabilitation quality improvement.