Testing a home-care planning tool for older adults with mental illness

Over the past 30 years, mental health policy has been geared towards increasing the number of people receiving care in the community, with a reduction of over 50% in the number of general psychiatric beds. The WHO recommends the implementation of alternatives to hospitalization, through the development of outpatient and home-based psychiatric care programs that support independent living.

People suffering from psychiatric disorders show cognitive decline as they age, including deficits in perception, attention, memory and problem-solving. These cognitive problems affect the ability to carry out the tasks of daily life, and make it more difficult to remain at home. In order to avoid hospitalization for these psychiatrically-stabilized patients who are losing their autonomy, it is necessary to take into account their mental and cognitive handicap, and to provide them with appropriate compensation.

Occupational therapy is a discipline concerned with the assessment, rehabilitation and integration of people with disabilities. Occupational therapists provide ecological assessments to support personalized care plans. The PRPP (Perceive, Recall, Plan and Perform) task analysis system is a validated, ecological tool that integrates an occupational therapy assessment and intervention model. The PRPP assessment measures occupational performance and the impact of cognitive impairments on information processing and on the cognitive strategies required to carry out activities. Research conducted in Canada illustrates the value of PRPP in supporting people with schizophrenia. To the best of our knowledge, no team has studied the use of PRPP in the decision-making process for maintaining people with aging psychiatric disorders (PATPV) at home.