This final chapter reinforces the potential of rehabilitation for older adults and reflects on the current challenges of implementation, with some take-home messages.
Conclusions
With population ageing and older people living for longer periods with frailty and multimorbidity and the resultant impacts on cognition, mobility and continence, the need for greater investment in rehabilitation is urgent and growing.
Rehabilitation for older adults is an important ‘invest to save’ approach for health and care systems as it reduces the impact of acute or chronic conditions, illnesses or injuries by preventing or delaying long term disability and dependency and reducing carer burden. Optimal rehabilitation helps prevent avoidable hospital admissions or readmissions, reduces hospital length of stay, reduces the need for long-term social care at home and reduces rates of admission to long-term care facilities. It should be embedded as a core component of care at all levels of an integrated health and social care approach, and be readily accessible at home, in hospitals, in care homes, in primary care services, ambulatory care settings and in other community facilities such as leisure centres.
However, there are continuing workforce challenges and no new national funding to ramp up rehabilitation capacity. To transform care and support, systems must view rehabilitation as critical ‘invest to save’ expenditure and rapidly work with partner organisations to build capability across the collective workforce. Rehabilitation involves healthcare professionals across the multidisciplinary team and across all care settings. Ensuring no older person is left behind requires integrated workforce planning for population health and strong collaborative leadership within integrated systems. To ensure that this issue is given adequate prominence by systems, a designated senior officer or Board member should be responsible for ensuring access to high-quality rehabilitation for older people.
| Key message 12 Senior leadership is critical for a strategic and sustainable approach to planning and delivering rehabilitation for older people. Systems should identify a senior officer or non-executive Board member with a specific role in assuring equitable access to rehabilitation attuned to the needs of older people and continually improving the quality of service delivered. |
Key messages at a glance
References
1. British Geriatrics Society, 2023. Joining the dots: A blueprint for preventing and managing frailty in older people. Available at: www.bgs.org.uk/Blueprint.
2. Community Rehabilitation Alliance, 2024. Rehab on track: Community rehabilitation best practice standards. Available at: www.csp.org.uk/system/files/publication_files/002028_Rehab%20on%20Track…
3. Chartered Society of Physiotherapy, 2022. Rehabilitation, recovery and reducing health inequity: Easing the pain. Available at: www.csp.org.uk/system/files/publication_files/001994_Easing%20the%20pai…
4. Tiberini R and Richardson H. 2015 Rehabilitative palliative care: enabling people to live fully until they die. A challenge for the 21st century. Available at: https://hukstage-new-bucket.s3.eu-west-2.amazonaws.com/s3fs-public/2022…
5. World Health Organization, 2024. Rehabilitation. Available at: https://www.who.int/news-room/fact-sheets/detail/rehabilitation
6. Grund, S., Gordon, A.L., van Balen, R. et al. European consensus on core principles and future priorities for geriatric rehabilitation: consensus statement. Eur Geriatr Med 11, 233–238 (2020). https://doi.org/10.1007/s41999-019-00274-1
7. Hendry A, Vanhecke E, Carriazo AM, López-Samaniego L, Espinosa JM, Sezgin D, et al. Integrated Care Models for Managing and Preventing Frailty: A Systematic Review for the European Joint Action on Frailty Prevention (ADVANTAGE JA). Transl Med UniSa. 2019;19:5-10.
8. Ellis G, Gardner M, Tsiachristas A, Langhorne P, Burke O, Harwood RH, Conroy SP, Kircher T, Somme D, Saltvedt I, Wald H, O’Neill D, Robinson D, Shepperd S. Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database Syst Rev. 2017 Sep 12;9(9):CD006211. doi: 10.1002/14651858.CD006211.pub3.
9. Ijadi Maghsoodi A, Pavlov V, Rouse P, Walker CG, Parsons M. Efficacy of acute care pathways for older patients: a systematic review and meta-analysis. Eur J Ageing. 2022 Nov 17;19(4):1571-1585. doi: 10.1007/s10433-022-00743-w.
10. NHS England, 2023. Proactive care: providing care and support for people living at home with moderate or severe frailty. Available at: www.england.nhs.uk/long-read/proactive-care-providing-care-and-support-…
11. Fogg et al, 2024. Primary and secondary care service use and costs associated with frailty in an ageing population: longitudinal analysis of an English primary care cohort of adults aged 50 and over, 2006–2017, Age and Ageing, Volume 53, Issue 2, February 2024, afae010, https://doi.org/10.1093/ageing/afae010
12. Hendry A, Law R. Proactive Care (editorial). British Journal of Hospital Medicine. Proactive Care (2024; awaiting publication)
13. NHS England, 2023. Intermediate care framework for rehabilitation, reablement and recovering following hospital discharge. Available at: www.england.nhs.uk/wp-content/uploads/2023/09/PRN00761-intermediate-car…
14. Prvu Bettger, J., Thoumi, A., Marquevich, V., De Groote, W., Battistella, L.M., Imamura,M., Stein, J. (2020). ‘COVID-19: maintaining essential rehabilitation services across the care continuum. BMJ Global Health;5:e002670. doi:10.1136/ bmjgh-2020-002670
15. Wise J. Long covid: WHO calls on countries to offer patients more rehabilitation. BMJ 2021; 372:n405. doi:10.1136/bmj.n405 pmid:33568362
16. United Nations, 2022. Decade of healthy ageing. Available at: www.decadeofhealthyageing.org
17. United Nations, 2006. Convention of the rights of persons with disabilities. Available at: https://social.desa.un.org/issues/disability/crpd/convention-on-the-rig…
18. World Health Organization, 2017. Rehabilitation 2030. Available at: www.who.int/initiatives/rehabilitation-2030
19. NHS England, 2023. A new community rehabilitation and reablement model. Available at: www.england.nhs.uk/wp-content/uploads/2023/09/PRN00761ii-a-new-communit…
20. NHS RightCare, 2020. RightCare: Community Rehabilitation Toolkit. Available at: www.england.nhs.uk/rightcare/wp-content/uploads/sites/40/2020/03/nhs-ri…
21. Whitty, C, 2023. Chief Medical Officer’s Annual Report 2023: Health in an ageing society. Available at: https://assets.publishing.service.gov.uk/media/65562ff2d03a8d000d07faa6…
22. Scottish Government, 2022. Rehabilitation and Recovery: A Once for Scotland Person-Centred Approach to Rehabilitation in a Post-COVID Era. Available at: www.gov.scot/publications/rehabilitation-recovery-once-scotland-person-…
23. Scottish Government, 2020. Framework for Supporting People through Recovery and Rehabilitation during and after the COVID-19 Pandemic. Available at: www.gov.scot/binaries/content/documents/govscot/publications/advice-and…
24. Welsh Government, 2022. All Wales Rehabilitation Framework: Principles to achieve a person-centred value-based approach. Available at: https://www.gov.wales/sites/default/files/publications/2022-10/all-wale…
25. Health Education and Improvement Wales, 2023. All-Wales community rehabilitation best practice standards. Available at: https://heiw.nhs.wales/files/community-rehabilitation-standards/
26. Chartered Society of Physiotherapy, 2022. Alliance work in Wales. Available at: https://www.csp.org.uk/professional-clinical/improvement-innovation/com…’s%20post%2Dcovid%20recovery%20plan.
27. British Geriatrics Society, 2023. Rehabilitation Case Studies: BGS Autumn Meeting 2023, Breathe Dance for Strength and Balance programme: GSTT. Available at: https://www.bgs.org.uk/resources/rehabilitation-case-studies-bgs-autumn….
28. British Geriatrics Society, 2023. Rehabilitation Case Studies: BGS Autumn Meeting 2023, Rehabilitation in the Community: the CAPA (Care About Physical Activity) Team. Available at: https://www.bgs.org.uk/resources/rehabilitation-case-studies-bgs-autumn….
29. Cowley A, Goldberg SE, Gordon AL, Keer M and Logan P, 2021. ‘Exploring rehabilitation potential in older people living with frailty: a qualitative focus group study. BMC Geriatrics, 21:165
30. Cowley, A., Goldberg, S.E., Gordon, A.L. and Logan, P. (2021) ‘A non-randomised feasibility study of the Rehabilitation Potential Assessment Tool (RePAT) in frail older people in the acute healthcare setting ‘ BMC Geriatrics, 22 (785), https://doi.org/10.1186/s12877-022-03420-w
31. British Geriatrics Society, Rehabilitation Case Studies: BGS Autumn Meeting 2023, The Benefits of Activities in Acute Clinical Gerontology. Available: https://www.bgs.org.uk/resources/rehabilitation-case-studies-bgs-autumn…
32. Theou O, Stathokostas L, Roland KP, et al. The effectiveness of exercise interventions for the management of frailty: A systematic review. J Aging Res. 2011; 2011:569194. [PubMed: 21584244
33. Sherrington C, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019:1:Cd012424
34. Pinheiro MB, et al. Impact of physical activity programs and services for older adults: a rapid review. Int J Behav Nutr Phys Act. 2022;19(1):87.
35. Kidd T, Mold F, Jones C, Ream E, Grosvenor W, Sund-Levander M, Tingström P, Carey N. What are the most effective interventions to improve physical performance in pre-frail and frail adults? A systematic review of randomised control trials. BMC Geriatr. 2019 Jul 11;19(1):184. doi: 10.1186/s12877-019-1196-x. -
36. Barber Sally E., Clegg Andrew P., Forster Anne, Iliffe Steve J., Young John B. Reviews in Clinical Gerontology 2012; Do home-based exercise interventions improve outcomes for frail older people? Findings from a systematic review 2011/08/24(1): 68-78.
37. Sherrington C, Lord SR, Vogler CM, Close JCT, Howard K, et al. (2014) A Post-Hospital Home Exercise Program Improved Mobility but Increased Falls in Older People: A Randomised Controlled Trial. PLoS ONE 9(9): e104412. doi:10.1371/journal.pone.0104412
38. Suikkanen S, Soukkio P, Aartolahti E, Kääriä S, Kautiainen H, Hupli MT, Pitkälä K, Sipilä S, Kukkonen-Harjula K. Effect of 12-Month Supervised, Home-Based Physical Exercise on Functioning Among Persons With Signs of Frailty: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2021 Dec;102(12):2283-2290. doi: 10.1016/j.apmr.2021.06.017.
39. Lin I, Glinsky J, Dean C, Graham P, Scrivener K. Effectiveness of home-based exercise for improving physical activity, quality of life and function in older adults after hospitalisation: A systematic review and meta-analysis. Clin Rehabil. 2022 Sep;36(9):1170-1185. doi: 10.1177/02692155221095936.
40. Travers J, Romero-Ortuno R, Bailey J, Cooney MT. Delaying and reversing frailty: a systematic review of primary care interventions. Br J Gen Pract. 2019 Jan;69(678):e61-e69. doi: 10.3399/bjgp18X700241.
41. Kidd Tara, Mold Freda, Jones Claire, Ream Emma, Grosvenor Wendy, Sund-Levander M., Tingström Pia, Carey Nicola. What are the most effective interventions to improve physical performance in pre-frail and frail adults? A systematic review of randomised control trials BMC Geriatrics 2019;19(1): 184.
42. Frost Rachael, Belk Celia, Jovicic Ana, Ricciardi Federico, Kharicha Kalpa, Gardner Benjamin, Iliffe Steve, Goodman Claire, Manthorpe Jill, Drennan Vari M., Walters Kate. Health promotion interventions for community-dwelling older people with mild or pre-frailty: a systematic review and meta-analysis BMC Geriatrics 2017;17(1): 157.
43. Rombey et al. BMC Medicine (2023) 21:265 https://doi.org/10.1186/s12916-023-02977-6
44. British Geriatrics Society, 2023. Rehabilitation Case Studies: BGS Autumn Meeting 2023, Good Boost. Available: https://www.bgs.org.uk/resources/rehabilitation-case-studies-bgs-autumn….
45. Nord M, Lyth J, Alwin J. et al. Costs and effects of comprehensive geriatric assessment in primary care for older adults with high risk for hospitalisation. BMC Geriatr 21, 263 (2021). https://doi.org/10.1186/s12877-021-02166-1
46. Mas MÀ, Miralles R, Ulldemolins MJ et al. Evaluating Person-Centred Integrated Care to People with Complex Chronic Conditions: Early Implementation Results of the ProPCC Programme. International Journal of Integrated Care, 2023; 23(4): 18, 1–12. DOI: https://doi. org/10.5334/ijic.7585
47. Fiona Aspinal, Jon Glasby, Tine Rostgaard, Hanne Tuntland, Rudi G. J. Westendorp, New horizons: Reablement - supporting older people towards independence, Age and Ageing, Volume 45, Issue 5, September 2016, Pages 574–578, https://doi.org/10.1093/ageing/afw094
48. Langeland, E., Tuntland, H., Folkestad, B. Førland, O., Jacobsen, F.F., & Kjeken I. (2019). A multicenter investigation of reablement in Norway: a clinical controlled trial. BMC Geriatr 19, 29 (2019). https://doi.org/10.1186/s12877-019-1038-x
49. National Institute for Health and Care Excellence, 2017. NICE guideline 74: Intermediate care including reablement. Available at: https://www.nice.org.uk/guidance/ng74
50. Nuffield Trust, 2022. QualityWatch: Supporting older people’s recovery after illness or injury. Available at: www.nuffieldtrust.org.uk/resource/supporting-older-people-s-recovery-af…
51. National Institute for Health and Care Excellence, 2018. NICE guideline 94 – Emergency and acute medical care in over 16s: service delivery and organisation: Chapter 13: community rehabilitation. Available at: www.nice.org.uk/guidance/ng94/evidence/13.community-rehabilitation-pdf-…
52. Caplan GA, Coconis J, Board N, Sayers A, Woods J. Does home treatment affect delirium? A randomised controlled trial of rehabilitation of elderly and care at home or usual treatment (The REACH-OUT trial). Age and Ageing. 2006; 35(1):53-60
53. Sezgin, D., O’Caoimh, R., O’Donovan, M.R. et al. Defining the characteristics of intermediate care models including transitional care: an international Delphi study. Aging Clin Exp Res 32, 2399–2410 (2020). https://doi.org/10.1007/s40520-020-01579-z
54. lston J, Gradinger F, Asthana S, Fox M, Dawson L, Butler D, & Byng R. (2022). Impact of ‘Enhanced’ Intermediate Care Integrating Acute, Primary and Community Care and the Voluntary Sector in Torbay and South Devon, UK. International Journal of Integrated Care, 2022; 22(1): 14, 1–17. DOI: https://doi.org/10.5334/ ijic.5665
55. Young J, Hulme C, Smith A, Buckell J, Godfrey M, Holditch C, Thiebaud J. (2020). Measuring and optimising the efficiency of community hospital inpatient care for older people: the MoCHA mixed-methods study. Health Serv Deliv Res;8(1).
56. Robert Benoît, Sun Annie H., Sinden Danielle, Spruin Sarah, Hsu Amy T. A Case-Control Study of the Sub-Acute Care for Frail Elderly (SAFE) Unit on Hospital Readmission, Emergency Department Visits and Continuity of Post-Discharge Care. Journal of the American Medical Directors Association 2021;22(3): 544-550.e2.
57. Ribbink, M.E., Roozendaal, C.C, MacNeil-Vroomen, J.L., Franssen, R. & Buurman, B.M. (2021b). “Patient experience and satisfaction with admission to an acute geriatric community hospital in the Netherlands: a mixed method study”, Journal of Integrated Care, Vol. 29 No. 4, pp. 390-402. https://doi.org/10.1108/JICA-04-2021-0018
58. British Geriatrics Society, 2022. Bringing hospital care home: Virtual wards and Hospital at Home for older people. Available at: www.bgs.org.uk/virtualwards
59. Healthcare Improvement Scotland, 2020. Hospital at Home: Guiding principles for service development. Available at: https://ihub.scot/project-toolkits/hospital-at-home/hospital-at-home/
60. Social Care Institute for Excellence, 2017. Intermediate Care: SCIE Highlights. Available at: https://www.scie.org.uk/prevention/independence/intermediate-care/highl…
61. Jalilian A, et al. Length of stay and economic sustainability of virtual ward care in a medium-sized hospital of the UK: a retrospective longitudinal study. BMJ Open 2024;14:e081378. doi:10.1136/bmjopen-2023-081378
62. British Geriatrics Society, 2021. Right time, right place: Urgent community-based care for older people. Available at: www.bgs.org.uk/righttimerightplace
63. Geohagen O, Hamer L, Lowton A, Guerra S, Milton-Cole R, Ellery P, Martin FC, Lamb SE, Sackley C, Sheehan KJ. The effectiveness of rehabilitation interventions including outdoor mobility on older adults’ physical activity, endurance, outdoor mobility and falls-related self-efficacy: systematic review and meta-analysis. Age Ageing. 2022 Jun 1;51(6):afac120. doi: 10.1093/ageing/afac120.
64. British Geriatrics Society, 2021. Silver Book II. Available at: www.bgs.org.uk/resources/resource-series/silver-book-ii
65. Faculty of Sport and Exercise Medicine UK, 2024. Moving medicine – Active Hospitals. Available at: https://movingmedicine.ac.uk/active-hospitals/
66. Dolan, B., 2017. Mindset shift on PJ paralysis. Nursing Standard (Royal College of Nursing (Great Britain): 1987), 31(47), pp.32-32.
67. McAulay J. 2023 Active Hospitals Project Report. Local document. Nottingham University Hospitals NHS Trust
68. Lambe, K., Guerra, S., Salazar de Pablo, G. et al. Effect of inpatient rehabilitation treatment ingredients on functioning, quality of life, length of stay, discharge destination, and mortality among older adults with unplanned admission: an overview review. BMC Geriatr 22, 501 (2022). https://doi.org/10.1186/s12877-022-03169-2
69. Cowley, A., Goldberg, S.E., Gordon, A.L. et al. A non-randomised feasibility study of the Rehabilitation Potential Assessment Tool (RePAT) in frail older people in the acute healthcare setting. BMC Geriatr 22, 785 (2022). https://doi.org/10.1186/s12877-022-03420-w
70. Fowler A, Abbott T, Prowle J, Pearse R. Age of patients undergoing surgery. Journal of British Surgery. 2019;106(8):1012–8.
71. Lin H-S, Watts J, Peel N, Hubbard R. Frailty and postoperative outcomes in older surgical patients: a systematic review. BMC Geriatrics 2016;16(1):1–12.
72. Eamer G, Saravana-Bawan B, van der Westhuizen B, Chambers T, Ohinmaa A, Khadaroo RG. Economic evaluations of comprehensive geriatric assessment in surgical patients: a systematic review. Journal of Surgical Research. 2017;218:9–17.
73. Joughin AL, Partridge JS, O’Halloran T, Dhesi JK. Where are we now in perioperative medicine? Results from a repeated UK survey of geriatric medicine delivered services for older people. Age and ageing. 2019;48(3):458–62.
74. Centre for Perioperative Care and British Geriatrics Society, 2021. Guideline for Perioperative Care for People Living with Frailty Undergoing Elective and Emergency Surgery. Available at: https://cpoc.org.uk/guidelines-resources-guidelines/perioperative-care-…
75. Fairhall NJ, Dyer SM, Mak JCS, Diong J, Kwok WS, Sherrington C. Interventions for improving mobility after hip fracture surgery in adults. Cochrane Database of Systematic Reviews 2022, Issue 9. Art. No.: CD001704. DOI: 10.1002/14651858.CD001704.pub5.
76. Handoll HH, Cameron ID, Mak JCS, Panagoda CE, Finnegan TP. Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database of Systematic Reviews 2021, Issue 11. Art. No.: CD007125.DOI: 10.1002/14651858.CD007125.pub3
77. Goubar A, Martin FC, Potter C, Jones GD, Sackley C, Ayis S, Sheehan KJ. The 30-day survival and recovery after hip fracture by timing of mobilization and dementia : a UK database study. Bone Joint J. 2021 Jul;103-B(7):1317-1324. doi: 10.1302/0301-620X.
78. Smith TO, Gilbert AW, Sreekanta A, Sahota O, Griffin XL, Cross JL, Fox C, Lamb SE. Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery. Cochrane Database of Systematic Reviews 2020, Issue 2. Art. No.: CD010569. DOI: 10.1002/14651858.CD010569.pub3.
79. National Institute for health and Care Excellence, 2017. NICE Quality Standard 158: Rehabilitation after critical illness in adults. Available at: https://www.nice.org.uk/guidance/qs158
80. British Geriatrics Society, 2021. Ambitions for Change: Improving Healthcare in Care Homes. Available at: https://www.bgs.org.uk/resources/ambitions-for-change-improving-healthc…
81. Montero-Odasso M, van der Velde N, Martin FC, et al. Task Force on Global Guidelines for Falls in Older Adults. World guidelines for falls prevention and management for older adults: a global initiative. Age Ageing. 2022 Sep 2;51(9):afac205. doi:10.1093/ageing/afac205. PMID: 36178003; PMCID: PMC9523684.
82. Wilson CL, Keevil VL, Goodman C. Funded hospital discharges to care homes: a cohort study. Age Ageing. 2023 Jul 1;52(7):afad135. doi: 10.1093/ageing/afad135. PMID: 37505990; PMCID: PMC10378721.
83. National Care Forum, 2022. Effective accommodation based (care home or community hospital) Intermediate Care and Reablement: A blueprint from the National Care Forum www.nationalcareforum.org.uk/wp-content/uploads/2022/12/Final-NCF-Bluep…
84. NHS England, 2023. NHS Long Term Workforce Plan. Available at: www.england.nhs.uk/publication/nhs-long-term-workforce-plan/
85. Welsh Government, 2022. Rehabilitation service modelling resource. Available at: www.gov.wales/rehabilitation-service-modelling-resource
86. Aynsley Cowie, Janet McKay, Jane Holt, and Moray Baylis, 2022. ‘Tackling multimorbidity: patient characteristics and outcomes from a generic rehabilitation programme’ International Journal of Therapy and Rehabilitation 29:4, 1-10
87. Chartered Society of Physiotherapy, undated. Collaborate Don’t Compete. Available at: hwww.csp.org.uk/professional-clinical/improvement-innovation/community-r…
88. British Geriatrics Society, undated. Frailty: Identification and interventions. Available at: www.bgs.org.uk/elearning/frailty-identification-and-interventions-0
89. E-learning for healthcare, 2024. Frailty. Available at: www.e-lfh.org.uk/programmes/frailty/
90. Skills for Health, 2023. Virtual ward and urgent community response capabilities framework. Available at: www.skillsforhealth.org.uk/info-hub/virtual-wards-and-urgent-community-…
91. British Heart Foundation, 2022. Cardiac rehabilitation: A participant’s perspective. Available at: www.bhf.org.uk/-/media/files/for-professionals/healthcare-professionals…
92. Malik, McFarlane et al. 2023 Qualitative study of participants of a feasibility trial of remote physiotherapy for early stage Parkinson’s disease. Age and Ageing, Volume 52, Issue Supplement_2, July 2023, afad104.089, https://doi.org/10.1093/ageing/afad104.089
93. Melez M, Lugo-Agudelo LH, Patiño Lugo DF, Glenton C, Posada AM, Mesa Franco LF, Negrini S, Kiekens C, Spir Brunal MA, Roberg AB, Cruz Sarmiento KM. Factors that influence the provision of home-based rehabilitation services for people needing rehabilitation: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2023 Feb 10;2(2):CD014823. doi: 10.1002/14651858.CD014823. PMID: 36780267; PMCID: PMC9918343.
94. Edwards D, Williams J, Carrier J, Davies J. Technologies used to facilitate remote rehabilitation of adults with deconditioning, musculoskeletal conditions, stroke, or traumatic brain injury: an umbrella review. JBI Evid Synth. 2022 Aug 1;20(8):1927-1968. doi: 10.11124/JBIES-21-00241.
95. Kukkohovi S, Siira H, Arolaakso S, Miettunen J, Elo S. The effectiveness of digital gaming on the functioning and activity of older people living in long-term care facilities: a systematic review and meta-analysis. Aging Clin Exp Res. 2023 Aug;35(8):1595-1608. doi: 10.1007/s40520-023-02459-y
96. Cowley A, Booth V, Di Lorito C, Chandria P, Chadwick O, Stanislas C, Dunlop M, Howe L, Harwood RH, Logan PA. A Qualitative Study on the Experiences of Therapists Delivering the Promoting Activity, Independence and Stability in Early Dementia (PrAISED) Intervention During the COVID-19 Pandemic. J Alzheimers Dis. 2023;91(1):203-214. doi: 10.3233/JAD-220424. PMID: 36404541; PMCID: PMC9881024.
97. National Institute for Health and Care Research, 2023. Guidelines for virtual home assessment tools. Available at: https://evidence.nihr.ac.uk/alert/guidelines-for-virtual-home-assessmen…
98. Chartered Society of Physiotherapy, 2022. Making Community Rehabilitation Data Count. Available at: www.csp.org.uk/professional-clinical/improvement-innovation/community-r…
99. Davenport, S.J. (2021), “Impact of occupational therapy in an integrated adult social care service: Audit of Therapy Outcome Measure Findings”, Journal of Integrated Care, Vol. 29 No. 4, pp. 439-451. https://doi.org/10.1108/JICA-04-2021-0020
100. Rutten-van Mölken et al. BMC Health Services Research (2018) 18:576 https://doi.org/10.1186/s12913-018-3367-4
101. Hoedemakers M, Tsiachristas A, Rutten-van Mölken M. Moving Beyond Quality-Adjusted Life-Years in Elderly Care: How Can Multicriteria Decision Analysis Complement Cost-Effectiveness Analysis in Local-Level Decision Making. Value Health. 2022 Oct;25(10):1717-1725. doi: 10.1016/j.jval.2022.04.1728. Epub 2022 May 25. PMID: 35623974.
102. Meaningful Measures, 2021. Measure Yourself Concerns and Wellbeing. Available at: www.meaningfulmeasures.co.uk/mycaw
103. International Consortium for Health Outcomes Measurement, undated. Patient-centred Outcomes Measures. Available at: www.ichom.org/patient-centered-outcome-measures/
104. Welsh Government, 2022. Rehabilitation: Evaluation framework. Available at: https://www.gov.wales/sites/default/files/publications/2022-10/all-wale…
105. Akpan, A., Roberts, C., Bandeen-Roche, K. et al. Standard set of health outcome measures for older persons. BMC Geriatr 18, 36 (2018). https://doi.org/10.1186/s12877-017-0701-3
106. Barron, W., Gifford, E., Knight, P. & Rainey, H. (2021), Does the indicator of relative need (IoRN2) tool improve inter-professional conversations?, Journal of Integrated Care, Vol. 29 No. 4, pp. 452-463. https://doi.org/10.1108/JICA-08-2021-0044
107. Smit, E.B., Bouwstra, H., van der Wouden, J.C. et al. Development of a Patient-Reported Outcomes Measurement Information System (PROMIS®) short form for measuring physical function in geriatric rehabilitation patients. Qual Life Res 29, 2563–2572 (2020). https://doi.org/10.1007/s11136-020-02506-5
108. Caulfield L et al. 2024. The Benchmarking Exercise Programme for Older People (BEPOP): Design, Results and Recommendations from The First Wave of Data Collection. Journal of Frailty Sarcopenia and Falls. www.researchgate.net/publication/379112522_
