Effect and cost-effectiveness analysis of occupational based occupational therapy for elderly people in geriatric facility: randmized controlled trial

INTERVENTION: In the intervention group, clients and occupational therapists begins to share and identifiy meaningful occupations for the client by using Aid for Decision‐making in Occupation Choice (ADOC). Then, occupational therapist observed the meaningful occupation and analyzed occupational performance. Interventions focused on enabling the occupation. During the care facility stay, majority interventions (had to be more than 2/3) was "Real‐occupationnal practice (P‐ADL)" and "Real‐occupational practice (except for P‐ADL)", and as appropriate, intervention in TOP group was allowed the "Basic function exercise" and "Simulated occupation practice" within the range of 1/3. In the control group, occupational therapist focus evaluations on the patient's generic abilities (i.e., boby functions and structures according to the ICF) and personal activities of daily living (P‐ADL). During the care facility stay, majority interventions (had to be more than 2/3) was "Basic function exercise" and "Simulated occupation practice", and as appropriate, intervention in BOT group was allowed the "Real‐occupationnal practice (P‐ADL)" and "Real‐occupational practice (except for P‐ADL)" within the range of 1/3. This intervention was usual practice in all occupational therapist participated in this study (data not shown). CONDITION: eldely people in geriatric facility PRIMARY OUTCOME: MOS 36‐Item Short‐Form Health Survey(japanes version) SECONDARY OUTCOME: Barthel index(Activities of daliy living:ADL); Occupational performance Autonomy:OPA; Total medical cost or total care cost INCLUSION CRITERIA: Participants don't have progressive disease, constitutional symptoms are stable, communication and a cognitive function not having the major problem. They conducted individual training twice a week.