Rehabilitation for outdoor activities and mobility in care homes: The ROAM study
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Care home residents should be offered opportunities to participate in meaningful activities in an environment of their choice (College of Occupational Therapists 2013). Whilst outdoor activities and mobility are believed to have health-related benefits, best practice recommendations are based on expert consensus. This research aimed to map the literature, identify evidence gaps and highlight implications for occupational therapy in UK care homes. A systematic mapping review was conducted. Ethical approval was not required. A range of databases were searched. Articles were categorised using keywords including: outdoor location outdoor activities barriers to outdoor activities and health benefits. 1066 abstracts were identified 39 articles were included. There were 20 pre-post and 19 descriptive studies, with 2974 resident participants. 312 were from the UK. The care home garden was the most frequent location (28, 72%). 1 pre-post study evaluated an occupational therapy programme. Most descriptive studies (13, 68%) were architecture, rather than therapy-focused. The most frequent outdoor activities were: walking (14, 74%) socialising (11, 58%) and observing surroundings (11, 58%). Co-produced research with residents occurred in only 1 study. Barriers included weather, access and lack of staff time. Benefits to the physical health, mental wellbeing and occupational functioning of residents were reported. This review is the first to systematically collate data on outdoor activities and mobility in care homes. There is a lack of robust evidence in this field. There is a need to incorporate the involvement and views of residents in further research. Dementia Care Mapping (Brooker 2005) may be an appropriate observational tool to use with residents unable to participate in interviews and focus groups. Occupational therapists are uniquely placed to explore the potential health benefits to residents, of tailored activities and mobility programmes in outdoor environments.