To address these challenges, an informal caregiver-led exercise program (+Care) was developed as an extension of GAPP. Semi-structured interviews were conducted during the development to evaluate the acceptability of involving patient’s informal caregivers in geriatric rehabilitation.
An observational feasibility study was conducted to assess the feasibility of implementing GAPP+Care.
This observational feasibility study of GAPP+Care was conducted on the geriatric rehabilitation ward of UZ Leuven, Belgium. GAPP+Care consists of 1) a hospitalization phase with GAPP (five 45-minute physiotherapy sessions per week) plus +Care (three 30-minute caregiver-led exercise sessions per week), and 2) a discharge phase of six weeks with private physiotherapy (prescribed as three 30-minute sessions per week) and +Care sessions (three caregiver-led exercise sessions per week).
Over the course of one year, we assessed the eligibility and participation rates for GAPP+Care, as well as fidelity to the program. Semi-structured interviews were used to collect opinions from patients and their informal caregivers on feasibility, acceptability, barriers, facilitators, and their general impressions.
The study included 13 patients with a mean age of 82.5 years. The overall participation rate was low, with only 4.6% of the 281 admitted patients taking part, primarily due to strict inclusion criteria and limited caregiver availability. On average, patients were enrolled in the study after 16 days of hospitalization and received GAPP+Care for 30 days in the hospital setting.
Fidelity to the three weekly +Care sessions was consistently high during hospitalization, with participants engaging in 2 to 5 sessions per week. Post-discharge fidelity varied, with three distinct groups: one group (n=3) did not adhere to the program at all, the second group (n=4) showed occasional compliance (once a week or sporadic compliance), and the third group (n=4) maintained high fidelity (two to four times per week).
Participants found GAPP+Care feasible, but barriers included hospital visit restrictions and time constraints at home. Participants found GAPP+Care feasible, but barriers included hospital visit restrictions and time constraints at home.
The low participation rate could potentially be improved by revising the inclusion criteria, although caregiver availability remains a significant challenge. High fidelity during hospitalization was attributed to increased physiotherapist-patient-caregiver interactions and fewer daily task interferences for caregivers.
While the study identified challenges in implementing GAPP+Care, it highlighted the positive reception of the program by both patients and caregivers. GAPP+Care, with three +Care sessions a week, appears acceptable and feasible for implementation on a geriatric rehabilitation ward.
This study suggests that incorporating informal caregivers into physical activity programs for geriatric rehabilitation patients is feasible and well-received, though addressing inclusion criteria and caregiver availability is crucial for broader implementation.
physical activity
caregiver involvement
