Perceptions and Attitudes of Performing Floor Transfers with Older Adults in Home Health

Although the frequency and impact of falls among older adults is well established, little is known about the perceptions and attitudes of licensed rehabilitation therapists (physical therapists, physical therapist assistants, occupational therapists and occupational therapist assistants) in working with floor transfer training with older adults in the home health setting.  The purpose of this study is to explore the perceptions and attitudes of performing floor transfers with older adults and better understand the practice patterns of home health therapists. 

A 20-question electronic survey was developed and distributed online to physical therapists, physical therapist assistants, occupational therapists, and occupational therapist assistants working in the home health setting in a southeastern state. 

A total of 32 rehabilitation clinicians completed the survey (n=19 physical therapists, n=7 physical therapist assistants, n=6 occupational therapists, and n=0 occupational therapist assistants), with half of those surveyed had >20 years of clinical experience (n=16).  93.8% (n=30) of respondents felt it “very important” or “important” to assess the risk of falling with older adult patients, however only 71.9% (n=23) felt it “very important” or “important” to teach older adult patients how to transfer on and off the floor.  Clinicians working in the home health setting identified a number of barriers preventing them from implementing floor transfer training with older adult patients, including safety (n=24), lack of a second person to assist (n=20), cleanliness of the home (n=12), and family request (n=10).

Rehabilitation clinicians working in the home health setting recognize the importance of  assessing risk of falling and fear of falling with older adult patients, yet fewer clinicians feel confident in teaching older adult patients how to transfer on and off the floor and only include education on floor transfers in their plan of care “sometimes”.  Furthermore, safety concerns often limit implementation of floor transfer training with older adult patients.  

Understanding the practice patterns, attitudes and beliefs of physical and occupational therapists working in the home health setting can help close the gap in the identified risk of older adults falling in the home and the lacking practice patterns of implementing floor transfer training and patient/family education.  Recognizing barriers that prevent therapists from working on floor transfer training in home health may lead to continuing professional development in falls preparedness training and a reallocation of resources to empower therapists to best meet the needs of their patients.