AA

Summary

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There is level 5 evidence (Forrest and Gombas 1995) that discharge from hospital was delayed for a significant portion of SCI patients due to lack of accessible housing, which leads to unnecessary increase of cost of care.

There is level 5 evidence (Fuhrer et al. 1990) that ILCs with MRP relationships serve more clients than those without, and that the most frequently serviced individuals are those with SCI who attend for peer counseling, skills training, and discharge planning.

There is level 5 evidence (DeJong and Hughes 1982) that living with a spouse and/or children, living alone, or living with unrelated persons were more desirable arrangements than living with parents and spouse/children together, living with distant family (i.e. grandparents), or living with parents and siblings.

There is level 4 evidence (DeJong et al. 1984) that marital status, transportation barriers, education level, medical supervision requirements, economic disincentives, services received, and severity of disability are predictors of independent living.

There is level 5 evidence (Boschen 1996) that issues of choice and control are important when planning living situations and setting goals with clients because they are directly related to residential and life satisfaction.

There is level 5 evidence (Boschen 1990) that individuals with SCI have lower perceived life satisfaction, locus of control and satisfaction with certain aspects housing than a normative sample.

There is level 5 evidence (Boschen 1988) that accommodation options for a person with a disability are limited. The preferred accommodation is a private house or apartment.

There is level 5 evidence (Anzai et al. 2006) that living with someone prior to SCI, having insurance or private funding for equipment, and being younger decreases the risk of being discharged to an extended care facility following SCI rehabilitation.

There is level 5 evidence (Cesar et al. 2002) that individuals with SCI have a need for assistance with fire safety to increase their perception of home safety.

There is qualitative evidence (Bergmark et al. 2008) that suggests individuals with SCI move multiple times after injury. In most cases they start living with their parents and/or in an institution before moving into their own homes.

There is qualitative evidence that suggest individuals with SCI have difficulties adjusting to life at home (Dickson et al. 2011). Reported difficulties are related to the loss of camaraderie, lack of post-discharge care and negative experiences with other people related to being in a wheelchair.

There is qualitative evidence (Kuipers et al. 2011) that suggest individuals with SCI who described their community in social and relationship terms reflected more positive views about this community compared to those who described their community in terms of physical space and access.

There is level 5 evidence (Guilcher et al. 2012) indicating size of available networks decrease following SCI for most individuals, and informal care networks engage in a variety of roles, including advice/validating concerns, knowledge brokers, advocacy, preventing secondary health conditions (SHCs), assisting with finances, and managing SHCs.

There is level 5 evidence (Foster et al. 2005; Robinson-Whelan and Rintala 2003) indicating that most informal caregivers are female spouses of SCI consumers who required additional assistance in fulfilling and maintaining provided services.

There is level 5 evidence (Berry et al. 1995) suggesting general satisfaction with informal attendant services from both clients and attendants although there are variations with some aspects of care.

There is level 5 evidence (Weitzenkamp et al. 2002) that the most significant predictors of PCA use are motor function, days spent in rehabilitation, and length of stay in a nursing home.

There is level 5 evidence (Bushnik et al. 2007) indicating that personal attendant turnover is positively correlated with higher injury level and increased need for assistance in exercise and transfers.

There is level 5 evidence (Gaijraj-Singh 2011) that increased family caregiver burden is associated with poorer levels of psychological well-being. Level 5 evidence (Arango-Lasprilla et al. 2010) indicates that poorer psychological well-being is associated with greater information, emotional, economic, physical health, sleep and psychological support needs.

There is level 5 evidence (Arango-Lasprilla et al. 2010) that the majority of family caregivers are overwhelmed with their caregiving responsibilities.

There is level 5 evidence (Gaijraj-Singh 2011) that increased family caregiver burden is associated with the number of hours of care provided per day and with increasing age of the caregiver.

There is level 5 evidence (Arango-Lasprilla et al. 2010) that increased family caregiver burden is associated with greater respite, information, emotional, economic, physical health, sleep and psychological support needs.

There is level 5 evidence (van Loo et al. 2010) that substantial unmet care needs requiring support for incidental activities of daily living and housekeeping support.

There is level 5 evidence (Owen and Marini 2012) that the use of life care planning may decrease use of unpaid attendant care, and increase the use of paid attendant care.

There is qualitative evidence (Cockerill and Durham 1992) that both consumers and attendants agree that the emphasis of care in transitional centres should be placed on facilitating consumer independence which may be accomplished by delineating the role of attendants. 

There is level 1 evidence (Cohen and Schemm 2007) indicating that client-centred visits by an occupational therapist can increase the number of life roles performed and improve life satisfaction.

There is level 4 evidence (Barber et al. 1999) that suggests recurrent UTIs can be reduced below threshold levels through a simple cost-effective educational intervention by a clinical nurse.

There is level 4 evidence (Beck and Scroggins 2001) that suggests that health can be maintained after participation in an educational intervention focused on skill development and support in the “real world.”

There is level 2 evidence (Schopp et al. 2007) that a skills training project can improve knowledge in both consumers and personal assistants up to six months post-training.

There is insufficient evidence (Frost et al. 1999) to determine the efficacy of training persons with disabilities to provide SCI attendant care.

There is Level 4 evidence (Mattson-Prince 1997) suggesting that an independent living self- managed model for attendant care results in decreased costs, better health outcomes and life satisfaction, and fewer re-hospitalizations than agency-based care.