***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: CONTEXT Illness and hospitalization often trigger functional decline among older persons .  Home care services implemented for functional decline provide an opportunity to intervene to improve outcomes . OBJECTIVE To compare functional status and the likelihood of remaining at home for persons receiving restorative care vs usual home care .  DESIGN AND SETTING Intervention using prospect i ve individual matching conducted between November 1 , 1998 , and April 30 , 2000 . Six offices of a home care agency in Connecticut were used . One branch office served as the restorative care unit and the other 5 served as usual care offices . PARTICIPANTS Patients receiving home care through the restorative care office who were 65 years or older ; in receipt of Medicare-covered home care lasting at least 7 days ; with absence of severe cognitive impairment ; and not terminal , bedridden , or requiring total care were matched with patients from 1 of the usual care offices  . The matching factors included age , sex , race , baseline self-care function , cognitive status , whether hospitalization preceded the home care episode , and date of the home care episode . Of the 712 eligible restorative care patients , 691 ( 97 % ) were matched with a usual care patient . INTERVENTION Restorative care , provided by the home care agency nursing , therapy , and home health aide staff , was based on principles from geriatric medicine , nursing , rehabilitation , and goal attainment . MAIN OUTCOME MEASURES Remaining at home , functional status at completion of the home care episode , and duration and intensity of home care episode . RESULTS Compared with usual care , and after adjusting for baseline characteristics and other factors , restorative care was associated with a greater likelihood of remaining at home ( 82 % vs 71 % ; odds ratio [ OR ] , 1.99 ; 95 % confidence interval [ CI ] , 1.47 - 2.69 ) and a reduced likelihood of visiting an emergency department ( 10 % vs 20 % ; OR , 0.44 ; 95 % CI , 0.32 - 0.61 ) . Home care episodes were shorter ( mean [ SD ] , 24.8 [ 26.8 ] days vs 34.3 [ 44.2 ] days ; S = -17 821 ; P<.001 ) . Restorative care patients had better mean ( SD ) scores than usual care patients in self-care ( 11.0 [ 2.1 ] vs 10.7 [ 2.5 ] ; P = .07 after adjustment ) , home management ( 9.5 [ 2.9 ] vs 9.2 [ 3.0 ] ; P = .05 after adjustment ) , and mobility ( 3.3 [ 0.8 ] vs 3.2 [ 0.9 ] ; P = .02 after adjustment ) . CONCLUSIONS This trial suggests that reorganizing the structure and goals of home care can enhance health outcomes of older patients without increasing health care utilization Objective To assess the effectiveness of an activity programme in improving function , quality of life , and falls in older people in residential care . Design Cluster r and omised controlled trial with one year follow-up . Setting 41 low level dependency residential care homes in New Zeal and . Participants 682 people aged 65 years or over . Interventions 330 residents were offered a goal setting and individualised activities of daily living activity programme by a gerontology nurse , reinforced by usual healthcare assistants ; 352 residents received social visits . Main outcome measures Function ( late life function and disability instruments , elderly mobility scale , FICSIT-4 balance test , timed up and go test ) , quality of life ( life satisfaction index , EuroQol ) , and falls ( time to fall over 12 months ) . Secondary outcomes were depressive symptoms and hospital admissions . Results 473 ( 70 % ) participants completed the trial . The programme had no impact overall . However , in contrast to residents with impaired cognition ( no differences between intervention and control group ) , those with normal cognition in the intervention group may have maintained overall function ( late life function and disability instrument total function , P=0.024 ) and lower limb function ( late life function and disability instrument basic lower extremity , P=0.015 ) . In residents with cognitive impairment , the likelihood of depression increased in the intervention group . No other outcomes differed between groups . Conclusion A programme of functional rehabilitation had minimal impact for elderly people in residential care with normal cognition but was not beneficial for those with poor cognition . Trial registration Australian Clinical Trials Register ACTRN12605000667617 PURPOSE OF THE STUDY The purpose of this study was to test the impact of Function-Focused Care for the Cognitively Impaired Intervention on nursing home residents with dementia and the nursing assistants who care for them . DESIGN AND METHODS This was a cluster-r and omized controlled trial using repeated measures . A total of 103 cognitively impaired residents and 77 nursing assistants were recruited from four nursing homes . For residents , outcome measures included function , physical activity ( survey and actigraphy ) , mood , behavior , and adverse events ( falls and hospitalization ) . Main outcome measures for nursing assistants included knowledge , beliefs , and performance of function focused care . RESULTS There were significant improvements in the amount and intensity of physical activity ( by survey and actigraphy ) and physical function in the treatment group . In addition , there was a significant decrease in the number of residents who fell during the treatment period with those in the treatment sites having fewer falls ( 28 % vs. 50 % in the control group ) . Nursing assistants were also observed to be providing a greater percentage of function focused care during resident care interactions in the treatment group at 6 months following the completion of baseline measures . IMPLICATION S This study provides some evidence that nursing home residents with severe cognitive impairment can safely and successfully be engaged in physical and functional activities Background There has been an increasing interest in reablement in Norway recently and many municipalities have implemented this form of rehabilitation despite a lack of robust evidence of its effectiveness . The aim of this study was to investigate the effectiveness of reablement in home-dwelling older adults compared with usual care in relation to daily activities , physical functioning , and health-related quality of life . Methods This is a parallel-group r and omised controlled trial conducted in a rural municipality in Norway . Sixty-one home-dwelling older adults with functional decline were r and omised to an intervention group ( n = 31 ) or a control group ( n = 30 ) . The intervention group received ten weeks of multicomponent home-based rehabilitation . The  Canadian Occupational Performance Measure ( COPM ) was used to measure self-perceived activity performance and satisfaction with performance . In addition , physical capacity and health-related quality of life were measured . The participants were assessed at baseline and at 3- and 9-month follow-ups . Results There were significant improvements in mean scores favouring reablement in COPM performance at 3 months with a score of 1.5 points ( p = 0.02 ) , at 9 months 1.4 points ( p = 0.03 ) and overall treatment 1.5 points ( p = 0.01 ) , and for COPM satisfaction at 9 months 1.4 points ( p = 0.03 ) and overall treatment 1.2 points ( p = 0.04 ) . No significant group differences were found concerning COPM satisfaction at 3 months , physical capacity or health-related quality of life . Conclusion A 10-week reablement program result ed in better activity performance and satisfaction with performance on a long-term basis , but not the other outcomes measured . Trial registration The trial was registered in Clinical Trials.gov November 20 , 2012 , identifier NCT02043262 BACKGROUND frail older people often require tailored rehabilitation in order to remain at home , especially following a period of hospitalisation . Restorative care services aim to enhance an older person 's ability to remain improve physical functioning , either at home or in residential care but evidence of their effectiveness is limited . OBJECTIVE to evaluate the effectiveness of a restorative care service on institutional-free survival and health outcomes in frail older people referred for needs assessment in New Zeal and . METHODS a r and omised controlled trial of restorative care or usual care in 105 older people at risk of permanent residential who were follow-up over 24 months . The restorative care service was delivered in short-stay residential care facilities and at participants ' residences with the aim of reducing the requirement for permanent residential care . It included a comprehensive geriatric assessment and care plan developed and delivered , initially by a multi-disciplinary team and subsequently by home care assistants . RESULTS compared with usual care , there was a non-significant absolute risk reduction of 14.3 % for death or permanent residential care ( 8.8 % for residential care and 7.2 % for death alone ) for the restorative care approach . There was no difference in levels of burden among caregivers . CONCLUSIONS restorative care models that utilise case management and multi-disciplinary care may positively impact on institutional-free survival for frail older people without adversely impacting on the health of caregivers INTRODUCTION Health services delivered in an older person 's home are often implemented at a critical juncture in an individual 's functional status . Although homecare has potential to improve this situation , it often focuses on treating disease and ' taking care ' of the patient rather than promoting independence . The aim of restorative homecare is to change the philosophy from one where delivery of care may create dependency to provision of care which maximises independence , self-esteem , self-image and quality of life , and reduces the care required . AIMS To assess impact of a design ated goal facilitation tool on health-related quality of life ( HRQoL ) , social support and physical function among community-dwelling older people referred for homecare . METHODS A total of 205 participants [ mean age 79.1 years , 71.3 % female ( intervention group ) and 76.9 years with 60.8 % female ( control group ) ] were cluster r and omised to an intervention or control assessor . The intervention arm involved participants completing a goal facilitation tool with assessors . This established rehabilitation aims . Control participants received a st and ard needs assessment . Clients from both groups were then referred to a homecare organisation for service delivery . RESULTS There was greater change over time in HRQoL [ measured by Short Form 36 Survey ( SF-36 ) ] in the intervention group ( P = 0.0001 ) . There was a marked variation across homecare providers in types of services provided ( P < 0.001 ) . Identification of a goal did not predict completion of a formalised review of participants ' needs by the homecare organisation . CONCLUSIONS Use of a goal facilitation tool in assessment of an older person 's needs on referral for homecare leads to significant improvements in HRQoL. This may be through a higher proportion of individualised activities tailored to a successful identification of the person 's goals . The findings contribute to greater underst and ing of factors necessary to implement improvements in homecare services for older people A r and omised controlled trial was conducted to test the effectiveness of the Home Independence Program ( HIP ) , a restorative home-care programme for older adults , in reducing the need for ongoing services .  Between June 2005 and August 2007 , 750 older adults referred to a home-care service for assistance with their personal care participated in the study and received HIP or ' usual ' home-care services .  Service outcomes were compared at 3 and 12 months . Subgroups of 150 from each group were also compared on functional and quality of life measures . Data were analysed by ' intention-to-treat ' and ' as-treated ' . The intention-to-treat analysis showed at 3 and 12 months that the HIP group was significantly less likely to need ongoing personal care [ Odds ratio ( OR ) = 0.18 , 95 % CI = 0.13 - 0.26 , P < 0.001 ; OR = 0.22 , 95 % CI = 0.15 - 0.32 , P < 0.001 ] . Both subgroups showed improvements on the individual outcome measures over time with the only significant differences being found at 12 months for Instrumental Activities of Daily Living ( IADL ) in the as-treated analysis . Contamination of the control group by an increased emphasis on independence across the home-care agency involved , together with other method ological problems encountered , is thought to account for the few differences between groups in individual outcomes . Despite no difference between the groups over time in their overall ADL scores , a significantly smaller proportion of the HIP group required assistance with bathing/showering , the most common reason for referral , at 3 and 12 months . The results support earlier findings that participating in a short-term restorative programme appears to reduce the need for ongoing home care . The implementation of such programmes more broadly throughout Australia could substantially offset the projected increase in dem and for home care associated with the five-fold projected increase in numbers of the oldest old expected over the next 40 years Due to the ageing population , there is an increased dem and for home care services . Restorative care is one approach to improving home care services , although there is little evidence to support its use in the community setting . The objective of this trial was to evaluate the impact of a restorative home care service for community-dwelling older people . The study was a cluster r and omised controlled trial undertaken at a home care agency in New Zeal and . The study period was from December 2005 to May 2007 . Older people were interviewed face-to-face at baseline , four and 7 months . A total of 186 older people who received assistance from a home care agency participated in the study , 93 received restorative home care and 93 older people received usual home care .  The primary outcome measure was change in health-related quality of life ( measured by the Short Form 36 [ SF36 ] Health Survey ) . Secondary outcomes were the physical , mental , and social well-being of older people ( Nottingham Extended Activities of Daily Living , Timed Up and Go , Mastery scale , Duke Social Support Index ) . Findings revealed that compared with usual care , 
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Quantitative data were promising in regards to residents ’ depression symptoms , functioning and social care related quality of life .
Conclusion It is feasible to deliver and evaluate LifeFul .