Function focused care approaches: literature review of progress and future possibilities.

BACKGROUND: Consistent with a care approach that optimizes the underlying ability of the patient/resident, the Omnibus Budget Reconciliation Act of 1987 mandated that residents attain and maintain their highest level of function. Restorative Care, which more recently has been referred to as Function Focused Care 4, is a philosophy of care that focuses on evaluating the older adult's underlying capability with regard to function and physical activity and helping him or her optimize and maintain functional abilities and increase time spent in physical activity. The purpose of this review was to consider the work that has been done in testing function focused care and to provide guidance on the best ways in which to integrate this philosophy within any setting.
METHODS: A systematic review of the available literature studying the impact of function focused care approaches was performed using MEDLINE and CINAHL search engines. The studies included were evaluated based on such things as design, specifically whether or not they were experimental designs (which included randomized trials or quasi experimental studies) or single group studies intended to pilot an intervention or for purposes of feasibility; randomization approaches; sample size/number of residents or patients included; descriptions of the intervention such as if there was a champion utilized (research supported or staff); or if motivation of older adults or caregivers was addressed.
RESULTS: Out of 41 articles identified by CINAHL and 148 via MEDLINE, 20 articles met our inclusion and exclusion criteria. Overall the results provided support for the safety and efficacy of function focused care approaches. Continued research is particularly needed to consider best approaches for dissemination and implementation of function focused care and to test function focused care in acute care settings.