Building rehabilitation care capacity for older adults living in long-term care through family/care partner and physical therapist engagement: a scoping review

BACKGROUND: Older adults living in long-term care homes often experience impairment in mobility and function requiring physical therapy rehabilitation. Maintaining residents' physical function can promote quality of life, reduce pain and skin breakdown, and support the provision of personal care. Family/care partners notably contribute to resident well-being. Understanding engagement between physical therapists and family/care partners is essential to advancing resident rehabilitation and health outcomes, particularly as staffing capacity, time, and access to rehabilitation services become increasingly constrained. This review aimed to synthesise and assess the quality of the literature describing engagement between physical therapists and family/care partners of older adults in long-term care. METHODS: A scoping review was conducted following Arksey and O'Malley's framework and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. Six databases and grey literature were searched without date restrictions. Papers were eligible for inclusion if they: (1) described engagement between physical therapists and family/care partners as reported by any participant group; (2) were conducted in a long-term care home or equivalent setting; (3) focused on physical rehabilitation for older adults; and (4) were available in English. Any study design was eligible. Data were analysed thematically and methodological quality was assessed. RESULTS: Of 3443 papers and records screened, nine studies were included. Most (n=8) were qualitative and conducted in high-income countries and all were rated as "good" quality. Four themes surfaced describing engagement between physical therapists and family/care partners in long-term care: (1) physical therapists support greater family/care partner involvement in rehabilitation; (2) opportunities to enhance structured communication between physical therapists and family/care partners; (3) misalignment of family/care partner expectations with physical therapy service capacity; and (4) enhancing role clarity and value of family/care partners in rehabilitation. CONCLUSION: Engagement between physical therapists and family/care partners in long-term care homes is underdeveloped despite recognition of its potential benefits. Clearer role definitions, structured communication, and supportive organisational policies are needed to enhance collaboration, reduce caregiver burden, and support manageable physical therapist workloads. Strengthening these partnerships could improve rehabilitation processes, resident health outcomes, and sustainability of long-term care services.