scholarly journals Paramedics assessing patients with complex comorbidities in community settings: results from the CARPE study

CJEM ◽  
2021 ◽  
Author(s):  
Matthew S. Leyenaar ◽  
Brent McLeod ◽  
Aaron Jones ◽  
Audrey-Anne Brousseau ◽  
Eric Mercier ◽  
...  
Keyword(s):  
Home Care ◽  
Support Services ◽  
Home Visit ◽  
Community Care ◽  
Community Support ◽  
Community Dwelling ◽  
Living Alone ◽  
Care Providers ◽  
Community Paramedicine ◽  
Community Support Services

Abstract Objectives The aim for this study was to provide information about how community paramedicine home visit programs best “navigate” their role delivering preventative care to frequent 9-1-1 users by describing demographic and clinical characteristics of their patients and comparing them to existing community care populations. Methods Our study used secondary data from standardized assessment instruments used in the delivery of home care, community support services, and community paramedicine home visit programs in Ontario. Identical assessment items from each instrument enabled comparisons of demographic, clinical, and social characteristics of community-dwelling older adults using descriptive statistics and z-tests. Results Data were analyzed for 29,938 home care clients, 13,782 community support services clients, and 136 community paramedicine patients. Differences were observed in proportions of individuals living alone between community paramedicine patients versus home care clients and community support clients (47.8%, 33.8%, and 59.9% respectively). We found higher proportions of community paramedicine patients with multiple chronic disease (87%, compared to 63% and 42%) and mental health-related conditions (43.4%, compared to 26.2% and 18.8% for depression, as an example). Conclusion When using existing community care populations as a reference group, it appears that patients seen in community paramedicine home visit programs are a distinct sub-group of the community-dwelling older adult population with more complex comorbidities, possibly exacerbated by mental illness and social isolation from living alone. Community paramedicine programs may serve as a sentinel support opportunity for patients whose health conditions are not being addressed through timely access to other existing care providers. Protocol registration ISRCTN 58273216.

scholarly journals Indicators of paramedic service use by community dwelling older adults

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Matthew S Leyenaar ◽  
Walter Tavares ◽  
Gina Agarwal ◽  
Andrew P Costa
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Home Care ◽  
Service Use ◽  
Community Dwelling ◽  
Care Providers ◽  
Community Paramedicine ◽  
Care Assessment ◽  
Ed Visits ◽  
Community Dwelling Older Adults

<p>Introduction:  Home care clients represent a patient group that may be served through community paramedicine (CP) programs.  The Detection of Indicators and Vulnerabilities for Emergency Room Trips (DIVERT) scale was recently validated to identify levels of risk for use of emergency care among this population.  This study investigates whether frail home care clients that were identified as being at higher risk based on their DIVERT scores were more likely to use paramedic services to access the emergency department within 90 days of assessment when compared to clients that had lower DIVERT scores.</p><p>Methods: A retrospective cohort study was conducted using regularly collected administrative data.  Home care assessment data were supplemented with data on emergency department (ED) visits.  Arrival by ambulance was modelled to control for DIVERT scores as well as several social and demographic variables.</p><p>Results:  Within the cohort, approximately 40% of individuals visited an ED within 90 days of a home care assessment and almost half of all individuals visited an ED more than once within a year.  About two-thirds of clients that visited an ED in the 90 days following assessment used an ambulance for transportation.  DIVERT scores were predictive of this use with highest scores indicating 4.15 times higher odds of paramedic service use (95% CI 3.60-4.78</p><p>Conclusion:  DIVERT was not developed to consider means of transportation to the ED.  The results indicate that it can be used to identify frail community dwelling older adults that are likely to use paramedic services to take them to the ED.  Further investigation of aspects of social isolation, carer resiliency, time of use, and characteristics associated with ED discharge are warranted.  Frequent ambulance use among this population suggests that collaboration between care providers may provide opportunities to prevent unnecessary ED visits by these individuals.</p>

scholarly journals Delivery of Community Support Services for Older Adults in Social Housing

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 910-911
Author(s):  
Matthew Yau ◽  
Christine Sheppard ◽  
Jocelyn Charles ◽  
Andrea Austen ◽  
Sander Hitzig
Keyword(s):  
Older Adults ◽  
Service Delivery ◽  
Low Income ◽  
Support Services ◽  
Social Housing ◽  
Service Providers ◽  
Community Support ◽  
Community Agencies ◽  
Visible Minorities ◽  
Community Support Services

Abstract Community support services are an integral component of aging in place. In social housing, older adult tenants struggle to access these services due to the siloed nature of housing and health services. This study aims to describe the relationship between community support services and social housing for older adults and examine ways to optimize delivery. Data on government-funded community support services delivered to 74 seniors’ social housing buildings in Toronto, Ontario was analyzed. Neighbourhood profile data for each building was also collected, and correlational analyses were used to examine the link between neighbourhood characteristics and service delivery. Fifty-six community agencies provided 5,976 units of services across 17 service categories, most commonly mental health supports, case management and congregate dining. On average, each building was supported by nine agencies that provided 80 units of service across 10 service categories. Buildings in neighbourhoods with a higher proportion of low-income older adults had more agencies providing on-site services (r = .275, p &lt; .05), while those in neighbourhoods with more immigrants (r = -.417, p &lt; .01), non-English speakers (r = -.325, p &lt; .01), and visible minorities (r = -.381, p &lt; .01) received fewer services. Findings point to a lack of coordination between service providers, with multiple agencies offering duplicative services within the same building. Vulnerable seniors from equity-seeking groups, including those who do not speak English and recent immigrants, may be excluded from many services, and future service delivery for seniors should strive to address disparities in availability and access.

scholarly journals Supporting the mental health needs of adults 50 and over: The importance of integrated community support services

2016 ◽  
Vol 16 (6) ◽  
pp. 282 ◽  
Author(s):  
Nelly D. Oelke ◽  
Kaela Schill ◽  
Carolyn Szostak ◽  
Betty Brown ◽  
Susana Caxaj ◽  
...  
Keyword(s):  
Mental Health ◽  
Support Services ◽  
Community Support ◽  
Health Needs ◽  
Mental Health Needs ◽  
Community Support Services

Sensory Impairment, Use of Community Support Services, and Quality of Life in Aged Care Clients

2007 ◽  
Vol 19 (2) ◽  
pp. 229-241 ◽  
Author(s):  
Tien Tay ◽  
Jie Jin Wang ◽  
Richard Lindley ◽  
Ee-Munn Chia ◽  
Peter Landau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Support Services ◽  
Community Support ◽  
Aged Care ◽  
Sensory Impairment ◽  
Community Support Services

Multi-Purpose Residential Homes: A Fair Deal for Residents?

1994 ◽  
Vol 14 (3) ◽  
pp. 383-404
Author(s):  
Fay Wright
Keyword(s):  
Older People ◽  
Elderly People ◽  
Support Services ◽  
Local Authority ◽  
Community Support ◽  
Residential Home ◽  
Model Case ◽  
Residential Homes ◽  
Department Of Health ◽  
Community Support Services

ABSTRACTThe paper reports on a study carried out in 1990 for the Department of Health looking at the development of local authority multi-purpose residential homes for elderly people in England and Wales. A national survey showed that one in five public sector residential homes for elderly people would soon be multi-purpose. This proportion could be expected to increase in the 1990S. Many of these homes had become the centre for virtually all the community support services for elderly people in the neighbourhood. Despite some obvious management advantages in making use of residential home facilities for older people in the community, there have to be serious reservations about a multi-purpose model. Case studies in six multi-purpose homes suggest that residents themselves may gain little or nothing from this arrangement. Few interact with elderly people from the neighbourhood in the day centre. So much activity on the premises meant that invasions of residents' privacy and space were common.

Services communautaires et qualité de la vie: une étude d'impact en région éloignée*

1992 ◽  
Vol 37 (8) ◽  
pp. 553-563 ◽  
Author(s):  
Céline Mercier ◽  
Raymond Tempier ◽  
Et Claude Renaud
Keyword(s):  
Quality Of Life ◽  
Support Services ◽  
Satisfaction With Life ◽  
Group Living ◽  
Community Support ◽  
Remote Area ◽  
Subjective Perception ◽  
Community Support Services ◽  
The Impact

This longitudinal study with a matched comparison group was conducted in Abitibi, an area in North-West Quebec. Its goal was to observe the impact of community support services on the quality of life of long term psychiatric patients living in a remote area. A cohort of 47 subjects, living in a small town with a comprehensive network of community support services, was compared with a similar group living in a neighbouring city with only outpatient services. The satisfaction with life domains scale developed by Andrews and Withey and adapted by Baker and Intagliata was used at four times during the study. According to the results, the subjective perception of the quality of life in the two groups is comparable, even though the objective conditions are less favorable for the group participating in the community support program. The highest ratings were given to the place of residence, the neighborhood and its commodities; the lowest ratings were given to their love life and financial situation. One can observe a stability of the measures of quality of life over time and for the two groups. The perceptions of the sample living in a remote area are much more favorable than the ones of a comparable group living in the Montreal area. These results are discussed in a double perspective: the role of community support services in the daily life of people who are having severe and persistant problems of mental health, and the interest of measures of quality of life.

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