Association of home care needs and functional recovery among community-dwelling elderly hip fracture patients

2013 ◽  
Vol 57 (3) ◽  
pp. 383-388 ◽  
Author(s):  
Li-Chu Wu ◽  
Ming-Yueh Chou ◽  
Chih-Kuang Liang ◽  
Yu-Te Lin ◽  
Yan-Chiou Ku ◽  
...  
2020 ◽  
pp. 084456212094942
Author(s):  
Connie Schumacher ◽  
Aaron Jones ◽  
Andrew P. Costa

Background Home care patients are a growing group of community-dwelling older adults with complex care needs and high health service use. Adult home care patients are at high risk for emergency department (ED) visits, which is greater on the same day as a nursing visit. Purpose The purpose of this study was to examine whether common nursing indicators modified the association between nursing visits and same-day ED visits. Methods A case-crossover design within a retrospective cohort of adult home care patients in Ontario. Results A total of 11,840 home care nursing patients were analyzed. Home care patients who received a home nursing visit were more likely to go the ED afterhours on the same day with a stronger association for visits not admitted to the hospital. Having a urinary catheter increased the risk of a same-day ED visit (OR: 1.78 (95% CI 1.15–1.60) vs. 1.21 (95% CI 1.15–1.28)). No other clinical indicator modified the association. Conclusions The findings of this study can be used to inform care policies and practices for home care nurses in the management of indwelling urinary catheter complications. Further examination of system factors such as capacity and resources available to respond to catheter related complications in the community setting are recommended.


2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.


2003 ◽  
Vol 15 (3) ◽  
pp. 234-242 ◽  
Author(s):  
Ángel Otero ◽  
María Jesús García de Yébenes ◽  
Ángel Rodríguez-Laso ◽  
María Victoria Zunzunegui

2017 ◽  
Vol 15 (6) ◽  
pp. 355
Author(s):  
Alexandra I.T. Van Solm, PhD ◽  
John P. Hirdes, PhD, FCAHS ◽  
Leslie A. Eckel, PhD(c), RSW ◽  
George A. Heckman, MD, FRCPC ◽  
Philip L. Bigelow, PhD

Objectives: Several studies have shown the increased vulnerability of and disproportionate mortality rate among frail community-dwelling older adults as a result of emergencies and disasters. This article will discuss the applicability of the Vulnerable Persons at Risk (VPR) and VPR Plus decision support algorithms designed based on the Resident Assessment Instrument- Home Care (RAI-HC) to identify the most vulnerable community-dwelling (older) adults.Design: A sample was taken from the Ontario RAI-HC database by selecting unique home care clients with assessments closest to December 31, 2014 (N = 275,797). Statistical methods used include cross tabulation, bivariate logistic regression as well as Kaplan-Meier survival plotting and Cox proportional hazards ratios calculations.Results: The VPR and VPR Plus algorithms, were highly predictive of mortality, long-term care admission and hospitalization in ordinary circumstances. This provides a good indication of the strength of the algorithms in identifying vulnerable persons at times of emergencies.Conclusions: Access to real-time person-level information of persons with functional care needs is a vital enabler for emergency responders in prioritizing and allocating resources during a disaster, and has great utility for emergency planning and recovery efforts. The development of valid and reliable algorithms supports the rapid identification and response to vulnerable community-dwelling persons for all phases of emergency management.


Gerontology ◽  
2020 ◽  
Vol 66 (6) ◽  
pp. 542-548
Author(s):  
Wendy L. Cook ◽  
Penelope M.A. Brasher ◽  
Pierre Guy ◽  
Stirling Bryan ◽  
Meghan G. Donaldson ◽  
...  

<b><i>Background:</i></b> Comprehensive geriatric care (CGC) for older adults during hospitalization for hip fracture can improve mobility, but it is unclear whether CGC delivered after a return to community living improves mobility compared with usual post-discharge care. <b><i>Objective:</i></b> To determine if an outpatient clinic-based CGC regime in the first year after hip fracture improved mobility performance at 12 months. <b><i>Methods:</i></b> A two-arm, 1:1 parallel group, pragmatic, single-blind, single-center, randomized controlled trial at 3 hospitals in Vancouver, BC, Canada. Participants were community-dwelling adults, aged ≥65 years, with a hip fracture in the previous 3–12 months, who had no dementia and walked ≥10 m before the fracture occurred. Target enrollment was 130 participants. Clinic-based CGC was delivered by a geriatrician, physiotherapist, and occupational therapist. Primary outcome was the Short Physical Performance Battery (SPPB; 0–12) at 12 months. <b><i>Results:</i></b> We randomized 53/313 eligible participants with a mean (SD) age of 79.7 (7.9) years to intervention (<i>n</i> = 26) and usual care (UC, <i>n</i> = 27), and 49/53 (92%) completed the study. Mean 12-month (SD) SPPB scores in the intervention and UC groups were 9.08 (3.03) and 8.24 (2.44). The between-group difference was 0.9 (95% CI –0.3 to 2.0, <i>p</i> = 0.13). Adverse events were similar in the 2 groups. <b><i>Conclusion:</i></b> The small sample size of less than half our recruitment target precludes definitive conclusions about the effect of our intervention. However, our results are consistent with similar studies on this population and intervention.


CJEM ◽  
2021 ◽  
Author(s):  
Matthew S. Leyenaar ◽  
Brent McLeod ◽  
Aaron Jones ◽  
Audrey-Anne Brousseau ◽  
Eric Mercier ◽  
...  

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.


2021 ◽  
Vol 13 (13) ◽  
pp. 7277
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Paolo Fabbietti ◽  
Giovanni Lamura

The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were reported. Seven clusters were identified, reflecting different combinations of changes in the formal/informal care provision. In most countries, informal care is more resilient than home care services that formal providers deliver. Since they are an essential source for sustainable care, their challenges related to care should be addressed. The impact of the pandemic does not follow the traditional characterization of welfare regimes. A clustering effort may yield more understanding of the priorities that future care policies should exhibit at the national level and may identify potential systems for policymakers to enhance sustainability of care for community-dwelling older adults.


1963 ◽  
Vol 12 (4) ◽  
pp. 258
Author(s):  
B. T. DALE ◽  
A. Smith
Keyword(s):  

2015 ◽  
Vol 27 (10) ◽  
pp. 1593-1600 ◽  
Author(s):  
Lee-Fay Low ◽  
Jennifer Fletcher

ABSTRACTBackground:Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care.Methods:We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs.Results:Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study.Conclusions:There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.


Author(s):  
Marsha Love ◽  
Felipe Tendick-Matesanz ◽  
Jane Thomason ◽  
Davine Carter ◽  
Myra Glassman ◽  
...  

The home care workforce, already at 2.7 million caregivers, will become the nation’s fastest growing occupation by 2024 as the senior boom generation accelerates the demand for in home services to meet its long-term care needs. The physically challenging work of assisting clients with intimate, essential acts of daily living places home care workers (HCWs) at risk for musculoskeletal disorders (MSDs); yet, HCWs typically receive little formal job training and may lack appropriate assistive devices. In this qualitative pilot study, HCW focus groups described workplace MSD risk factors and identified problem-solving strategies to improve ergonomic conditions. The results revealed that HCWs rely on their behavioral insights, self-styled communications skills and caring demeanor to navigate MSD risks to themselves and increase clients’ physical independence of movement. We suggest changes in employer and government policies to acknowledge HCWs as valued team members in long-term care and to enhance their effectiveness as caregivers.


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