One-year predictors of turnover among personal-care workers for older adults living at home in Italy

2010 ◽  
Vol 31 (4) ◽  
pp. 611-624 ◽  
Author(s):  
CLAUDIO BILOTTA ◽  
PAOLA NICOLINI ◽  
CARLO VERGANI
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Multivariate Logistic Regression Analysis ◽  
Community Dwelling ◽  
Care Staff ◽  
Personal Care ◽  
Care Workers ◽  
Informal Carers ◽  
One Year ◽  
At Home

ABSTRACTThis paper reports a study that aimed to identify the predictors of the turnover of privately-employed personal-care staff that provide community-dwelling older adults in Italy with assistance in the activities of daily living. The prospective cohort study enrolled 121 older adults (mean age 85.6 years) living at home, along with their personal-care workers and 107 informal carers. The older participants underwent a comprehensive geriatric assessment. At a one-year follow-up between May 2006 and June 2008, 12 of the older participants had been placed in a nursing home and 26 had died. Of the 83 still living at home, 22 had changed their personal-care staff (26.5% turnover). Multivariate logistic regression analysis identified one characteristic of the personal-care staff, living far away from their families (odds ratio (OR) 16.30, p=0.01), and two characteristics of the elders, namely being widowed (OR 0.09, p=0.01) and having cognitive impairment (OR 0.10, p=0.01), as one-year predictors of turnover and of the retention of personal-care workers, respectively. Further studies are needed both to evaluate whether immigration politics that enable family reconjunction would reduce the turnover of personal-care workers, and to investigate the lower turnover among personal-care staff caring for widowed elders and older adults with cognitive impairment.

EXPLORING FACTORS THAT CONTRIBUTE TO JOINING AND REGULARLY PRACTICING IN COGNITIVE TRAINING AMONG HEALTHY OLDER ADULTS: A ONE-YEAR FOLLOW-UP QUALITATIVE STUDY

2020 ◽  
pp. 1-7
Author(s):  
P. Srisuwan ◽  
D. Nakawiro ◽  
S. Chansirikarnjana ◽  
O. Kuha ◽  
S. Kengpanich ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Cognitive Training ◽  
Individual Characteristics ◽  
Community Dwelling ◽  
Notification System ◽  
Healthy Older Adults ◽  
Effective Program ◽  
One Year ◽  
At Home

BACKGROUND: Cognitive interventions have the potential to enhance cognition among healthy older adults. However, little is known of the factors associated with the joining and participating of older people in group-based multicomponent cognitive training (CT). OBJECTIVES: To explore factors that contribute to joining and regularly practicing CT over 1 year among healthy older adults. DESIGN: A qualitative study. SETTING: Geriatric clinic in Bangkok, Thailand. PARTICIPANTS: 40 nondemented community-dwelling older adults INTERVENTION: The CT of executive functions, attention, memory and visuospatial functions (TEAM-V) program was conducted over 5 sessions, with a 2-week interval between each session. MEASUREMENTS: An inductive qualitative approach, based on semi-structure interviews with 40 healthy older adults, was employed. The interviews explored factors of joining CT at baseline, factors of regularly participating in class at 6 months and at home at 1 year. Data were coded and analyzed using and the thematic analysis approach. RESULTS: After analyzing factors concerning joining CT, 3 core themes emerged: (1) individual characteristics with 3 subthemes of “health status”, “time arrangement”, and “financial status”; (2) individual perceptions with 2 subthemes of “perceived susceptibility to dementia” and “perceived severity of dementia” and (3) encouragement from families and friends. After analyzing factors of practicing CT in class, 3 core themes emerged: (1) program with 3 subthemes of “session”, “group facilitators” and “notification before class”; (2) accessibility with 2 subthemes of “distance” and “transportation” and (3) encouragement from families and friends. After analyzing factors of practicing CT at home, 2 core themes emerged: (1) contents of the training program and (2) encouragement from families and friends. CONCLUSIONS: Increased awareness of holistic factors including older adults’ characteristic and perceptions, support from families and friends and accessibility should be emphasized in planning CT. Designing the content of CT that could be applied or adapted in daily living and effective program components such as a notification system could increase practicing.

scholarly journals Do Communication Patterns Affect the Association between Cognitive Impairment and Hearing Loss among Older Adults in Vietnam?

2021 ◽  
Vol 18 (4) ◽  
pp. 1603
Author(s):  
Tran Dai Tri Han ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Vo Nu Hong Duc ◽  
Thang Van Vo
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Vision Loss ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Ordinal Logistic Regression Analysis ◽  
Communication Devices ◽  
Community Dwelling Older Adults

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.

scholarly journals Quality of Diet Among Community-Dwelling Elders Participating in the Mobility and Vitality Lifestyle Program

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 841-841
Author(s):  
Jessica Cheng
Keyword(s):  
Older Adults ◽  
Disease Prevention ◽  
Diet Quality ◽  
Group Intervention ◽  
Health Workers ◽  
Effective Means ◽  
Quality Score ◽  
Community Dwelling ◽  
Total Quality ◽  
One Year

Abstract Dietary choices play an important role in disease prevention both through its effect on weight and independent of it. Improving diet can be an effective means of disease prevention among older adults. Participants (n=303) were recruited from the Allegheny County, PA area and received nutritional education in group sessions led by trained community health workers over one year. Diet quality was captured at baseline and final endpoint (either 9 or 13 months) using the Rate Your Plate (RYP) instrument for assessing healthfulness of diet and includes 24 items that can be summed to generate a total quality score. The mean RYP diet quality score improved from baseline (RYP=50.87) to endpoint (RYP=54.85) (p<.001). Over the course of the intervention, 30.9% of participants made enough improvement in diet to move to a better RYP category. A community-based group intervention for older adults was effective in inducing improvements in diet quality.

scholarly journals Physical Restraint of Older Adults at Home: Preliminary Analysis of a Prospective Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 683-683
Author(s):  
Asa Inagaki ◽  
Ayumi Igarashi ◽  
Maiko Noguchi-Watanabe ◽  
Mariko Sakka ◽  
Chie Fukui ◽  
...  
Keyword(s):  
Older Adults ◽  
Online Survey ◽  
Physical Restraint ◽  
Community Dwelling ◽  
Physical Restraints ◽  
Care Nurse ◽  
Factors Associated ◽  
Home Care Nurse ◽  
Community Dwelling Older Adults ◽  
At Home

Abstract Our study aimed to explore the prevalence and factors of physical restraints among frail to dependent older adults living at home. We conducted an online survey to ask about the physical/mental conditions, demographics, service utilization, and physical restraints of community-dwelling older adults. Either home care nurse or care managers who were responsible for the older adult answered the survey that were conducted at baseline and one month later. We obtained data from 1,278 individuals. Physical restraint was reported for 53 (4.1%) participants. Multiple logistic regression revealed the factors associated with physical restraints at home: having been restrained at baseline, having pneumonia or heart failure, receiving home bathing, or using rental assistive devices were associated with physical restraints at one month. The findings could be used to promote discussion about which services prevent physical restraints and what we should do to support clients and their family to stay at home safely.

Exploring the Association between Multimorbidity and Cognitive Impairment in Older Adults Living in the Community: A Review of the Literature

2021 ◽  
pp. 108482232110304
Author(s):  
Grace F. Wittenberg ◽  
Michelle A. McKay ◽  
Melissa O’Connor
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Assessment Tool ◽  
Adult Population ◽  
Home Health ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Cognitive Screening ◽  
Review Of The Literature ◽  
Increased Risk

Two-thirds of older adults have multimorbidity (MM), or co-occurrence of two or more medical conditions. Mild cognitive impairment (CI) is found in almost 20% of older adults and can lead to further cognitive decline and increased mortality. Older adults with MM are the primary users of home health care services and are at high risk for CI development; however, there is no validated cognitive screening tool used to assess the level of CI in home health users. Given the prevalence of MM and CI in the home health setting, we conducted a review of the literature to understand this association. Due to the absence of literature on CI in home health users, the review focused on the association of MM and CI in community-dwelling older adults. Search terms included home health, older adults, cognitive impairment, and multimorbidity and were applied to the databases PubMed, CINAHL, and PsychInfo leading to eight studies eligible for review. Results show CI is associated with MM in older adults of increasing age, among minorities, and in older adults with lower levels of education. Heart disease was the most prevalent disease associated with increased CI. Sleep disorders, hypertension, arthritis, and hyperlipidemia were also significantly associated with increased CI. The presence of MM and CI was associated with increased risk for death among older adults. Further research and attention are needed regarding the use and development of a validated cognitive assessment tool for home health users to decrease adverse outcomes in the older adult population.

scholarly journals Process evaluation of a reablement training program for homecare staff to encourage independence in community-dwelling older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teuni H. Rooijackers ◽  
G. A. Rixt Zijlstra ◽  
Erik van Rossum ◽  
Ruth G. M. Vogel ◽  
Marja Y. Veenstra ◽  
...  
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Process Evaluation ◽  
Community Dwelling ◽  
Team Approach ◽  
Staff Members ◽  
Care Plans ◽  
Lump Sum ◽  
Community Dwelling Older Adults ◽  
At Home

Abstract Background Many community-dwelling older adults experience limitations in (instrumental) activities of daily living, resulting in the need for homecare services. Whereas services should ideally aim at maintaining independence, homecare staff often take over activities, thereby undermining older adults’ self-care skills and jeopardizing their ability to continue living at home. Reablement is an innovative care approach aimed at optimizing independence. The reablement training program ‘Stay Active at Home’ for homecare staff was designed to support the implementation of reablement in the delivery of homecare services. This study evaluated the implementation, mechanisms of impact and context of the program. Methods We conducted a process evaluation alongside a 12-month cluster randomized controlled trial, using an embedded mixed-methods design. One hundred fifty-four homecare staff members (23 nurses, 34 nurse assistants, 8 nurse aides and 89 domestic workers) from five working areas received the program. Data on the implementation (reach, dose, fidelity, adaptations and acceptability), possible mechanisms of impact (homecare staff's knowledge, attitude, skills and support) and context were collected using logbooks, registration forms, checklists, log data and focus group interviews with homecare staff (n = 23) and program trainers (n = 4). Results The program was largely implemented as intended. Homecare staff's average compliance to the program meetings was 73.4%; staff members accepted the program, and particularly valued its practical elements and team approach. They experienced positive changes in their knowledge, attitude and skills about reablement, and perceived social and organizational support from colleagues and team managers to implement reablement. However, the extent to which homecare staff implemented reablement in practice, varied. Perceived facilitators included digital care plans, the organization’s lump sum funding and newly referred clients. Perceived barriers included resistance to change from clients or their social network, complex care situations, time pressure and staff shortages. Conclusions The program was feasible to implement in the Dutch homecare setting, and was perceived as useful in daily practice. Nevertheless, integrating reablement into homecare staff's working practices remained challenging due to various personal and contextual factors. Future implementation of the program may benefit from minor program adaptations and a more stimulating work environment. Trial registration ClinicalTrials.gov (Identifier NCT03293303). Registered 26 September 2017.

scholarly journals A Modified CAIDE Risk Score as a Screening Tool for Cognitive Impairment in Older Adults

2021 ◽  
pp. 1-14
Author(s):  
Magdalena I. Tolea ◽  
Jaeyeong Heo ◽  
Stephanie Chrisphonte ◽  
James E. Galvin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Risk Score ◽  
Clinical Sample ◽  
Community Sample ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Risk Scores ◽  
Predictive Values

Background: Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today’s US population, and requires laboratory biomarkers, which are not always available. Objective: Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. Methods: Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. Results: Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by >  85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.

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