Association of long-term care utilization and functional ability in older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Kyaw
Keyword(s):  
Older Adults ◽  
Functional Ability ◽  
Daily Living ◽  
Healthy Aging ◽  
Long Term Care ◽  
World Health ◽  
Health Priorities ◽  
High Quality ◽  
Term Care

Abstract Background Healthy Ageing is the process of developing and maintaining the functional ability that enables wellbeing in older age as per the World Health Organization (WHO). Establishing foundations necessary for improvements in long-term care (LTC) systems for increasing the world's older adults is one of the public health priorities. LTC provides assisted daily living (ADLs), instrumental assisted daily living (IDALs), healthcare, and social services. This study aims to assess the association of LTC utilization and functional ability in the two industrialized countries with a globalized aging perspective. This study would guide to identify the approaches for establishing fundamentals, developing and sustaining a trained workforce to achieve high-quality, healthy aging. Methods This retrospective longitudinal population-based study, individuals age 65 and above from the national data of the United Kingdom, UK, (English Longitudinal Study of Aging) and the United States, U.S, (Health and Retirement Study). The outcome is LTC: nursing home and home care. Predictors: functional status: scores of ADLs and IADLs, and declining ADLs and IADLs. Covariates are age, gender, marital status, income, chronic diseases. Multiple logistic regression analysis was carried out in SAS software version 9.4, p-vale (p) <0.05. Results LTC utilization (UK) is associated with declining IADLs (OR: 15.01, 95%CI: 1.62,139.23), p- 0.02 with adjustments for covariates. LTC utilization (U.S) is associated with declining ADLs (OR: 2.66, 95%CI:1.82,3.87) and IADLs (OR: 2.42, 95%CI:1.73,3.40), both at p-<0.001. With adjustment for covariates, LTC utilization (U.S) is associated with declining ADLs (OR: 2.20,95%CI:1.51,3.22), p-0.001 and declining IADLs (OR: 2.12, 95%CI:1.49,3.02), p-<0.001. Conclusions Declining functional ability is associated with LTC utilization. This study guide to improve LTC systems to develop personalized social and healthcare foundations, increase the trained workforce. Key messages To demonstrate the long-term care (LTC) utilization by declining functional capacity in the UK and the US older adults to a better understanding of the distribution of LTC utilization between them. To guide developing approaches in the improving long-term care system to achieve high-quality, healthy aging through evidence findings of this national study.

scholarly journals EAST MEETS WEST: IMPROVING HEALTH AND LONG-TERM CARE FOR OLDER ADULTS IN THE U.S. AND CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S243-S244
Author(s):  
Bei Wu ◽  
Jie Hua Lu
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Long Term Care ◽  
Panel Discussion ◽  
Community Dwelling ◽  
Term Care ◽  
Spousal Caregiving ◽  
Pragmatic Clinical Trials ◽  
The U.S

Abstract As the number of older adults in the U.S. and China continues to increase, promoting healthy aging is essential for individuals, family, and society. Both countries face many similar issues due to their aging populations, including prolonging healthy life expectancy and providing quality of care. However, the change in demographics brings with it unique challenges for both the U.S and China. This forum invites scholars and researchers from these two countries to share their knowledge and insights on promoting healthy aging and improving care for older adults. This forum includes five presentations and one-panel discussion. Two presentations will focus on long-term care (LTC) in China, one is to forecast the needs of LTC in the next five decades, and the other is to evaluate the current LTC needs and discuss LTC policy. Using the data from the Health and Retirement Study, the third presentation aims to re-conceptualize spousal caregiving as a dyad-level phenomenon and provides a dynamic view of the spousal caregiving experiences. The last two presentations will focus on promoting healthy aging through clinical interventions. The fourth one is to evaluate the effectiveness of adaptive computer-based cognitive training among community-dwelling older adults in China. The last presentation provides some examples of using pragmatic clinical trials to improve the care of older adults in skilled nursing facilities in the U.S. After the five presentations, the three panelists will provide feedback to the presentations and share their views on healthy aging with the audience.

scholarly journals THE IMPACT OF A PARO INTERVENTION ON DEPRESSION AND WELL-BEING IN OLDER ADULTS WITH DEPRESSION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S341-S341
Author(s):  
Shu-Chuan Chen ◽  
Wendy Moyle ◽  
Cindy Jones
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Older People ◽  
Long Term Care ◽  
Well Being ◽  
World Health ◽  
Term Care ◽  
Care Facilities

Abstract Aim: This study aimed to explore the effect of a social robot Paro intervention on depression and well-being in older adults with depression living in long-term care facilities in Taiwan. Methods: This study was adopted a single group and quasi-experimental with repeated measures design. Each participant participated in two stages: observation and Paro intervention stages. Stage 1 was an 8-week observation stage in long-term care facilities where the purpose was to observe the normal mood, behaviour and activities of older adults with depression. In stage 2, each participant was given a Paro by the researcher to keep for 24 hours for 7 days in for 8 weeks. Outcome measurements were obtained 4 times: a week before the intervention (T1), immediately the end of 8-week observation (T2), mid-point of Paro intervention (T3), and immediately the end of 8-week Paro intervention (T4). Instruments included the Geriatric Depression Scale, the UCLA Loneliness Scale version 3, and the World Health Organization Quality of Life Questionnaire-OLD. Results: There were 20 participants completed the study. The mean age of participants was 81.1years (SD = 8.2). After 8-week Paro intervention, statistically significant differences in changes were found on depression, loneliness, and quality of life from pre-intervention to post-intervention. Conclusion: This study was found that Paro intervention has beneficial effects on depression and mental well-being for older people with depression in long-term care facilities. Paro Intervention might be a suitable psychosocial intervention for older people with depression and should be considered as a useful tool in clinical practice.

scholarly journals Examining Consequences Related to Unmet Care Needs Across the Long-Term Care Continuum

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 90-90
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie Robert
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Residential Care ◽  
Informal Care ◽  
Daily Living ◽  
Long Term Care ◽  
Community Care ◽  
Term Care ◽  
Care Arrangement

Abstract At some point in our lives, approximately 70% of us will need support to help with daily care. Without adequate assistance we may experience unmet care need consequences (UCNC) – such as skipping meals, going without clean clothes, or taking the wrong medication. This study examines the likelihood of experiencing UCNC related to gaps in assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) across long-term care arrangements: informal community care, paid community care, residential care, and nursing homes. We examine a sample of older adults receiving assistance in a care arrangement (N=2,499) from the nationally representative 2015 National Health and Aging Trends Study. Cross-sectional and longitudinal regression models, adjusting for differences in demographic and health/functioning characteristics, examine if type of care arrangement in 2015 is associated with UCNC in 2015 and change in UCNC by 2017. Holding all else constant, there were no significant differences in UCNC related to ADLs in 2015 across care arrangements. However, those receiving paid community care were more likely to experience UCNC related to IADLs (going without clean clothes, groceries, or a hot meal and making medication errors) compared to those receiving only informal care (OR=1.64, p<.05) or residential care (OR=2.19, p<.01). By 2017, paid care was also significantly associated with continued UCNC, but older adults in informal care arrangements were most likely to experience a new UCNC. Results suggest improving/expanding assistance with IADLs among community-dwelling older adults, and promoting equitable access to residential care, to reduce UCNC.

scholarly journals Disability and Long-Term Care in Singapore

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 705-705
Author(s):  
Cynthia Chen Huijun ◽  
Ngee Choon Chia
Keyword(s):  
Older Adults ◽  
Older Persons ◽  
Healthy Aging ◽  
Long Term Care ◽  
Population Aging ◽  
International Comparisons ◽  
Term Care ◽  
Life Lessons ◽  
The Impact

Abstract Public systems for long term care (LTC) redistribute resources between generations. Population aging is one of the most significant transformations in the 21st century, where the number of older persons aged 60 years and above is expected to double by 2050, rising to 2.1 billion. We used the Future Elderly Model (FEM) to project the impact of population aging in Singapore up to the year 2050. The FEM is a dynamic economic and demographic microsimulation model. By 2050, the total number of older adults with potential limitation in activities of daily living (ADL) was projected to increase to 275 thousand (18.9%). With the increasing prevalence of disability and chronic diseases, older adults might not have sufficient savings to meet future needs sustainably, despite the expansion of disability insurance from ElderShield to CareShield Life. Lessons and best practices for LTC could be transferred from our experiences to other aging cities globally. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.

scholarly journals IS THERE A RELATIONSHIP BETWEEN PAIN AND FEAR OF FALLING IN OLDER ADULTS LIVING IN LONG-TERM CARE FACILITIES?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S718-S719
Author(s):  
Edgar R Vieira ◽  
Diego Tavares ◽  
Particia Nobrega ◽  
Alvaro Maciel
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Long Term Care ◽  
Fear Of Falling ◽  
Term Care ◽  
Assessment Scores ◽  
Care Facilities ◽  
Geriatric Pain

Abstract Fear of falling is common in older adults and it is associated with multiple factors such as gait and balance issues, difficulties in activities of daily living, visual impairment, and frailty. Unfortunately, fear of falls increases the risk of falls as opposed to protect from falls. Pain can impair mobility, affects activities of daily living, and may also be associated with fear of falling but no studies have evaluated this potential association. The objectives of this study were to evaluate if there was an association between pain and fear of falling in older adults living in long-term care facilities. One hundred and eight older adults living in long-term care facilities participated in the study. The mean age was 79±7 years, and 65% of the participants were women. The participants completed the Geriatric Pain Measure (GPM) questionnaire for multidimensional pain assessment (scores range from 0 to 42), and the Falls Efficacy Scale International (FES-I) for fear of falling assessment (scores range from 16 to 64). The data was analyzed using multiple linear regression. Forty-five percent of the participants had chronic pain (≥3 months) and 18% had acute pain (<3 months). Pain scores were 29±31. Pain was associated with an increase of 3 to 7 points (out of 64 max) in the FES-I. The prevalence of pain in long-term care residents was high, and pain was associated with increased fear of falling.

scholarly journals Population with Long-Term Care Needs in Six Latin American Countries: Estimation of Older Adults Who Need Help Performing ADLs

2021 ◽  
Vol 18 (15) ◽  
pp. 7935
Author(s):  
Mauricio Matus-Lopez ◽  
Alexander Chaverri-Carvajal
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Latin American ◽  
Daily Living ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Latin American Countries

The population in Latin America is ageing, and there is an inevitable demand for long-term care services. However, there are no comparative analyses between Latin American countries of the dependency situation of older adults. This study aims to calculate and compare percentages of older adults who need help performing the activities of daily living in six Latin American nations. The study is observational, transversal, and cross-national and uses microdata drawn from national surveys conducted in Argentina (n = 3291), Brazil (n = 3903), Chile (n = 31,667), Colombia (n = 17,134), Mexico (n = 7909), and Uruguay (n = 4042). Comparable indicators of the need for help in performing the basic and instrumental activities of daily living were calculated. The percentages of older adults in need of help for basic activities of daily living ranged from 5.8% in Argentina to 11% in Brazil; for instrumental activities of daily living, from 13.8% in Mexico to 35.7% in Brazil; and combined, from 18.1% in Argentina to 37.1% in Brazil. Brazil thus has the highest indicators, followed by Colombia. The results warn of the frail physical condition of older people and the high potential demand for long-term care services. The information provided could be useful for further research on and planning for long-term care needs in Latin American and middle-income countries.

scholarly journals Pain assessment of elderly with neurocognitive disorders in long-term care: an occupational lens

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Ruest ◽  
G Léonard ◽  
E Lagueux ◽  
P Boissy ◽  
M H Milot ◽  
...  
Keyword(s):  
Older Adults ◽  
Daily Living ◽  
Long Term Care ◽  
Neurocognitive Disorders ◽  
Neurocognitive Disorder ◽  
Occupational Performance ◽  
Term Care ◽  
Care Facilities ◽  
Pain Symptoms

Abstract Background Occupational performance of older adults living in long-term care facilities is influenced by environmental possibilities and service provision. Pain among older adults with neurocognitive disorders might be a factor mitigating functional status. However, pain evaluation during daily routine through advanced stages of the disorder is scarce. Objective Identify pain-related behaviors of older adults with neurocognitive disorders during their morning routine in long-term care facilities. Methods A multiple-case study based on an embedded concurrent mixed methods design (quan-QUAL) was conducted in Quebec (Canada) in three long-term care units. Older adults with a neurocognitive disorder were observed (from 7:00 to 12:00 AM) and evaluated through the accomplishment of their morning routine. Through inter- and intra-case analyses, pain assessment scales (PACSLAC-II, Algoplus and DS-DAT) and morning routine assessment (occupational therapist's observations of the person, occupations and environment, functional autonomy measure, field notes) were integrated in mixed methods matrixes. Results Sixteen (n = 16) participants (average age: 76 years old [59, 93]) with various but advanced functional declines and pain symptoms were included. Participants' significant occupations all related to basic activities of daily living. Hygiene care and getting dressed were occupations for which an alteration of occupational performance was identified. Conclusions During their morning routine, older adults with a neurocognitive disorder living in long-term care facilities are facing pain symptoms and occupational deprivation, limiting the fulfilment of their needs and their engagement in occupations. Accordingly, older adults' occupations in relation to their environment should also be considered in future studies investigating pain. Key messages Occupational performance of older adults with a neurocognitive disorder living in long term care facilities is limited to basic activities of daily living. Assessment of pain of patients with a neurocognitive disorder in long-term care units should include the identification of environmental and occupational factors contributing to this pain.

scholarly journals A social robot intervention on depression, loneliness, and quality of life for Taiwanese older adults in long-term care

2020 ◽  
Vol 32 (8) ◽  
pp. 981-991 ◽  
Author(s):  
Shu-Chuan Chen ◽  
Wendy Moyle ◽  
Cindy Jones ◽  
Helen Petsky
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Long Term Care ◽  
Well Being ◽  
Social Robot ◽  
World Health ◽  
Term Care ◽  
Mental Well Being

ABSTRACTObjectives:To investigate the effect of a social robot intervention on depression, loneliness, and quality of life of older adults in long-term care (LTC) and to explore participants’ experiences and perceptions after the intervention.Design:A mixed-methods approach consisting of a single group, before and after quasi-experimental design, and individual interview.Participants:Twenty older adults with depression from four LTC facilities in Taiwan were recruited.Intervention:Each participant participated in 8 weeks of observation and 8 weeks of intervention. In the observation stage, participants received usual care or activities without any research intervention. In the intervention stage, each participant was given a Paro (Personal Assistive RobOt) to keep for 24 hours, 7 days a week.Measurements:The Geriatric Depression Scale, the UCLA Loneliness Scale Version 3, and the World Health Organization Quality of Life Questionnaire for older adults were administered at four time points. Individual qualitative interviews with thematic analysis followed.Results:A repeated multivariate analysis of variance and Friedmanʼs test showed no significant changes during the observation stage between T1 and T2 for depression and quality of life (p >.5). For the intervention stage, statistically significant changes in decreasing depression and loneliness and improving quality of life over time were identified. Three themes emerged from the interviews: (i) humanizing Paro through referring to personal experiences and engagement; (ii) increased social interaction with other people; and (iii) companionship resulting in improved mental well-being.Conclusions:There were significant improvements in mental well-being in using Paro. Further research may help us to understand the advantages of using a Paro intervention as depression therapy.

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