Use of Community Support Services and Activity Limitations Among Older Adults With Chronic Kidney Disease

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 < .05), while those in neighbourhoods with more immigrants (r = -.417, p < .01), non-English speakers (r = -.325, p < .01), and visible minorities (r = -.381, p < .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.

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Social determinants of older adults’ awareness of community support services in Hamilton, Ontario

Health & Social Care in the Community ◽

10.1111/j.1365-2524.2011.01013.x ◽

2011 ◽

Vol 19 (6) ◽

pp. 661-672 ◽

Cited By ~ 3

Author(s):

J. Tindale ◽

M. Denton ◽

J. Ploeg ◽

J. Lillie ◽

B. Hutchison ◽

...

Keyword(s):

Older Adults ◽

Social Determinants ◽

Support Services ◽

Community Support ◽

Community Support Services

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Where Would You Turn for Help? Older Adults' Awareness of Community Support Services

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.3138/cja.27.4.359 ◽

2008 ◽

Vol 27 (4) ◽

pp. 359-370 ◽

Cited By ~ 18

Author(s):

M. Denton ◽

J. Ploeg ◽

J. Tindale ◽

B. Hutchison ◽

K. Brazil ◽

...

Keyword(s):

Older Adults ◽

Nous Avons ◽

Support Services ◽

Community Support ◽

Cette Situation ◽

Community Support Services ◽

Reference Et

RÉSUMÉLes résultats précédents visant la sensibilisation des aînés aux services de soutien communautaires ne s'accordent pas et sont gâchés par l'acquiescence ou des allégations de partialité. Cela étant, la présente étude a utilisé une série de 12 scénarios pour décrire des situations courantes dans lesquelles se retrouvent les aînés pour qui des services de soutien communautaires seraient appropriés. Lors d'une entrevue téléphonique, nous avons lu à 1152 adultes âgés de 50 et plus une série de scénarios et nous leur avons demandé s'ils pouvaient indiquer un organisme communautaire vers lequel ils pourraient se tourner dans cette situation précise. Nous leur avons aussi interrogés sur leurs plus importantes sources de renseignements en matière de services de soutien communautaires. Les résultats indiquent que, si l'on a recours à une méthodologie par scénarios, la sensibilisation aux services de soutien communautaires était beaucoup plus faible qu'on ne l'avait d'abord pensé. Les plus importantes sources de renseignements sur les services de soutien communautaires comprenaient des sources de référence et des renseignements, l'annuaire téléphonique, les bureaux de médecins, et le bouche-à-oreille.

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Would Older Adults Turn to Community Support Services for Help to Maintain Their Independence?

Journal of Applied Gerontology ◽

10.1177/0733464809345495 ◽

2009 ◽

Vol 29 (5) ◽

pp. 554-578 ◽

Cited By ~ 6

Author(s):

Margaret Denton ◽

Jenny Ploeg ◽

Joseph Tindale ◽

Brian Hutchison ◽

Kevin Brazil ◽

...

Keyword(s):

Older Adults ◽

Support Services ◽

Community Support ◽

Community Support Services

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What's going on with comprehensive community support services

PsycEXTRA Dataset ◽

10.1037/e522132010-003 ◽

2006 ◽

Author(s):

Steve Johnson

Keyword(s):

Support Services ◽

Community Support ◽

Community Support Services

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

CJEM ◽

10.1007/s43678-021-00153-4 ◽

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.

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Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084370 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4370

Author(s):

A Kim ◽

Hayeon Lee ◽

Eun-Jeong Shin ◽

Eun-Jung Cho ◽

Yoon-Sook Cho ◽

...

Keyword(s):

Older Adults ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Medication Management ◽

Medication Use ◽

Potentially Inappropriate Medications ◽

Management Service ◽

Ckd Stage ◽

The Impact

Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population.

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Everyday Discrimination and Kidney Function Among Older Adults: Evidence From the Health and Retirement Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glz294 ◽

2019 ◽

Vol 75 (3) ◽

pp. 517-521

Author(s):

Ryon J Cobb ◽

Roland J Thorpe ◽

Keith C Norris

Keyword(s):

Older Adults ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Function ◽

The United States ◽

Health And Retirement Study ◽

Disease Epidemiology ◽

Lower Egfr ◽

Everyday Discrimination ◽

Retirement Study

Abstract Background With advancing age, there is an increase in the time of and number of experiences with psychosocial stressors that may lead to the initiation and/or progression of chronic kidney disease (CKD). Our study tests whether one type of experience, everyday discrimination, predicts kidney function among middle and older adults. Methods The data were from 10 973 respondents (ages 52–100) in the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative survey of older adults in the United States. Estimated glomerular filtration rate (eGFR) derives from the Chronic Kidney Disease Epidemiology Collaboration equation. Our indicator of everyday discrimination is drawn from self-reports from respondents. Ordinary Least Squared regression (OLS) models with robust standard errors are applied to test hypotheses regarding the link between everyday discrimination and kidney function. Results Everyday discrimination was associated with poorer kidney function among respondents in our study. Respondents with higher everyday discrimination scores had lower eGFR after adjusting for demographic characteristics (B = −1.35, p < .05), and while attenuated, remained significant (B = −0.79, p < .05) after further adjustments for clinical, health behavior, and socioeconomic covariates. Conclusions Our study suggests everyday discrimination is independently associated with lower eGFR. These findings highlight the importance of psychosocial factors in predicting insufficiency in kidney function among middle-aged and older adults.

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