scholarly journals National Estimates of Climate-Related Disasters among Older Adults with Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 781-782
Author(s):  
Katelyn Ferreira ◽  
Katherine Ornstein ◽  
Sue Anne Bell ◽  
Mohammed Husain ◽  
Cynthia Yee ◽  
...  
Keyword(s):  
Older Adults ◽  
Self Care ◽  
Population Level ◽  
Community Dwelling ◽  
Policy Makers ◽  
Disaster Policy ◽  
Disaster Data ◽  
National Estimates ◽  
Care Assistance ◽  
Community Dwelling Older Adults

Abstract Climate-related disasters can have devastating consequences, particularly for the growing population of older adults with dementia. Increasingly, older adults with dementia are aging in place at home, where they often receive assistance for mobility or self-care activities from family and/or paid caregivers. Understanding this population’s experience with climate-related disasters is integral to mitigation, preparedness, and emergency response outside of institutional (e.g., nursing home) settings. We aimed to estimate the population of community-dwelling older adults—including those with dementia—who live in counties that experienced climate-related disasters. We used 2000-2016 data from the Health and Retirement Study (HRS), linked 2000-2018 with Federal Emergency Management Agency (FEMA) disaster data. We flagged each occurrence of climate-related disaster (e.g., hurricane, flood) and then identified HRS participants living in counties with a disaster declaration. Using survey weights, we obtained population-level estimates by disaster frequency and sample characteristics. In each two-year HRS period, we found that 14.26-20.50 million community-dwelling adults over age 65 in the contiguous US (32.2%-53.7%) resided in a county with at least one disaster. This includes 0.62 -1.12 million persons with dementia, 67.2%-76.8% of whom are reliant on caregivers. On average (per two-year period), more than one-third (36.3%) of community-dwelling older adults living with dementia lived in a county with a least one disaster. Policy makers and emergency planners should strongly consider the needs of older adults at the intersection of dementia and risk of climate-related disasters, with an eye towards ensuring access to mobility and self-care assistance.

scholarly journals Effects of Self-Care for Older PErsons (SCOPE) on Functional and Physiological Measures: A Cluster Randomized Controlled Trial

2020 ◽  
Vol 9 (3) ◽  
pp. 885
Author(s):  
Ted Kheng Siang Ng ◽  
David Bruce Matchar ◽  
Rehena Sultana ◽  
Angelique Chan
Keyword(s):  
Older Adults ◽  
Older Persons ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Self Care ◽  
Community Dwelling ◽  
Physiological Measures ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults

Background: Population aging poses unprecedented demands on the healthcare system. There is also a scarcity of evidence on self-care intervention to improve objective measures of morbidity and aging-associated functional and physiological measures in a low-income multi-ethnic population setting. Methods: We conducted a cluster randomized controlled trial (ClinicalTrials.gov Identifier: NCT01672177) to examine the effects of the Self-Care for Older PErsons (SCOPE) program. We randomized 14 Senior Activity Centers and randomly selected older adults within these centers. Functional and physiological measurements were performed at baseline, 10-month, and 18-month periods. The primary outcome was a composite of three morbidity-specific measures, which include hemoglobin A1c (HbA1C), peak expiratory flow, and systolic blood pressure. Aging-associated functional and physiological measures were examined as secondary outcomes. Repeated-measure mixed models were employed to examine the effects of SCOPE on these measures. Results: 378 community-dwelling older adults participated in either the treatment (n= 164) or the control arm (n = 214). The primary outcome was not significantly improved. For the secondary outcomes, SCOPE participants demonstrated slower oxygen desaturation at an 18-month period (p = 0.001), improved time to complete the chair-stand test (p < 0.001) at a 10-month period with the effect persisting at the 18-month period (p < 0.001). SCOPE participants also had significantly improved vitamin B12 levels at the 18-month period (p < 0.001), increased hemoglobin concentration (p < 0.001), decreased mean corpuscular volume (p = 0.001), and decreased creatinine (p = 0.002) at the 10-month period. Conclusions: SCOPE did not improve morbidity-specific measures. However, it improved several aging-associated measures implicated in geriatric syndromes. This study highlights the potential of a self-care program in the prevention of geriatric syndromes in community-dwelling older adults, while emphasizing self-management to manage existing morbidities.

IMPACT OF NUTRITIONAL RISK ON SELF-CARE CAPACITY: SOCIAL SUPPORT AS A SOURCE OF PROTECTION FOR COMMUNITY-DWELLING OLDER ADULTS LIVING IN A RURAL AREA

2013 ◽  
pp. 1-5
Author(s):  
S.E. JUNG ◽  
J.R. HERMANN ◽  
A. BISHOP
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Self Care ◽  
Community Dwelling ◽  
Nutritional Risk ◽  
Functional Impairments ◽  
Care Capacity ◽  
Community Dwelling Older Adults ◽  
Social Provisions ◽  
Rural Older Adults

Background:Loss of independence is a major concern for rural older adults. Older adults living inrural areas are at an increased nutritional risk, which can lead to functional impairments in self-care capacity.Identifying factors, which have a role in sustaining rural older adults’ self-care capacity, could help withmaintaining independence as long as possible. Objective:The objective of this study was to examine the effect ofsocial support as a moderator between nutritional risk and self-care capacity. Design:Cross sectional designusing convenient sampling. Setting:Rural Oklahoma counties designated as “non-metro” and having populationsunder 5,000. Participants:Participants included 171 community-dwelling older adults, 65 years of age and older.Measurements:Data were collected using self-report surveys on self-care capacity (using the Duke OlderAmericans Resources and Services Procedures), social support (using the Social Provisions Scale), andnutritional risk (using the Mini-Nutritional Assessment short form). Using hierarchical linear regressiontechniques, data were analyzed to explore the moderating influence of social support in the association betweennutritional risk and self-care capacity. Results:A significant interaction emerged between nutritional risk, socialsupport, and self-care capacity (β = 0.20 p < 0.05). Thus, the deleterious impact of nutritional risk on self-carecapacity was reduced by social support. Conclusions:Results provide further support of the “buffering-hypothesis” and have implications relative to the importance of accessible social provisions to enhance self-carecapacity and quality of life among older adults residing in rural settings.

Enhancing self-care in community dwelling older adults

2004 ◽  
Vol 25 (5) ◽  
pp. 272-276 ◽  
Author(s):  
Linda D. Gerson ◽  
Carm Dorsey ◽  
Janet Berg ◽  
Linda E. Rose
Keyword(s):  
Older Adults ◽  
Self Care ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

Wheelchair Use Among Community-Dwelling Older Adults: Prevalence and Risk Factors in a National Sample

2005 ◽  
Vol 24 (2) ◽  
pp. 191-198 ◽  
Author(s):  
Philippa Clarke ◽  
Angela Colantonio
Keyword(s):  
Older Adults ◽  
Research Council ◽  
Self Care ◽  
National Sample ◽  
Community Dwelling ◽  
Canadian Study ◽  
Wheelchair Users ◽  
The University ◽  
Health Canada ◽  
Community Dwelling Older Adults

ABSTRACTOlder adults are the largest group of wheelchair users yet there are no peer-reviewed studies on the national profile of older wheelchair users in Canada. We investigated the characteristics of wheelchair users in a national sample of community-dwelling older adults from the Canadian Study of Health and Aging (CSHA-2). Questions on the use of assistive technology were asked of 5395 Canadians (over 64), and 4.6 per cent reported using a wheelchair. Logistic regression was used to model the factors associated with wheelchair use. Controlling for age, gender, and cognitive impairment, older adults who reported greater dependence in basic self-care and instrumental activities of daily living were more likely to use a wheelchair. However, the effects of self-care dependence on wheelchair use varied by gender, with men more likely than women to use wheelchairs with increasing self-care dependence. The number of chronic health conditions and being unmarried also increased the odds of wheelchair use. This paper quantifies the risk of wheelchair use according to critical factors that can be used to project use and plan for services.The data reported in this paper were collected as part of the Canadian Study of Health and Aging. The core study was funded by the Seniors' Independence Research Program, through the National Health Research and Development Program (NHRDP) of Health Canada (project no. 6606-3954-MC[S]). Additional funding was provided by Pfizer Canada Incorporated through the Medical Research Council/Pharmaceutical Manufacturers Association of Canada Health Activity Program, NHRDP (project no. 6603-1417–302[R]), Bayer Incorporated, and the British Columbia Health Research Foundation (projects no. 38[93-2] and no. 34[96-1]). The study was coordinated through the University of Ottawa and the Division of Aging and Seniors, Health Canada. Additional funds for the preparation of this manuscript were made available from the Opportunities Fund of the M-THAC Research Unit (from Medicare to Home and Community) at the University of Toronto, and from a post-doctoral fellowship awarded to the first author by the Social Sciences and Humanities Research Council of Canada.

Building skill in heart failure self-care among community dwelling older adults: Results of a pilot study

2014 ◽  
Vol 96 (2) ◽  
pp. 188-196 ◽  
Author(s):  
Victoria Vaughan Dickson ◽  
Gail D’Eramo Melkus ◽  
Stuart Katz ◽  
Alissa Levine-Wong ◽  
Judy Dillworth ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Pilot Study ◽  
Self Care ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

Cost-effectiveness of a preventive self-care health management program for community-dwelling older adults: a randomised controlled trial

2020 ◽  
Author(s):  
Arkers Kwan Ching Wong ◽  
Frances Kam Yuet Wong ◽  
Ching SO
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Cost Effectiveness ◽  
Health Management ◽  
Self Care ◽  
Management Program ◽  
Community Dwelling ◽  
Control Group ◽  
Care Health ◽  
Community Dwelling Older Adults

Abstract Objective To examine the cost-effectiveness of a preventive self-care health management program for community-dwelling older adults as compared to usual care. Design/Intervention A cost-effectiveness analysis was executed alongside a randomised controlled trial. Nurse case managers provided interventions, including holistic assessment, empowerment of self-care, preventive health behaviours and self-efficacy with co-produced care planning, supported by nursing students. The control group received social control calls. Participants/Setting Community-dwelling older adults were randomly assigned to the intervention (n = 271) or control (n = 269) group. The intervention was conducted in collaboration with 11 community centres under four non-government organisations in various districts of Hong Kong. Measurements Cost and quality-adjusted life years (QALYs) were collected pre (baseline, 0 months) and post intervention (3 months) and 3 months after completion of the program (6 months). Incremental cost-effectiveness ratios between the groups were calculated, dividing the difference in cost by the difference in QALYs. Results Analysis showed that the net incremental QALY gain was 0.0014 (3 months) and 0.0033 (6 months) when the intervention group was compared to the control group. The probability of being cost-effective at 6 months was 53.2% and 53.4%, based on the cost-effectiveness thresholds recommended by both the National Institute for Health and Clinical Excellence ($200,000/QALYs) and the World Health Organization (Hong Kong gross domestic product/capita, HK$381,780). Conclusions The results provide some evidence to suggest that the addition of a home-based, preventive self-care health management program may have effects on cost outcomes for community-dwelling older adults in Hong Kong.

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