Feasibility of home-based dietetic intervention to improve the nutritional status of older adults post-hospital discharge

Social distancing measures following the outbreak of COVID-19 have led to a rapid shift to virtual and telephone care. Social workers and mental health providers in VA home-based primary care (HBPC) teams face challenges providing psychosocial support to their homebound, medically complex, socially isolated patient population who are high risk for poor health outcomes related to COVID-19. We developed and disseminated an 8-week telephone or virtual group intervention for front-line HBPC social workers and mental health providers to use with socially isolated, medically complex older adults. The intervention draws on skills from evidence-based psychotherapies for older adults including Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, and Problem-Solving Therapy. The manual was disseminated to VA HBPC clinicians and geriatrics providers across the United States in March 2020 for expeditious implementation. Eighteen HBPC teams and three VA Primary Care teams reported immediate delivery of a local virtual or telephone group using the manual. In this paper we describe the manual’s development and clinical recommendations for its application across geriatric care settings. Future evaluation will identify ways to meet longer-term social isolation and evolving mental health needs for this patient population as the pandemic continues.

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Effectiveness of a Comprehensive Patient-centered Hospital Discharge Planning Intervention for Frail Older Adults

Case Medical Research ◽

10.31525/ct1-nct04154917 ◽

2019 ◽

Author(s):

Keyword(s):

Older Adults ◽

Hospital Discharge ◽

Discharge Planning ◽

Patient Centered ◽

Frail Older Adults ◽

Planning Intervention

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Older adults’ experiences and expectations after discharge from home-based occupational therapy

British Journal of Occupational Therapy ◽

10.1177/0308022618756217 ◽

2018 ◽

Vol 81 (8) ◽

pp. 450-459 ◽

Cited By ~ 1

Author(s):

Tove Lise Nielsen ◽

Merete Bjerrum ◽

Claus Vinther Nielsen ◽

Kirsten Schultz Petersen

Keyword(s):

Older Adults ◽

Occupational Therapy ◽

Home Based

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The Effect of Unsupervised Home-Based Exercise Training on Physical Functioning Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Biological Research For Nursing ◽

10.1177/1099800421989439 ◽

2021 ◽

pp. 109980042198943

Author(s):

Mahdi Mahjur ◽

Ali Asghar Norasteh

Keyword(s):

Older Adults ◽

Exercise Training ◽

Randomized Controlled Trials ◽

Physical Functioning ◽

Meta Analysis ◽

Upper Body ◽

Controlled Trials ◽

Randomized Controlled ◽

Home Based ◽

Body Strength

Background: Exercise training such as balance, aerobic, and resistance training is able to improve physical functioning of older adults. Delivering such exercise regimes at home without supervision may be useful for older adults because they do not have to leave their homes. Objective: This systematic review and meta-analysis of randomized controlled trials aimed to establish the effect of unsupervised home-based exercise training regimes on physical functioning (balance and muscle strength) in older adults. Data sources: PubMed, CINAHL, Medline, Google Scholar, and Scopus databases and reference lists of included investigations were searched. Study selection: Thirteen randomized controlled trials (RCTs) of exercise training impact on balance and upper body strength with concurrent control groups were included in the analysis. Results: Our analyses revealed that in older adults, unsupervised home-based various exercise training was effective in improving measures of proactive balance (mean difference (MD) = −1.37 s; 95% confidence interval (CI), −2.24, −0.51 s; p = 0.002) and balance test battery (MD: 1.80; 95% CI, 0.46, 3.14 s; p = 0.009). There were no significant differences between the experimental and control groups for upper body strength ( p > 0.05). Conclusion: Unsupervised home-based exercise training improves balance in older adults. Future investigations are needed to clarify the mechanisms underlying unsupervised home-based exercise training’s effect on this population’s physical functioning outcomes.

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Impact of Pain and Discomfort on the Lives of Cognitively Impaired Older Adults and Their Informal Caregivers

Innovation in Aging ◽

10.1093/geroni/igaa057.2848 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 786-787

Author(s):

Hyunjin Noh

Keyword(s):

Older Adults ◽

Cognitively Impaired ◽

Community Settings ◽

Adult Age ◽

Face To Face ◽

Disease Trajectory ◽

Care Recipients ◽

Home Based ◽

The Impact ◽

Future Program

Abstract This qualitative study explored the impact of pain and discomfort on the lives of cognitively impaired older adults and their caregivers from the caregiver perspective. Forty-three individuals of age 19+, who identified themselves as primary caregiver to a chronically or seriously ill older adult (age 50+) with cognitive impairment, such as Alzheimer’s Disease and Related Dementia, were recruited at various community settings. Individual, face-to-face interviews were conducted to ask participants how they thought their care-recipient’s pain and discomfort affected the care-recipient’s and the caregiver’s life respectively. Inductive, thematic analysis of interview transcripts revealed several key themes: compromised mobility, limited social interaction or activities, and depressive symptoms in both care-recipients and caregivers; aggravated cognitive decline in care-recipients; and poorer physical health in caregivers. Participants wanted more information on the disease trajectory and available services, particularly home-based therapies and social activities for care-recipients, which provides future program/practice implications.

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Self-reported morbidities, nutritional characteristics, and associated factors in institutionalized and non-institutionalized older adults

BMC Geriatrics ◽

10.1186/s12877-021-02067-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abdelhafid Benksim ◽

Rachid Ait Addi ◽

Elhassania Khalloufi ◽

Aziz Habibi ◽

Mohamed Cherkaoui

Keyword(s):

Older Adults ◽

Health Insurance ◽

Nutritional Status ◽

Statistical Significance ◽

Well Being ◽

Public Institution ◽

Subjective Well Being ◽

Number Of Children ◽

Significant Difference ◽

Nutritional Characteristics

Abstract Background As the world’s population ages and people live longer, it seems important to ensure that older people have a good quality of life and positive subjective well-being. The objective of this study is to determine socio-economic, health and nutritional characteristics of institutionalized and non-institutionalized elders in the province of Marrakech. Methods This study was conducted among 368 older adults in the province of Marrakech between March 2017 and June 2019. Of all participants, 180 older adults reside in a public institution and 188 of them live in their own homes. Data on health conditions, nutritional status, functional and socio-economic characteristics were collected. Data was analyzed using SPSS Statistics for Windows, Version 16.0. Statistical significance was set at p < 0.05. Results Institutionalized elders were illiterate (80.0%), had low incomes (95.5%), and unmarried (73.3%), they reported also no children (56.1%) and no health insurance (98.9%). Institutional residents suffered from malnutrition (22.2%), hearing impairments (35.6%) and severe edentulism (43.3%). There was no significant difference between both groups on daily activities and depression. A multivariate analysis identified a model with three significant variables associated with non-institutionalized elders: health insurance (P = 0.001; OR = 107.49), number of children (P = 0.001; OR = 1.74) and nutritional status (p = 0.001; OR = 3.853). Conclusions This study shows that the institutionalization of older adults is considerably induced by various factors such as nutritional problems, lack of health insurance and family structure. To mitigate the effects of this phenomenon, home care strategies and preventive actions should be implemented to delay the institutionalization of older adults and therefore keep them socially active in their own homes.

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Home-based exercise programmes improve physical fitness of healthy older adults: A PRISMA-compliant systematic review and meta-analysis with relevance for COVID-19

Ageing Research Reviews ◽

10.1016/j.arr.2021.101265 ◽

2021 ◽

Vol 67 ◽

pp. 101265 ◽

Cited By ~ 1

Author(s):

H. Chaabene ◽

O. Prieske ◽

M. Herz ◽

J. Moran ◽

J. Höhne ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Physical Fitness ◽

Meta Analysis ◽

Healthy Older Adults ◽

Home Based ◽

Exercise Programmes

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Supporting Older Adults and Caregivers Through Integrative Service Learning During COVID

Innovation in Aging ◽

10.1093/geroni/igaa057.3503 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 958-958

Author(s):

Keith Chan ◽

Sarah LaFave ◽

Maggie Ratnayake ◽

Christina Marsack-Topolewski ◽

Jillian Graves ◽

...

Keyword(s):

Older Adults ◽

Service Learning ◽

Community Resources ◽

Learning Models ◽

Process Data ◽

Community Based ◽

Age In Place ◽

Home Based ◽

Hands On ◽

Hands On Learning

Abstract There is a growing population of older adults who are living longer and acquiring chronic illness and disabilities, making it difficult for them to complete everyday activities and age in place. More than 2 million of these older adults are homebound and 5 million need help leaving their homes. They experience social isolation, food insecurity, and lack of connection to community resources which has intensified since the pandemic. Integrative service learning models can provide home-based support to older adults while offering valuable, hands-on learning experiences for students. This study examined findings for a community-based program which trained university students to provide practical home-based support for older adults and their caregivers. Data was collected for 109 older adults who were connected with student trainees. Students provided services with groceries, companionship, and help accessing needed services. Findings from t-test results using the UCLA Loneliness Scale indicated that older adults reported less loneliness after engagement with students (mean difference = 6.15, t = 3.14, df = 82, p < 0.01). Qualitative process data suggested that older adults benefited from services and a connection to their assigned students prior to and during the pandemic. Student trainees reported that the experience enriched their learning and reaffirmed their commitment to working with older adults. Community-based service learning can address home-based needs of older adults and their caregivers and enhance learning opportunities for students. Policies and practice can support a pipeline of geriatric health professionals through innovative service learning models to benefit older adults, caregivers and students.

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