Causes of changes in basic activities of daily living in older adults with long‐term care needs

Author(s):  
Akira Sagari ◽  
Takayuki Tabira ◽  
Michio Maruta ◽  
Hironori Miyata ◽  
Gwanghee Han ◽  
...  
Author(s):  
Mauricio Matus-Lopez ◽  
Alexander Chaverri-Carvajal

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.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S244-S244
Author(s):  
Juan Juan Sun ◽  
Haichao Wu

Abstract With the life expectancy in China continuing to increase, age-dependent chronic diseases are also likely to increase, as is the number of people with long-term care needs. This study evaluated the Long Term Care (LTC) needs of the Chinese older population and introduced related policy priorities. Using the 2014 and 2016 “China Longitudinal Aging Social Survey”, this study assessed the physical functions of older adults by measuring their ability to perform Activities of Daily Living independently, compared changes within the two years, and explored other related indicators including, Instrumental Activities of Daily Living, major chronic disease, and mental health conditions. The study also discussed the development of long-term care policies in China and highlighted the priorities of these policies.


Author(s):  
Harriet L. Komisar ◽  
Judith Feder ◽  
Judith D. Kasper

People who are dually eligible for Medicare and Medicaid are the focus of fiscal struggles between federal and state governments. Drawing on a survey of community-based elderly “dual eligibles,” this paper examines how well their medical and long-term care needs are being met under the current combination of Medicare and Medicaid policies. While few people report difficulty getting medical care, 58% of people needing long-term care (help with activities of daily living) report unmet needs. As a result, many experience serious consequences, such as falls. Although unmet needs are substantial in all six states surveyed, we find the greater the use of paid home care in a state, the lower the likelihood of unmet needs, suggesting states' policies can make a difference.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 90-90
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie Robert

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.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S718-S719
Author(s):  
Edgar R Vieira ◽  
Diego Tavares ◽  
Particia Nobrega ◽  
Alvaro Maciel

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.


Author(s):  
Muhammad Syakir Asrulsani ◽  
Mazlynda Md Yusuf

Funding for long-term care costs among elderly people is a critical matter, especially due to high costs and an unexpected length of time. Placement for long-term care that is funded under Jabatan Kebajikan Masyarakat (JKM) is very limited, hence, the next option is through private nursing homes. However, the cost could be up to RM 2,000 a month for each person. Therefore, Long- Term Care Insurance is an alternative to fund for Long-Term Care costs as it is expected to reduce financial burden during old age. It is a risk protection mechanism for an insured that needs health and financial protection when an individual is unable to do activities of daily living (ADL) or supports in instrumental activities of daily living (IADL). This paper reviews three models that have been used in pricing long-term care insurance. All three models use the equivalent principle of premium to price the insurance policy. However, the probability and assumptions used for each model differ, depending on the insured's needs and profile.


Author(s):  
Sunhee Park ◽  
Heejung Kim ◽  
Chang Gi Park

Abstract Background South Korea established universal long-term care insurance (LTCI) in 2008. However, actual requests for LTCI remain lower than government estimates because some eligible candidates never apply despite their strong care needs. This study aimed to examine factors affecting LTCI applications for older, community-dwelling Koreans. Methods Both individual- and community-level data were obtained from a national dataset from the Korea Health Panel Survey and the Korea National Statistical Office (N = 523). Data were analyzed using multilevel modeling. Results Only 16.4% of older adults in need of care applied for LTCI. Those who applied were more likely to be older, report poor self-rated health, receive care from non-family caregivers, and have caregivers experiencing high levels of caregiving burden. Regional differences in LTCI applications existed concerning the financial condition of one’s community. Conclusions Our study findings emphasize that Korean LTCI should implement both individual and community strategies to better assist older adults in properly acquiring LTCI. The government should make comprehensive efforts to increase access to LTCI in terms of availability, quality, cost, and information by collaborating with local centers.


2016 ◽  
Vol 31 (2) ◽  
pp. 325-328
Author(s):  
Tomohiko KAMO ◽  
Katsuhiko EGUCHI ◽  
Hideaki ISHII ◽  
Yusuke NISHIDA

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