Assessment without action; a randomised evaluation of theinterRAI home care compared to a national assessment tool on identification of needs and service provision for older people in New Zealand

2013 ◽  
Vol 21 (5) ◽  
pp. 536-544 ◽  
Author(s):  
Matthew Parsons ◽  
Hugh Senior ◽  
Xenia Mei-Hu Chen ◽  
Stephen Jacobs ◽  
John Parsons ◽  
...  
Keyword(s):  
New Zealand ◽  
Home Care ◽  
Older People ◽  
Service Provision ◽  
Assessment Tool ◽  
National Assessment

scholarly journals Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study

2020 ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Assessment Tool ◽  
Glucose Monitoring ◽  
Cognitive Status ◽  
Ease Of Use ◽  
Quality Of Data ◽  
Care Services

Abstract BackgroundHypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care.MethodsCGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home.ResultsThe practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted.ConclusionThe feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

scholarly journals Frailty of Māori, Pasifika, and Non-Māori/Non-Pasifika Older People in New Zealand: A National Population Study of Older People Referred for Home Care Services

2020 ◽  
Author(s):  
Rebecca Abey-Nesbit ◽  
Nancye M Peel ◽  
Hector Matthews ◽  
Ruth E Hubbard ◽  
Prasad S Nishtala ◽  
...  
Keyword(s):  
New Zealand ◽  
Home Care ◽  
Older People ◽  
Frailty Index ◽  
Indigenous Populations ◽  
Potential Range ◽  
Linear Regression Models ◽  
Care Assessment ◽  
The Mean ◽  
Age And Sex

Abstract Background Little is known about the prevalence of frailty in indigenous populations. We developed a frailty index (FI) for older New Zealand Māori and Pasifika who require publicly funded support services. Methods An FI was developed for New Zealand adults aged 65 and older who had an interRAI Home Care assessment between June 1, 2012 and October 30, 2015. A frailty score for each participant was calculated by summing the number of deficits recorded and dividing by the total number of possible deficits. This created a FI with a potential range from 0 to 1. Linear regression models for FIs with ethnicity were adjusted for age and sex. Cox proportional hazards models were used to assess the association between the FI and mortality for Māori, Pasifika, and non-Māori/non-Pasifika. Results Of 54 345 participants, 3096 (5.7%) identified as Māori, 1846 (3.4%) were Pasifika, and 49 415 (86.7%) identified as neither Māori nor Pasifika. New Zealand Europeans (48 178, 97.5%) constituted most of the latter group. Within each sex, the mean FIs for Māori and Pasifika were greater than the mean FIs for non-Māori and non-Pasifika, with the difference being more pronounced in women. The FI was associated with mortality (Māori subhazard ratio [SHR] 2.53, 95% CI 1.63–3.95; Pasifika SHR 6.03, 95% CI 3.06–11.90; non-Māori and non-Pasifika SHR 2.86, 95% CI 2.53–3.25). Conclusions This study demonstrated differences in FI between the ethnicities in this select cohort. After adjustment for age and sex, increases in FI were associated with increased mortality. This suggests that FI is predictive of poor outcomes in these ethnic groups.

scholarly journals Choice, needs or equality? Discursive struggles about defining home care for older people in Sweden

2021 ◽  
pp. 1-21
Author(s):  
Elin Peterson ◽  
Helene Brodin
Keyword(s):  
Home Care ◽  
Older People ◽  
Service Provision ◽  
Social Care ◽  
Local Authority ◽  
Universal Service ◽  
Structured Interviews ◽  
Care Policy ◽  
Starting Point ◽  
Care For Older People

Abstract Focusing on Swedish home care for older people, this article explores the discursive (re)production of home care as an institution. Equality and universal service provision have been described as defining features of the Nordic care regime. At the same time, Nordic research has highlighted a shift in social care policy, from a focus on universalism and egalitarian ideals towards a focus on freedom of choice, diversity and individualised services. This article takes as a starting point that home care for older people is formed by different and potentially conflicting ideas. We understand home care as a contested formation and define institutional change in terms of ongoing discursive struggles. The analysis draws on qualitative semi-structured interviews with key informants, including politicians, local authority officials and representatives of interest organisations. Informants were engaged in policy making, implementation or advocacy related to care for older people. We examine the meanings attached to home care for older people and the analysis reveals three different discourses – on choice, needs and equality. By comparing and contrasting discourses, we reveal silences, conflicts and tensions, and highlight the politics involved in (re)creating home care as an institution.

scholarly journals In-home care and ‘supported independence’ for the frail elderly: A social work perspective

2016 ◽  
Vol 24 (1) ◽  
pp. 3-13
Author(s):  
Doug Matthews
Keyword(s):  
New Zealand ◽  
Home Care ◽  
Older People ◽  
Medical Care ◽  
Daily Living ◽  
Positive Aging ◽  
Home Based ◽  
Care For Older People

The article focuses on role of social workers in providing in-home care and assistance with the activities of daily living (ADL) for older people in New Zealand. From the physician- and hospital-based medical care for older people, a shift back to home-based medical care was emphasized by the Ministry of Social Development in April 2001. The New Zealand Health of Older People Strategy was implemented with the aim of achieving positive aging, quality of life and independence.

scholarly journals Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study. 

2020 ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Feasibility Study ◽  
Assessment Tool ◽  
Glucose Monitoring ◽  
Ease Of Use ◽  
Quality Of Data ◽  
Care Services

Abstract Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care. MethodsCGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home. Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted. ConclusionThe feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals, where we will reconsider the use of the MMSE questionnaire. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

scholarly journals Continuous glucose monitoring in older people with diabetes receiving home care—a feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Assessment Tool ◽  
Glucose Monitoring ◽  
Cognitive Status ◽  
Ease Of Use ◽  
Quality Of Data ◽  
Care Services

Abstract Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities, and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home-dwelling individuals with diabetes type 2 receiving home care. Methods CGM with the Ipro2-blinded monitoring system were performed for 5 days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c)) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)), and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home. Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent, and ease of use. The MMSE survey required extensive training of personnel to be conducted. Conclusion The feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home-dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used “as is” for future studies.

scholarly journals Changes in home care clients’ characteristics and home care in five European countries from 2001 to 2014: comparison based on InterRAI - Home Care data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
I. V. Kristinsdottir ◽  
P. V. Jonsson ◽  
I. Hjaltadottir ◽  
K. Bjornsdottir
Keyword(s):  
Home Care ◽  
Older People ◽  
Community Care ◽  
Assessment Tool ◽  
European Countries ◽  
Cognitive Performance Scale ◽  
Term Care ◽  
Care Assessment ◽  
The Government

Abstract Background Policymakers advocate extended residence in private homes as people age, rather than relocation to long-term care facilities. Consequently, it is expected that older people living in their own homes will be frailer and have more complex health problems over time. Therefore, community care for aging people is becoming increasingly important to facilitate prevention of decline in physical and cognitive abilities and unnecessary hospital admission and transfer to a nursing home. The aim of this study was to examine changes in the characteristic of home care clients and home care provided in five European countries between 2001 and 2014 and to explore whether home care clients who are most in need of care receive the care required. Methods This descriptive study used data from two European research projects, Aged in Home Care (AdHOC; 2001–2002) and Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care (IBenC; 2014–2016). In both projects, the InterRAI-Home Care assessment tool was used to assess a random sample of home care clients 65 years and older in five European countries. These data facilitate a comparison of physical and cognitive health and the provided home care between countries and study periods. Results In most participating countries, both cognitive (measured on the Cognitive Performance Scale) and functional ability (measured on the Activities of Daily Living Hierarchy scale) of home care clients deteriorated over a 10-year period. Home care provided increased between the studies. Home care clients who scored high on the physical and cognitive scales also received home care for a significantly higher duration than those who scored low. Conclusion Older people in several European countries remain living in their own homes despite deteriorating physical and cognitive skills. Home care services to this group have increased. This indicates that the government policy of long-term residence at own home among older people, even in increased frailty, has been realised.

scholarly journals Hypoglycemia in older people with diabetes receiving home care: A feasibility-study

2020 ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Feasibility Study ◽  
Assessment Tool ◽  
Ease Of Use ◽  
Risk Assessment Tool ◽  
Quality Of Data ◽  
Care Services

Abstract Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidence of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to investigate the feasibility of using continuous glucose monitoring (CGM) and standardized questionnaires on issues associated with increased risk of hypoglycemia among older home dwelling individuals with diabetes type 2 receiving home care. Methods CGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data were collected by a study nurse in the individuals’ home.Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted. Conclusion The feasibility study inform an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals, were we will reconsider the use of the MMSE questionnaire. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

Randomised trial of restorative home care for frail older people in New Zealand

2017 ◽  
Vol 29 (7) ◽  
pp. 27-33 ◽  
Author(s):  
Matthew Parsons ◽  
Hugh Senior ◽  
Ngaire Kerse ◽  
Mei-hua Chen ◽  
Stephen Jacobs ◽  
...  
Keyword(s):  
New Zealand ◽  
Home Care ◽  
Older People ◽  
Randomised Trial ◽  
Frail Older People

scholarly journals Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study

2020 ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Assessment Tool ◽  
Glucose Monitoring ◽  
Cognitive Status ◽  
Ease Of Use ◽  
Quality Of Data ◽  
Care Services

Abstract Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care. Methods CGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home. Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted. Conclusion The feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

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