The experience of older people of entering into the phase of asking for public home help - a qualitative study

Abstract Background Knowledge is scarce on how needs for home help and special housing evolve among older people who begin to receive support from municipal social care. The purpose of this study was to describe baseline distributions and transitions over time between levels of dependency among older persons after being granted social care in a Swedish municipality. Methods Based on a longitudinal cohort study in a Swedish municipality, data was collected retrospectively from municipal records. All persons 65 years or older who received their first decision on social care during 2010 (n = 415) were categorized as being in mild, moderate, severe, or total dependency, and were observed until the end of 2013. Baseline distributions and transitions over time were described descriptively and analysed with survival analysis, with the Kaplan-Meier estimator, over the entire follow-up period. To test potential differences in relation to gender, we used the Cox-Proportional hazards model. Results Baseline distributions between mild, moderate, severe, and total dependency were 53, 16, 24, and 7.7%. During the first year, between 40 and 63% remained at their initial level of dependency. Among those with mild and moderate levels of dependency at baseline, a large proportion declined towards increasing levels of dependency over time; around 40% had increased their dependency level 1 year from baseline and at the end of the follow-up, 75% had increased their dependency level or died. Conclusions Older people in Sweden being allocated home help are at high risk for decline towards higher levels of dependency, especially those at mild or moderate dependency levels at baseline. Taken together, it is important that municipalities make use of existing knowledge so that they implement cost-effective preventative interventions for older people at an early stage before a decline toward increasing levels of dependency.

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Skill mix change between general practitioners, nurse practitioners, physician assistants and nurses in primary healthcare for older people: a qualitative study

BMC Family Practice ◽

10.1186/s12875-018-0746-1 ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 8

Author(s):

Marleen H. Lovink ◽

Anneke J. A. H. van Vught ◽

Anke Persoon ◽

Lisette Schoonhoven ◽

Raymond T. C. M. Koopmans ◽

...

Keyword(s):

Qualitative Study ◽

Older People ◽

General Practitioners ◽

Nurse Practitioners ◽

Primary Healthcare ◽

Physician Assistants ◽

Skill Mix

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What is a key step in the falling process in older people? A qualitative study in an Iranian context

Educational Gerontology ◽

10.1080/03601277.2015.1089694 ◽

2015 ◽

Vol 42 (3) ◽

pp. 209-219 ◽

Cited By ~ 1

Author(s):

Shahrzad Habibi Ghahfarrokhi ◽

Hamid Reza Khankeh ◽

Ahmad Ali Akbari Kamrani ◽

Reza Fadayevatan

Keyword(s):

Qualitative Study ◽

Older People ◽

Iranian Context

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Community based service providers' perspectives on frequent and/or avoidable admission of older people with chronic disease in rural NSW: a qualitative study

BMC Health Services Research ◽

10.1186/1472-6963-11-265 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 15

Author(s):

Jo M Longman ◽

Judy B Singer ◽

Yu Gao ◽

Lesley M Barclay ◽

Megan E Passey ◽

...

Keyword(s):

Chronic Disease ◽

Qualitative Study ◽

Older People ◽

Service Providers ◽

Community Based

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Cardiovascular disease risk prediction in older people: a qualitative study

British Journal of General Practice ◽

10.3399/bjgp.2020.1038 ◽

2021 ◽

pp. BJGP.2020.1038

Author(s):

Denise Ann Taylor ◽

Katharine Wallis ◽

Sione Feki ◽

Sione Segili Moala ◽

Manusiu He-Naua Esther Latu ◽

...

Keyword(s):

Cardiovascular Disease ◽

Risk Assessment ◽

Qualitative Study ◽

Older People ◽

Focus Groups ◽

Risk Prediction ◽

Heart Attack ◽

Clinical Decision Making ◽

Community Dwelling ◽

Cvd Risk

Background: Despite cardiovascular disease (CVD) risk prediction equations becoming more widely available for people aged 75 years and over, views of older people on CVD risk assessment are unknown. Aim: To explore older people’s views on CVD risk prediction and its assessment. Design and Setting: Qualitative study of community dwelling older New Zealanders. Methods: We purposively recruited a diverse group of older people. Semi-structured interviews and focus groups were conducted, transcribed verbatim and thematically analysed. Results: Thirty-nine participants (mean age 74 years) of Māori, Pacific, South Asian and European ethnicities participated in one of 26 interviews or three focus groups. Three key themes emerged, (1) Poor knowledge and understanding of cardiovascular disease and its risk assessment, (2) Acceptability and perceived benefit of knowing and receiving advice on managing personal cardiovascular risk; and (3) Distinguishing between CVD outcomes; stroke and heart attack are not the same. Most participants did not understand CVD terms but were familiar with ‘heart attack,’ ‘stroke’ and understood lifestyle risk factors for these events. Participants valued CVD outcomes differently, fearing stroke and disability which might adversely affect independence and quality of life, but being less concerned about a heart attack, perceived as causing less disability and swifter death. These findings and preferences were similar across ethnic groups. Conclusion: Older people want to know their CVD risk and how to manage it, but distinguish between CVD outcomes. To inform clinical decision making for older people, risk prediction tools should provide separate event types rather than just composite outcomes.

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