scholarly journals Understanding the Complexity of Diabetes and Urinary Incontinence in Older Adults Receiving Home Care Services: Protocol for a Mixed Methods Study

2019 ◽  
Vol 18 ◽  
pp. 160940691985200 ◽  
Author(s):  
Melissa Northwood ◽  
Jenny Ploeg ◽  
Maureen Markle-Reid ◽  
Diana Sherifali
Keyword(s):  
Older Adults ◽  
Urinary Incontinence ◽  
Mixed Methods ◽  
Home Care ◽  
Mixed Methods Research ◽  
Home Care Services ◽  
Research Attention ◽  
Care Services ◽  
Care Assessment ◽  
Home Care Nurses

Urinary incontinence (UI) is a very prevalent problem for older adults with type 2 diabetes mellitus (T2DM) receiving home care services. However, the complexities of living with UI and T2DM and providing nursing care for older adults in the home care context have received very little research attention. This article describes a protocol for a convergent, mixed methods research design study to address this knowledge and practice gap. The objectives of the proposed study are to (a) determine the prevalence and correlates of UI in older adults living with T2DM receiving home care services, (b) explore the experiences of older adults living with T2DM and UI receiving home care services, (c) explore the experiences of home care nurses caring for this population, and (d) converge the multiple data sources to provide a deeper understanding of the problem and implications for provision of home care services to this population. The research methods are informed by a model of clinical complexity. The quantitative strand will involve descriptive and inferential analysis of standardized home care assessment data (interRAI) to determine the prevalence and correlates of UI in older adults with T2DM receiving home care services. Interpretive description methods will be used in the qualitative strand, and interviews will be conducted with older adults and home care nurses. The findings will be converged to inform a better understanding of the complexity of living with these chronic conditions for older adults receiving home care services and generate implications for complex intervention development. This protocol highlights methodological insights in utilizing mixed methods research to inform intervention design.

scholarly journals The Complexity of Living with Diabetes and Urinary Incontinence for Older Adults with Multiple Chronic Conditions Receiving Home Care Services: An Interpretive Description Study

2021 ◽  
Vol 8 ◽  
pp. 233339362199345
Author(s):  
Melissa Northwood ◽  
Jenny Ploeg ◽  
Maureen Markle-Reid ◽  
Diana Sherifali
Keyword(s):  
Older Adults ◽  
Urinary Incontinence ◽  
Home Care ◽  
Chronic Conditions ◽  
Self Care ◽  
Home Care Services ◽  
Experiential Knowledge ◽  
Multiple Chronic Conditions ◽  
Interpretive Description ◽  
Care Services

Over 40% of older adults with diabetes receiving home-care services experience urinary incontinence. However, experiential knowledge is lacking on how these older adults live with diabetes and incontinence. Interpretive description methodology was used to explore the experiences of 18 older adults with diabetes and urinary incontinence receiving home-care services in Ontario, Canada. Five themes emerged from the findings: (a) enduring urinary incontinence: “patch it in pads”; (b) struggling to manage diabetes, incontinence, and multiple chronic conditions: “a balancing act”; (c) covering the costs of care: “I can’t afford it”; (d) counting on a caregiver: “he does everything”; and (e) home-care services not meeting my needs: “it’s not individual.” These findings suggest that living with urinary incontinence and diabetes is a complex and challenging experience. This evidence could inform the provision of comprehensive home care to support self-care for this population.

scholarly journals Impact of the Outbreak of the COVID-19 Pandemic on Formal and Informal Care of Community-Dwelling Older Adults: Cross-National Clustering of Empirical Evidence from 23 Countries

2021 ◽  
Vol 13 (13) ◽  
pp. 7277
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Paolo Fabbietti ◽  
Giovanni Lamura
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Informal Care ◽  
Home Care Services ◽  
Community Dwelling ◽  
European Countries ◽  
Care Services ◽  
The Impact ◽  
Community Dwelling Older Adults ◽  
Informal Help

The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were reported. Seven clusters were identified, reflecting different combinations of changes in the formal/informal care provision. In most countries, informal care is more resilient than home care services that formal providers deliver. Since they are an essential source for sustainable care, their challenges related to care should be addressed. The impact of the pandemic does not follow the traditional characterization of welfare regimes. A clustering effort may yield more understanding of the priorities that future care policies should exhibit at the national level and may identify potential systems for policymakers to enhance sustainability of care for community-dwelling older adults.

scholarly journals Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services

2017 ◽  
Vol 15 (1) ◽  
pp. 20-26
Author(s):  
Guillermina R. Solis ◽  
Jane Dimmitt Champion
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Home Health Care ◽  
Fall Risk ◽  
Health Care Services ◽  
Home Care Services ◽  
Recurrence Risk ◽  
The United States ◽  
Care Services ◽  
Risk Of Fall

Introduction: Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person’s quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. Method: A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. Results: A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Conclusion: Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

scholarly journals Hospital to Home: Supporting the Transition From Hospital to Home for Older Adults

2021 ◽  
pp. 084456212110443
Author(s):  
Brittany Barber ◽  
Lori Weeks ◽  
Lexie Steeves-Dorey ◽  
Wendy McVeigh ◽  
Susan Stevens ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Family Caregivers ◽  
Older Adult ◽  
Long Term Care ◽  
Home Care Services ◽  
Term Care ◽  
Care Services ◽  
Hospital To Home

Background An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Older adults often lack adequate support to transition from hospital to home, without access to appropriate health services when they are needed in the community and resources to live safely at home. Purpose This study collaborated with an existing enhanced home care program called Home Again in Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods Using a case study design, this study examined in-depth experiences of multiple stakeholders, from December 2019 to February 2020, through analysis of nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results Findings indicate home care services for older adults are being sought too late, after hospital readmission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services led to barriers preventing family caregivers from continuing to care for older adults at home. Conclusions This study contributes knowledge about gaps within home care and transitional care services, highlighting the importance of investing in additional home care services for rehabilitation and prevention of rapidly deteriorating health.

Challenges associated with the recognition and treatment of depression in older recipients of home care services

2010 ◽  
Vol 22 (4) ◽  
pp. 514-522 ◽  
Author(s):  
Liat Ayalon ◽  
Daniela Fialová ◽  
Patricia A. Areán ◽  
Graziano Onder
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Home Environment ◽  
Home Care Services ◽  
Caregiver Distress ◽  
Care Services ◽  
Psychotherapeutic Interventions ◽  
Care Recipients ◽  
Treatment Of Depression ◽  
Older Recipients

ABSTRACTBackground: Home care for older adults is a common phenomenon worldwide because it allows older adults to remain in their home environment. Research has shown that depression is frequently found in older recipients of home care services. Nonetheless, it is often poorly recognized and treated. Untreated or poorly treated depression in older home care recipients has been associated with a variety of negative outcomes, including increased morbidity and mortality, greater likelihood of nursing home institutionalization and higher caregiver distress.Methods: The present review outlines some of the challenges associated with appropriate recognition and treatment of depression in older home care recipients.Results: Our review demonstrates that more aggressive management of depressive symptoms and the employment of an interdiciplinary team can result in beneficial outcomes.Conclusions: Further research is needed, especially in the area of psychotherapeutic interventions as these should be flexible enough to meet the unique and evolving needs of this frail population of older adults.

scholarly journals The Impact of Urinary Incontinence on Quality of Life in Those Receiving Home Care Services

2018 ◽  
Vol 31 (1) ◽  
pp. 30-34
Author(s):  
Mahcube Cubukcu
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Home Care ◽  
Chronic Diseases ◽  
Short Form ◽  
Home Care Services ◽  
Care Services ◽  
The Mean ◽  
The Impact

This study aims to evaluate the impact of urinary incontinence on the quality of life in those receiving home care services and the factors that influence this. This cross-descriptive study was performed in 180 patients who were served from Home Care Services between 01 and 28 February 2018. An International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) was implemented in person to those who gave their informed consent with orientation and cooperation. The mean age of a 180 patients was 74.40 ± 7.80 years (min = 18, max = 104), of which 55.2% were women. The mean ICIQ-SF score was found to be 12.42 ± 4.83 (min = 0, max = 21). The lowest points were given as responses to the question, “In your opinion, what amount of leakage do you experience?” The highest points, however, were given to the question of “How much does urinary leakage interfere with your everyday life?” It was seen that when quality of life is assessed with a visual analog scale within the ICIQ-SF, the quality of life for 66.6% of elderly individuals was affected moderately or significantly. The mean ICIQ-SF scores were higher in those with chronic diseases ( p < .005). Urinary Incontinence negatively affects quality of life to a moderate and significant degree in those receiving home care. The quality of life for those who have chronic diseases was worse. In this respect, there is a need to support patients in those receiving home care services.

scholarly journals Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Julien Dupraz ◽  
Yves Henchoz ◽  
Brigitte Santos-Eggimann
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Home Care Services ◽  
Community Dwelling ◽  
Care Utilization ◽  
Financial Situation ◽  
Care Services ◽  
Major Interest ◽  
Professional Home ◽  
Professional Home Care

Abstract Background Given the increasing importance of formal home care services in policies dedicated to elder care, there is major interest in studying individuals’ characteristics determining their utilization. The main objective of this research was to quantify, during a 6-year timeframe, home care use trajectories followed by community-dwelling participants in a cohort study of older adults. The secondary objective was to identify factors associated with home care utilization using Andersen’s Behavioural Model of Health Services Use. Methods We proceeded to an analysis of data prospectively collected in the setting of the Lc65+ population-based study conducted in Lausanne (Switzerland). Self-reported utilization of professional home care in 2012 and 2018 was used to define trajectories during this timeframe (i.e. non-users, new users, former users and continuing users). Bivariable analyses were performed to compare new users to non-users regarding the three dimensions of Andersen’s model (predisposing, enabling and need factors) measured at baseline. Then, binomial logistic regression was used in a series of two hierarchical models to adjust for need factors first, before adding predisposing and enabling factors in a second model. Results Of 2155 participants aged between 69 and 78 in 2012, 82.8% remained non-users in 2018, whereas 11.2% started to use professional home care. There were 3.3% of continuing users and 2.7% of former users. New users exhibited a higher burden of physical and psychological complaints, chronic health conditions and functional limitations at baseline. After adjusting for these need factors, odds of home care utilization were higher only in participants reporting a difficult financial situation (OR 1.65, 95% CI 1.12–2.45). Conclusions In the setting of a Swiss city, incident utilization of formal home care by older adults appeared to be largely determined by need factors. Modifiable factors like personal beliefs and knowledge about home care services did not play a role. After adjusting for need, odds of becoming home care user remained higher in participants reporting a difficult financial situation, suggesting such vulnerability does not hamper access to professional home care in this specific context.

scholarly journals Use of home care services in a cohort of older adults resident in Lazio region, Italy

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
F Gilardi ◽  
P Scarcella ◽  
P Pellegrini ◽  
F Lozzi ◽  
I D'Ascanio ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Home Care Services ◽  
Lazio Region ◽  
Care Services
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