scholarly journals Social factors influencing utilization of home care in community-dwelling older adults: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jasmine C. Mah ◽  
Susan J. Stevens ◽  
Janice M. Keefe ◽  
Kenneth Rockwood ◽  
Melissa K. Andrew
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Scoping Review ◽  
Social Factors ◽  
Community Dwelling ◽  
Policy Implications ◽  
Care Utilization ◽  
Factors Influencing ◽  
Wide Range ◽  
Community Dwelling Older Adults

Abstract Background Older adults want to live at home as long as possible, even in the face of circumstances that limit their autonomy. Home care services reflect this emergent preference, allowing older adults to ‘age in place’ in familiar settings rather than receiving care for chronic health conditions or ageing needs in an institutionalized setting. Numerous social factors, generally studied in isolation, have been associated with home care utilization. Even so, social circumstances are complex and how these factors collectively influence home care use patterns remains unclear. Objectives To provide a broad and comprehensive overview of the social factors influencing home care utilization; and to evaluate the influence of discrete social factors on patterns of home care utilization in community-dwelling older adults in high-income countries. Methods A scoping review was conducted of six electronic databases for records published between 2010 and 2020; additional records were obtained from hand searching review articles, reference lists of included studies and documents from international organisations. A narrative synthesis was presented, complemented by vote counting per social factor, harvest plots and an evaluation of aggregated findings to determine consistency across studies. Results A total of 2,365 records were identified, of which 66 met inclusion criteria. There were 35 discrete social factors grouped into four levels of influence using a socio-ecological model (individual, relationship, community and societal levels) and grouped according to outcome of interest (home care propensity and intensity). Across all studies, social factors consistently showing any association (positive, negative, or equivocal in pattern) with home care propensity were: age, ethnicity/race, self-assessed health, insurance, housing ownership, housing problems, marital status, household income, children, informal caregiving, social networks and urban/rural area. Age, education, personal finances, living arrangements and housing ownership were associated with home care intensity, also with variable patterns in utilization. Additional community and societal level factors were identified as relevant but lacking consistency across the literature; these included rurality, availability of community services, methods of financing home care systems, and cultural determinants. Conclusion This is the first literature review bringing together a wide range of reported social factors that influence home care utilization. It confirms social factors do influence home care utilization in complex interactions, distinguishes level of influences at which these factors affect patterns of use and discusses policy implications for home care reform.

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.

Swallowing disorders and 1-year functional decline in community-dwelling older adults receiving home care

2017 ◽  
Vol 44 (12) ◽  
pp. 982-987 ◽  
Author(s):  
K. Takeuchi ◽  
M. Furuta ◽  
Y. Okabe ◽  
S. Suma ◽  
T. Takeshita ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Functional Decline ◽  
Swallowing Disorders ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Physical Activity Level Following Resistance Training in Community-Dwelling Older Adults Receiving Home Care: Results from a Cluster-Randomized Controlled Trial

2021 ◽  
Vol 18 (13) ◽  
pp. 6682
Author(s):  
Hilde Bremseth Bårdstu ◽  
Vidar Andersen ◽  
Marius Steiro Fimland ◽  
Lene Aasdahl ◽  
Hilde Lohne-Seiler ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Resistance Training ◽  
Home Care ◽  
Community Dwelling ◽  
Activity Level ◽  
Group Differences ◽  
Control Group ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults

Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.

scholarly journals Leisure Activity Variety and Brain Volume Among Community-Dwelling Older Adults: Analysis of the Neuron to Environmental Impact Across Generations Study Data

2021 ◽  
Vol 13 ◽  
Author(s):  
Ai Iizuka ◽  
Hiroshi Murayama ◽  
Masaki Machida ◽  
Shiho Amagasa ◽  
Shigeru Inoue ◽  
...  
Keyword(s):  
Older Adults ◽  
Environmental Impact ◽  
Gray Matter ◽  
Brain Volume ◽  
Linear Regression Analysis ◽  
Leisure Activity ◽  
Community Dwelling ◽  
Wide Range ◽  
Gray Matter Volumes ◽  
Community Dwelling Older Adults

Background: Recent findings indicate that leisure activity (LA) delays cognitive decline and reduces the risk of dementia. However, the association between LA and brain volume remains unclear. This study aimed to examine the association between LA variety and brain volume with a focus on the hippocampus and gray matter.Methods: Data were obtained from the baseline survey of the Neuron to Environmental Impact across Generations study, which had targeted community-dwelling older adults living in Niigata, Japan. We divided LAs into 10 categories, and counted the number of categories of activities in which the participants engaged. We classified them as follows: 0 (i.e., no activity), 1, 2, or ≥ 3 types. Brain volume was assessed through magnetic resonance imaging, and hippocampal and gray matter volumes were ascertained.Results: The sample size was 482. Multiple linear regression analysis showed that hippocampal and gray matter volumes were significantly greater among participants with ≥ 3 types of LAs than among their no-activity counterparts. Hippocampal volume was significantly greater among those who engaged in one type of LA than among those who engaged in no such activity. Sex-stratified analysis revealed that hippocampal volumes were significantly greater among males who engaged in ≥ 3 types of LAs and one type of LA. However, no such association was found among females.Conclusion: The present findings suggest that engaging in a wide range of LAs is related to hippocampal and gray matter volumes. Furthermore, there was a sex difference in the association between LA variety and brain volume.

scholarly journals LO13: Characteristics of emergency department visits by community-dwelling older adults who screened positive for elder abuse during home care assessments

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S11 ◽  
Author(s):  
E. Mercier ◽  
A. Jones ◽  
A. Brousseau ◽  
J. Hirdes ◽  
F. Mowbray ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Reporting System ◽  
Elder Abuse ◽  
Frailty Index ◽  
Population Based ◽  
Community Dwelling ◽  
Care Assessment ◽  
Ed Visits ◽  
Community Dwelling Older Adults

Introduction: Elder abuse is infrequently detected in the emergency department (ED) and less than 2% are reported to proper law authorities by ED physicians. This study aims to examine the characteristics of community-dwelling older adults who screened positive for elder abuse during home care assessments and the epidemiology of ED visits by these patients relative to other home care patients. Methods: This study utilized a population-based retrospective cohort study of home care patients in Canada between April 1, 2007 and March 31, 2015. Standardized, comprehensive home care assessments were extracted from the Home Care Reporting System. A positive screen for elder abuse was defined as at least one these criteria: fearful of a caregiver; unusually poor hygiene; unexplained injuries; or neglected, abused, or mistreated. Home care assessments were linked to the National Ambulatory Care Reporting System in the regions and time periods in which population-based estimates could be obtained to identify all ED visits within 6 months of the home care assessment. Results: A total of 30,413 from the 2,401,492 patients (1.3%) screened positive for elder abuse during a home care assessment. They were more likely to be male (40.5% versus 35.3%, p < 0.001), to have a cognitive impairment (82.9% versus 65.3%, p < 0.001), a higher frailty index (0.27 versus 0.22, p < 0.001) and to exhibit more depressive symptoms (depression rating scale 1 or more: 68.7% versus 42.7%, p < 0.001). Patient who screened positive for elder abuse were less likely to be independent in activities of daily living (41.9% versus 52.7%, p < 0.001) and reported having fallen more frequently (44.2% versus 35.5%, p < 0.001). Caregiver expressing distress was associated with elder abuse (35.3% versus 18.3%, p < 0.001) but not a higher number of hours caring for the patient. Victims of elder abuse were more likely to attend the ED for low acuity conditions (Canadian triage and acuity scale (CTAS) 4 or 5). Diagnosis at discharge from ED were similar with the exception of acute intoxication that was more frequent in patients who are victims of abuse. Conclusion: Elder abuse is infrequently detected during home care assessments in community-dwelling older adults. Higher frailty index, cognitive impairment, depressive symptoms were associated with elder abuse during homecare assessments. Patients who are victims of elder abuse are attending EDs more frequently for low acuity conditions but ED diagnosis at discharge, except for acute intoxication, are similar.

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.

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