Utilization of care services among the oldest old

2010 ◽  
Author(s):  
Laura Catherine Temple Scheetz
Keyword(s):  
Oldest Old ◽  
Care Services

scholarly journals The demand for elderly care services and anticipated living arrangements among the oldest-old in China based on the Andersen model

2020 ◽  
Author(s):  
Yanbing Zeng ◽  
Shuang Que ◽  
Chenxi Lin ◽  
Ya Fang
Keyword(s):  
Health Education ◽  
Influencing Factors ◽  
Living Arrangements ◽  
Elderly Care ◽  
Oldest Old ◽  
Supply And Demand ◽  
Home Visits ◽  
Care Services ◽  
Andersen Model ◽  
The Relationship

Abstract Background: In China, the issues arising from an aging population are becoming increasingly serious, so research on elderly health has become a topic of discussion. However, few studies have focused on the oldest-old with regards to their existing demand for elderly care services and anticipated living arrangements. Methods: The data of 4738 participants aged ≥80 years were extracted from the Chinese Longitudinal Health Longevity Survey (CLHLS) carried out in 2014. Using the Andersen model as the analysis framework, a multiple logistic regression was used to analyze the relationship between anticipated use of social services and intended residence and influencing factors. Odds ratios (ORs) were calculated to indicate the relationship between the influencing factors and the dependent variables.Results: From the descriptive analysis results, it is found that oldest-old showed high anticipated needs for care services, such as home visits (83.5%), health education (76.4%). And there exists a huge imbalance between supply and demand for aged care services. Moreover, living with children is still the most important way of providing for the oldest-old (44.4% in urban, 55.6% in rural). The multivariate regression results showed that the demand for elderly care services and anticipated living arrangements among the oldest-old in China are influenced by predisposing factors, enabling factors, and need factors (P<0.05). The oldest-old who are older, without housing property rights, childless, and ADL-restricted are more tend to live in long-term care institutions (ORs>1, P<0.05). Conclusions: The most vital needs of the oldest-old are home visits, health education, and spiritual comfort. There is a huge imbalance between supply and demand. Moreover, living with children is still the most important way of providing for the oldest-old. Demand for elderly care services and anticipated living arrangements are influenced by predisposing, enabling and need factors. Although the family plays an essential role in the healthcare of the oldest-old, the traditional pension model no longer meets the multi-level and diversified healthcare service needs of the oldest-old due to the rapidly aging Chinese population, which requires countermeasures from policy makers.

scholarly journals Use of Video-Enabled Tablet for Virtual Care Among Older Veterans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 197-197
Author(s):  
Maria Yefimova ◽  
Jiaqi Hu ◽  
Cindie Slightam ◽  
Liberty Greene ◽  
Camila Chaudhary ◽  
...  
Keyword(s):  
Primary Care ◽  
Older Patients ◽  
Oldest Old ◽  
Age Groups ◽  
Old Patients ◽  
Younger Patients ◽  
Care Services ◽  
Virtual Care ◽  
Primary Care Services ◽  
Home Based

Abstract With the proliferation of virtual care, healthcare systems are exploring ways to bridge the digital divide among vulnerable patients. Department of Veterans Affairs (VA) is distributing devices for qualifying Veterans to enable video visits with medical providers at home, yet their use among older patients is unknown. This retrospective cohort study used administrative data to characterize the use of VA-loaned iPads among older Veterans compared to younger Veterans and identify demographic predictors of utilization. Among 16,385 patients who were shipped a VA-loaned iPad in 2014-2019, 33.66% (n=5,516) were over 65 years old, and 3.1% (n=503) were over the age of 85. Two thirds (n=6799) of younger patients had a video visit (mean=3 visits) with provider using iPad in the 6 months since shipment, compared to 50% (n=253) of 85+ year-olds (mean=1.8 visits). Most common types of virtual visits for the oldest old patients were for geriatrics or home-based primary care, compared to mental health visits among younger patients. Logistic regression identified characteristics of older patients who were more likely to use iPads, such a marital status, urban location, and lower disease burden, which is similar to their younger counterparts. While older age groups used VA-loaned tablets less frequently, those who engaged with the devices were similar in demographics as their younger counterparts. Older patients used iPads differently, with higher engagement in geriatric and primary care services. Providing devices for virtual care may allow health systems to more easily reach older patients in the comfort of their home.

scholarly journals The Expected Demand for Elderly Care Services and Anticipated Living Arrangements Among the Oldest Old in China Based on the Andersen Model

2021 ◽  
Vol 9 ◽  
Author(s):  
Yanbing Zeng ◽  
Shuang Que ◽  
Chenxi Lin ◽  
Ya Fang
Keyword(s):  
Property Rights ◽  
Influencing Factors ◽  
Living Arrangements ◽  
Elderly Care ◽  
Oldest Old ◽  
Multiple Logistic Regression Analysis ◽  
Term Care ◽  
Care Services ◽  
Andersen Model ◽  
The Relationship

Objective: The first aim of this study was to explore expected demands of the oldest old and their determinants for different types of elderly care services. The second aim was to investigate preferred choices of living arrangements among the oldest old and the influencing factors.Methods: Data of 4,738 participants aged ≥80 years were extracted from the Chinese Longitudinal Health Longevity Survey carried out in 2014. Using the Andersen model as the analysis framework, a multiple logistic regression analysis was performed to analyze the relationship between the expected elderly care services and living arrangements and other influencing factors. The odds ratios were calculated to indicate the relationship between the influencing factors and the dependent variables.Results: From the descriptive analysis results, we found that the oldest old showed high anticipated needs for home visits (83.5%) and health education (76.4%). Further, there existed a huge imbalance between the supply and demand of care services for the aged. Living with children is still the most important way of providing for the oldest old. The regression results showed that the expected demands for elderly care services and anticipated living arrangements among the oldest old in China are influenced by age, residence, housing property rights, economic status, loneliness, and activities of daily living (ADLs). The oldest old who are older without housing property rights, childless, and have restricted ADLs were more frequently observed to live in long-term care institutions.Conclusions: There is an inequality of the supply and expected demand for elderly care services, and living with children is still a preferred choice of the Chinese oldest old. Our findings indicate that when planning how to promote elderly care services among the oldest old, it is important to consider their expectations, especially for the subgroup that is relatively disadvantaged. Related policies should be developed to offer incentives to family caregivers when they live with the oldest old.

scholarly journals Changes in older people’s care profiles during the last 2 years of life, 1996–1998 and 2011–2013: a retrospective nationwide study in Finland

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e015130 ◽  
Author(s):  
Mari Aaltonen ◽  
Leena Forma ◽  
Jutta Pulkki ◽  
Jani Raitanen ◽  
Pekka Rissanen ◽  
...  
Keyword(s):  
Older People ◽  
End Of Life ◽  
Long Term Care ◽  
Oldest Old ◽  
Care Transitions ◽  
Life Care ◽  
Term Care ◽  
Care Services ◽  
At Home

ObjectivesThe time of death is increasingly postponed to a very high age. How this change affects the use of care services at the population level is unknown. This study analyses the care profiles of older people during their last 2 years of life, and investigates how these profiles differ for the study years 1996–1998 and 2011–2013.DesignRetrospective cross-sectional nationwide data drawn from the Care Register for Health Care, the Care Register for Social Care and the Causes of Death Register. The data included the use of hospital and long-term care services during the last 2 years of life for all those who died in 1998 and in 2013 at the age of ≥70 years in Finland.MethodsWe constructed four care profiles using two criteria: (1) number of days in round-the-clock care (vs at home) in the last 2 years of life and (2) care transitions during the last 6 months of life (ie, end-of-life care transitions).ResultsBetween the study periods, the average age at death and the number of diagnoses increased. Most older people (1998: 64.3%, 2013: 59.3%) lived at home until their last months of life (profile 2) after which they moved into hospital or long-term care facilities. This profile became less common and the profiles with a high use of care services became more common (profiles 3 and 4 together in 1998: 25.0%, in 2013: 30.9%). People with dementia, women and the oldest old were over-represented in the latter profiles. In both study periods, fewer than one in ten stayed at home for the whole last 6 months (profile 1).ConclusionsPostponement of death to a very old age may translate into more severe disability in the last months or years of life. Care systems must be prepared for longer periods of long-term care services needed at the end of life.

scholarly journals A comparative study of healthcare and placement needs among older forensic patients in a high secure versus medium/low secure hospital setting

2010 ◽  
Vol 23 (5) ◽  
pp. 847-848 ◽  
Author(s):  
Kavita Das ◽  
Kevin Murray ◽  
Rick Driscoll ◽  
S Rao Nimmagadda
Keyword(s):  
Health Care ◽  
Growth Rate ◽  
United Nations ◽  
Older People ◽  
Health Care Services ◽  
Oldest Old ◽  
Hospital Setting ◽  
Forensic Patients ◽  
Care Services ◽  
Psychiatric Conditions

It is predicted that there will be a significant growth in the population aged over 65 years in the U.K., from 15.9% in 2000 to 23.3% in 2050, with the fastest growth rate being among the oldest old (United Nations, 2005). In line with such growth, there will be a commensurate increase in the population of older people suffering from psychiatric conditions. This will lead to a demand for increased health care services and the need for reorganization and prioritization of resources channeled into health care for this group.

Attitudes Towards Changing Care Needs and Experiences of Social Care for People Aged 95 years and Older Living At Home: A Population-Based Study

2020 ◽  
Author(s):  
Jackie Buck ◽  
Rehana Di Rico ◽  
Fiona Scheibl ◽  
Stephen Barclay ◽  
Morag Farquhar ◽  
...  
Keyword(s):  
Informal Care ◽  
Social Care ◽  
Oldest Old ◽  
Unmet Need ◽  
Population Based ◽  
Community Dwelling ◽  
Formal Care ◽  
Old People ◽  
Care Needs ◽  
Care Services

Abstract Background: The ‘oldest old’ are amongst the largest recipients of social care services and informal care, yet they are under-represented in research and service-user experience surveys. The aim of this study was to understand experiences of receiving social care from formal services and informal carers amongst very old people living in the community. Method: Framework analysis of qualitative data from 36 interviews with community-dwelling people aged 95-101 (n=24) and/or their relatives/carers participating in the UK population-based Cambridge City over-75s Cohort (CC75C) study.Results: Fifty-eight percent lived alone, 75% were disabled, and 42% moderately or severely cognitively impaired. Sixty-seven percent had contact with formal care services and 85% with relatives at least weekly. Informal care mainly supported instrumental activities of daily living, though substituted for, and complemented, formal care at low and higher disability levels respectively. Impractical service delivery and lack of awareness of social care processes and entitlements caused unnecessary distress. Lack of meaningful social interaction, difficulties with bathing and management of continence were key areas of unmet need. Poor continuity of service and frequent changes of formal carers posed a threat to older people’s autonomy, dignity and safety.Conclusions: This study revealed a rich complexity of older old care recipients’ responses and attitudes not adequately captured in national surveys. As the urgent need to review social care provision receives more attention, there are valuable opportunities to incorporate the views of older old people into service design and delivery, honouring policy directives for person-centred care and improved quality of life.

scholarly journals Inter-Individual and Intra-Individual Relationships Between Neuroticism and Cognition: A Coordinated Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 387-388
Author(s):  
Tomiko Yoneda ◽  
Jonathan Rush ◽  
Graciela Muniz Terrera ◽  
Almar Kok ◽  
Boo Johansson ◽  
...  
Keyword(s):  
Sex Education ◽  
Cognitive Aging ◽  
Growth Parameters ◽  
Growth Models ◽  
Meta Analysis ◽  
Oldest Old ◽  
Treatment Strategies ◽  
Care Services ◽  
Longitudinal Aging Study Amsterdam ◽  
Aging Study

Abstract Existing literature indicates a relatively consistent relationship between neuroticism and cognitive functioning (CF). Interindividually, high levels of neuroticism may predispose individuals to cognitive aging and dementia-related neuropathology. Intraindividually, increases in neuroticism may be intrinsic to the aging process or to dementia pathology. These hypotheses are not mutually exclusive, though the relationships are rarely examined using the same individuals, which may contribute to publication bias and confusion regarding the hypotheses as mutually exclusive. Data were drawn from the Origins of Variance in the Oldest-Old (Sweden, Mage=83.6, 67% female), Swedish Adoption/Twin Study of Aging (Sweden, Mage=60.4, 59% female), and Longitudinal Aging Study Amsterdam (Netherlands; Mage=68.1, 52% female). Controlling for age, sex, education, and depressive symptoms, parallel process latent growth models were fit independently in each sample (NT=3293) to simultaneously estimate growth parameters of neuroticism with three measures of CF (processing speed, learning/memory, and reasoning). Multilevel meta-analysis estimated the pooled covariation between neuroticism and CF at baseline and overtime, revealing a significantly negative intercept-intercept relationship across datasets (covariance= -0.46, 95% CIs [-0.90,-0.02], z=-2.02, p=0.04, τ2=0.06). The slope-slope covariances were consistently negative, but the meta-analytic pooled estimate was not significant despite some significant individual estimates across studies. Overall, results provide some evidence for intraindividual and interindividual relationships between neuroticism and CF, such that higher neuroticism is associated with lower CF, and neuroticism tends to increase as CF decreases. Identification of the early indicators and risk factors for cognitive decline may facilitate development of screening assessments and aid in treatment strategies for dementia care services.

scholarly journals Ludzie bardzo starzy – niewidoczna grupa docelowa polityki społecznej?

2014 ◽  
pp. 57-78 ◽  
Author(s):  
Piotr Szukalski
Keyword(s):  
Long Term Care ◽  
Oldest Old ◽  
Family Care ◽  
Policy Decision ◽  
Decision Makers ◽  
Term Care ◽  
Factors Affecting ◽  
Care Services ◽  
Population Forecasts

The next decades will see a sharp increase in the number of the oldest old in Poland. The increase in the number of people aged 80 years and more will be caused both by the cohort factors, as well as by a decrease in the probability of dying at advanced and very advanced age. The paper is focused on the results of official population forecasts for the oldest old and on the related challenges that should be treated as important by social policy decision makers. Particular attention is paid to surviving to the age of eligibility for receiving long-term care services, changes in health status of the oldest old, factors affecting the range of family care, and to circumstances of death.

scholarly journals Is loneliness associated with increased health and social care utilisation in the oldest old? Findings from a population-based longitudinal study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024645 ◽  
Author(s):  
Hanyuying Wang ◽  
Emily Zhao ◽  
Jane Fleming ◽  
Tom Dening ◽  
Kay-Tee Khaw ◽  
...  
Keyword(s):  
Service Use ◽  
Social Care ◽  
Oldest Old ◽  
Population Based ◽  
Social Care Service ◽  
Care Services ◽  
Meals On Wheels ◽  
Health And Social Care ◽  
The Impact

ObjectivesThe present study aimed to examine the impact of loneliness on health and social care service use in the oldest old over a 7-year follow-up.DesignProspective study.SettingUK population-based cohort.Participants713 people aged 80 years or older were interviewed at wave 3 of the Cambridge City over-75s Cohort Study. Of these, 665 provided data on loneliness. During 7 years’ follow-up, 480 participants left the study, of which 389 due to death. 162 still in the study answered the loneliness question.Main outcome measureUse of health and social care services, assessed at each wave from wave 3 to wave 5.ResultsAt wave 3, of 665 participants who had data on loneliness, about 60% did not feel lonely, 16% felt slightly lonely and 25% felt lonely. Being slightly lonely at wave 3 was associated with a shorter time since last seeing a general practitioner (β=−0.5, 95% CI: −0.8 to –0.2); when examining the association between time-varying loneliness and health and social care usage, being lonely was associated with three times greater likelihood of having contact with community nurses and using meals on wheels services (community nurse contact: incidence rate ratio (IRR)=3.4, 95% CI: 1.4 to 8.7; meals on wheels service use: IRR=2.5, 95% CI: 1.1 to 5.6). No associations between loneliness and other health and social care services use were found.ConclusionLoneliness was a significant risk factor for certain types of health and social care utilisations, independently of participants’ health conditions, in the oldest old. Study findings have several implications, including the need for awareness-raising and prevention of loneliness to be priorities for public health policy and practice.

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