Activities of Daily Living in Nursing Home and Home Care Settings: A Retrospective 1-Year Cohort Study

2015 ◽  
Vol 16 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Tae Wha Lee ◽  
Eunhee Cho ◽  
Eun Shil Yim ◽  
Hye Sun Lee ◽  
Yu Kyung Ko ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Home Care ◽  
Activities Of Daily Living ◽  
Daily Living

scholarly journals Do premorbid characteristics of home care clients predict delayed discharges in acute care hospitals: a retrospective cohort study in Ontario and British Columbia, Canada

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e038484
Author(s):  
Stella A Arthur ◽  
John P Hirdes ◽  
George Heckman ◽  
Anne Morinville ◽  
Andrew P Costa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Activities Of Daily Living ◽  
Retrospective Cohort Study ◽  
Daily Living ◽  
Retrospective Cohort ◽  
Term Care ◽  
Delayed Discharge ◽  
Hospitalised Patients ◽  
Care Assessment

BackgroundImproved identification of patients with complex needs early during hospitalisation may help target individuals at risk of delayed discharge with interventions to prevent iatrogenic complications, reduce length of stay and increase the likelihood of a successful discharge home.MethodsIn this retrospective cohort study, we linked home care assessment records based on the Resident Assessment Instrument for Home Care (RAI-HC) of 210 931 hospitalised patients with their Discharge Abstract Database records. We then undertook multivariable logistic regression analyses to identify preadmission predictive factors for delayed discharge from hospital.ResultsCharacteristics that predicted delayed discharge included advanced age (OR: 2.72, 95% CI 2.55 to 2.90), social vulnerability (OR: 1.27, 95% CI 1.08 to 1.49), Parkinsonism (OR: 1.34, 95% CI 1.28 to 1.41) Alzheimer’s disease and related dementias (OR: 1.27, 95% CI 1.23 to 1.31), need for long-term care facility services (OR: 2.08, 95% CI 1.96 to 2.21), difficulty in performing activities of daily living and instrumental activities of daily living, falls (OR: 1.16, 95% CI 1.12 to 1.19) and problematic behaviours such as wandering (OR: 1.29, 95% CI 1.22 to 1.38).ConclusionPredicting delayed discharge prior to or on admission is possible. Characteristics associated with delayed discharge and inability to return home are easily identified using existing interRAI home care assessments, which can then facilitate the targeting of pre-emptive interventions immediately on hospital admission.

scholarly journals Developing composite indices of geographical access and need for nursing home care in Ireland using multiple criteria decision analysis

2020 ◽  
Vol 3 ◽  
pp. 65 ◽  
Author(s):  
Brian P. Reddy ◽  
Stephen O'Neill ◽  
Ciaran O'Neill
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Activities Of Daily Living ◽  
Decision Analysis ◽  
Daily Living ◽  
Multiple Criteria ◽  
Nursing Home Care ◽  
Spatial Accessibility ◽  
Multiple Criteria Decision Analysis ◽  
Composite Indices

Background: Spatial accessibility has consistently been shown to influence utilisation of care and health outcomes, compared against local population needs. We sought to identify how appropriately nursing homes (NHs) are distributed in Ireland, as its NH market lacks central planning. Methods: We used multiple criteria decision analysis (MCDA) approaches to develop composite indices of both access (incorporating measures of availability, choice, quality and affordability) and local NH need for over 65s (relating to the proportion living alone, with cognitive disabilities or with low self-rated health, estimated scores for activities of daily living and instrumental activities of daily living, the average number of disabilities per person and the average age of this group). Data for need were derived from census data. Results were mapped to better understand underlying geographical patterns. Results: By comparing local accessibility and need, underserved areas could be identified, which were clustered particularly in the country’s northwest. Suburbs, particularly around Dublin, were by this measure relatively overserved. Conclusions: We have developed multi-dimensional indices of both accessibility to, and need for, nursing home care. This was carried out by combining granular, open data sources and elicited expert/stakeholder opinion from practitioners. Mapping these data helped to highlight clear evidence of inequitable variation in nursing home distribution.

scholarly journals Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044416
Author(s):  
Tan Van Nguyen ◽  
Huyen Thanh Dang ◽  
Mason Jenner Burns ◽  
Hiep HH Dao ◽  
Tu Ngoc Nguyen
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Tertiary Hospital ◽  
Logistic Regression Models ◽  
Hospitalised Patients ◽  
Patients With Heart Failure ◽  
The Impact

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

scholarly journals Improved outcome in hip fracture patients in the aging population following co-managed care compared to conventional surgical treatment: a retrospective, dual-center cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carl Neuerburg ◽  
Stefan Förch ◽  
Johannes Gleich ◽  
Wolfgang Böcker ◽  
Markus Gosch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Trauma Care ◽  
Daily Living ◽  
Aging Population ◽  
Readmission Rates ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Background Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC). Methods We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of ≥ 70 years were consecutively assigned within a 1 year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were 1 year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL). Results A total of 436 patients were included (219 with OGC / 217 with CTC). The mean age was 83.55 (66–99) years for OGC and 83.50 (70–103) years for CTC (76.7 and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After 1 year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up. Conclusions Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards. Trial registration The study was approved and registered by the bavarian medical council (BLAEK: 7/11192) and the local ethics committee of munich university (Reg. No. 234–16) and was conducted as a two-center, cohort study at a hospital with integrated orthogeriatric care and a hospital with conventional trauma care.

Predictors of difficulty in carrying out basic activities of daily living among the old-old: A 2-year community-based cohort study

2015 ◽  
Vol 16 (2) ◽  
pp. 214-222 ◽  
Author(s):  
Ryota Sakamoto ◽  
Kiyohito Okumiya ◽  
Masayuki Ishine ◽  
Taizo Wada ◽  
Michiko Fujisawa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Community Based

scholarly journals Depressive symptoms, emotional support and activities of daily living disability onset: 15-year follow-up of the Bambuí (Brazil) Cohort Study of Aging

2018 ◽  
Vol 34 (7) ◽  
Author(s):  
Juliana Lustosa Torres ◽  
Erico Castro-Costa ◽  
Juliana Vaz de Melo Mambrini ◽  
Sérgio William Viana Peixoto ◽  
Breno Satler de Oliveira Diniz ◽  
...  
Keyword(s):  
Cohort Study ◽  
Social Network ◽  
Depressive Symptoms ◽  
Activities Of Daily Living ◽  
Psychosocial Factors ◽  
Emotional Support ◽  
Daily Living ◽  
Wide Range

Psychosocial factors appear to be associated with increased risk of disability in later life. However, there is a lack of evidence based on long-term longitudinal data from Western low-middle income countries. We investigated whether psychosocial factors at baseline predict new-onset disability in long term in a population-based cohort of older Brazilians adults. We used 15-year follow-up data from 1,014 participants aged 60 years and older of the Bambuí (Brazil) Cohort Study of Aging. Limitations on activities of daily living (ADL) were measured annually, comprising 9,252 measures. Psychosocial factors included depressive symptoms, social support and social network. Potential covariates included sociodemographic characteristics, lifestyle, cognitive function and a physical health score based on 10 self-reported and objectively measured medical conditions. Statistical analysis was based on competitive-risk framework, having death as the competing risk event. Baseline depressive symptoms and emotional support from the closest person were both associated with future ADL disability, independently of potential covariates wide range. The findings showed a clear graded association, in that the risk gradually increased from low emotional support alone (sub-hazard ratio - SHR = 1.11; 95%CI: 1.01; 1.45) to depressive symptoms alone (SHR = 1.52; 95%CI: 1.13; 2.01) and then to both factors combined (SHR = 1.61; 95%CI: 1.18; 2.18). Marital status and social network size were not associated with incident disability. In a population of older Brazilian adults, lower emotional support and depressive symptoms have independent predictive value for subsequent disability in very long term.

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