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The prevalence of older couples with ADL limitations and factors associated with ADL help receipt
- Authors:
- SHENA Huei-Wern, et al
- Journal article citation:
- Journal of Gerontological Social Work, 58(2), 2015, pp.171-189.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Using the Andersen-Newman model, this study investigates the prevalence of activities of daily living (ADLs) limitations in older married couples, and couple characteristics associated with activities of daily living (ADL) help-receipt. In this sample of 3,235 couples age 65+ in the 2004 US Health and Retirement Study, 74.3%, 22.1%, and 3.6% were couples in which neither partner, one partner, or both partners had limitations, respectively. Logistic regression results indicate that help-receipt was associated with certain health needs in the couple, but not with their predisposing characteristics or enabling resources. The data showed that couples in which both partners have ADL limitations were more likely to receive any ADL help than were couples with one such partner. When the couples’ predisposing socio-demographic characteristics, enabling family and financial resources, and health needs were taken into account, only the couple-level measures of health needs (i.e., ADL limitations, IADL limitations, and use of equipment) emerged as key determinants of ADL help-receipt. Whether the couple included one or two partners with ADL limitations was not among the significant predictors. This finding suggests that it is not simply the number of partners in a couple with ADL limitations but other aspects of the health of the couple that influence their help-receipt. Social workers could target couples most in need of assistance by assessing both partners’ health problems. (Edited publisher abstract)
Characterisation of user-defined health status in older adults with intellectual disabilities
- Authors:
- STARR J. M., MARSDEN L.
- Journal article citation:
- Journal of Intellectual Disability Research, 52(6), June 2008, pp.483-489.
- Publisher:
- Wiley
Older adults with Intellectual Disabilities (ID) have an excess disease burden that standard health assessments are designed to detect. Older adults with ID have a broader concept of health with dimensions of well being in addition to absence of disease in line with the World Health Organization's health definition. This study sought to characterise user-defined health status in a sample of older adults with ID. A user-led health assessment was administered to 57 adults with ID aged 40 years and over. Cluster analysis on user-defined health themes of participation, nutrition and hygiene/self-care identified clear separation of participants into a healthier and a less healthy group. Disease burden and medication use were greater in the less healthy group. The healthier group were taller, stronger and had better vision than the less healthy group. Constipation, urinary incontinence and faecal incontinence were commoner in the less healthy group. There were few significant differences between health groups on the majority of standard physical-examination items. There is considerable overlap between user-defined health and that assessed by standard instruments. In addition, user-defined health encompasses aspects of physical fitness not captured by traditional disease-based health models.
Health risk appraisal in older people 1: are older people living alone an 'at-risk' group?
- Authors:
- KHARICHA Kalpa, et al
- Journal article citation:
- British Journal of General Practice, 57(537), April 2007, pp.271-276.
- Publisher:
- Royal College of General Practitioners
In the UK, population screening for unmet need has failed to improve the health or older people. Attention is turning to interventions targeted at 'at-risk' groups. Living alone in later life is seen as a potential health risk. This study aimed to investigate the associations between lone status and health behaviours, health status, and service use in non-disabled older people. The study used secondary analysis of baseline data from a randomised controlled trial of health risk appraisal in older people. Sixty percent of 2,641 community-dwelling non-disabled people aged 65 years and over registered in four group practice in London agreed to participate in the study; 84% of these returned completed questionnaires. A third of this group (n=860, 33.1%) lived along and two-thirds (n=1,741, 66.9%) lived with someone else. Those living alone were more likely to reports fair to poor health, poor vision, difficulties in instrumental and basic activities of daily living, worse memory and mood, lower physical activity, poorer diet, risk of social isolation, hazardous alcohol use, having no emergency carer, and multiple falls in the previous 12 months. After adjustment for age, sex, income, and educational attainment, living alone remained associated with multiple falls, functional impairment, poor diet, smoking status, risk of social isolation, and three self-reported chronic conditions: arthritis and/or rheumatism, glaucoma, and cataracts. It is concluded that targeted population screening using lone status may be useful in identifying older individuals at high risk of falling.
Everyday competence and depressive symptoms: social support and sense of control as mediators or moderators?
- Author:
- CHOU K.-L.
- Journal article citation:
- Aging and Mental Health, 9(2), March 2005, pp.177-183.
- Publisher:
- Taylor and Francis
Depression is common among the elderly members of Hong Kong Chinese society. The objectives of the present study are to assess the relationship between everyday competence and depressive symptoms and to test whether sense of control and social support mediate and moderate the impact of deterioration in everyday competence on depressive symptoms. The respondents were 393 people aged 60 years and older from a cross-sectional study of a representative community sample of the elderly population in Hong Kong and they were interviewed using a structured questionnaire. In multiple regression analyses, we found that everyday competence was significantly and negatively related to depressive symptoms (ß?=?-0.26, p?<?0.01) after we had adjusted age, gender, marital status, years of education, self-rated health status, and number of chronic illnesses. Moreover, both sense of control and social support were mediators in the linkage between everyday competence and depression. However, neither sense of control nor social support moderated the effect of everyday competence on depression. Findings suggest that both sense of control and social support play important roles in the relationship between everyday competence and depression.
Correlates of everyday competence in Chinese older adults
- Author:
- CHOU K. L.
- Journal article citation:
- Aging and Mental Health, 7(4), July 2003, pp.308-315.
- Publisher:
- Taylor and Francis
Whether older adults can maintain levels of adaptation that allow continuation of independent living is necessarily contingent upon the maintenance of levels of everyday competence. This study identifies factors correlated to everyday competence measured by a Chinese version of the Direct Assessment of Functional Abilities among Hong Kong Chinese elderly people. The respondents were 393 people aged 60 years or older from a cross-sectional study of a representative community sample of the elderly population in Hong Kong and they were interviewed in a face-to-face format. In multiple regression analyses, we found that self-rated health, sight, and global cognitive ability were positively associated with everyday competence whereas the presence of arthritis had a negative impact on the everyday competence. All these findings are consistent with previous Western studies.
The relationship between frailty, functional dependence, and healthcare needs among community‐dwelling people with moderate to severe dementia
- Authors:
- ABREU Wilson, et al
- Journal article citation:
- Health and Social Care in the Community, 27(3), 2019, pp.642-653.
- Publisher:
- Wiley
This paper examines the healthcare needs of community‐dwelling older people living in Porto, Portugal, diagnosed with moderate or severe dementia, linked to functional dependency, cognitive decline, limitations in the activities of daily life, and frailty levels. A sample of 83 participants was recruited. Data were collected between 2013 and 2017. A sociodemographic questionnaire, the Clinical Dementia Rating (CDR), the Barthel Index (BI), the Lawton and Brody Instrumental Activities of Daily Living (IADL) Scale, and the Edmonton Frail Scale (EFS) were used. A set of 26 healthcare needs was defined to support the assessment. The Pearson chi‐square or Fisher's exact test (as appropriate) was used to examine the association of the needs (unmet and met) with the levels of dementia and frailty. Participants were diagnosed previously with moderate or severe dementia and benefited from a structured home‐care program. There was a high number rated as “severe dementia,” “fully dependent,” “severely or fully dependent in the activities of daily living (ADL),” and “severe frailty.” There were statistically significant differences among needs identified in people with moderate or severe dementia and moderate or severe frailty. The most prevalent healthcare needs in the sample were food preparation, medication/taking pills, looking after their home, toilet use, sensory problems, communication/interaction, bladder, bowels, eating and drinking, memory, sleeping, and falls prevention. In particular, the study identifies a set of needs that are present simultaneously in both frailty and dementia stages. This study underlines that despite well‐structured home‐care programs for people with dementia, unmet health needs remain. Timely healthcare needs assessment may help professionals to avoid fragmented care and to tailor quality‐integrated interventions, including the emotional and psychological balance of the caregiver. (Edited publisher abstract)
Independence and well-being of older people: baseline report: a social portrait of ageing in the UK
- Author:
- GREAT BRITAIN. Department for Work and Pensions
- Publisher:
- Corporate Document Services; Great Britain. Department for Work and Pensions
- Publication year:
- 2006
- Pagination:
- 70p.
- Place of publication:
- Leeds
The implications of an ageing society are wide reaching. As well as ensuring financial security, it is equally important to promote wider well-being and independence for older people, both before and after retirement. Older people continue to contribute to the economy, society and their local communities and to enjoy active lives. Income is not the only factor – and often not the main factor – in ensuring a happy and fulfilling later life. Housing, health, care, transport and social contacts all play a crucial part in enabling older people to live life to the full. A set of indicators of older people’s independence and well-being that have been selected and cover five domains a) Independence in supportive communitiesp; b) Healthy active living; c) Fairness in work and later life; d) Material well-being; and e) Support and care.
Ageing with a lifelong disability: a guide to practice, program and policy issues for human services professionals
- Author:
- BIGBY Christine
- Publisher:
- Jessica Kingsley
- Publication year:
- 2004
- Pagination:
- 319p.
- Place of publication:
- London
Based on the author's 18 years' research experience and social work practice expertise, this guide provides up to date specialist knowledge about ageing with a disability in the context of the more mainstream knowledge about ageing processes. The author uses the concept of 'successful ageing' as a framework in which to consider the issues and practicalities for older people with a lifelong disability. She presents strategies for the various challenges involved in the physiological, psychological and sociological aspects of ageing and proposes an integrated framework of service development and policy directions for the implementation of these strategies. Particular focus is given to lifestyle planning, encompassing subjects such as daily activity and leisure, housing and support, advocacy, case management and health. Consideration is also given to working with older parental carers of adults with a lifelong disability to support preparation and planning for the transition from parental care.
People aged 65 and over: results of a study carried out on behalf of the Department of Health as part of the 2001 general household survey
- Authors:
- TRAYNOR Joe, WALKER Alison, GREAT BRITAIN. Office for National Statistics
- Publisher:
- Stationery Office
- Publication year:
- 2003
- Pagination:
- 104p., tables.
- Place of publication:
- London
In 2001, 37 per cent of people aged 65 and over lived alone, according to detailed results from the 2001 General Household Survey (GHS) about people aged 65 and over . Five per cent of elderly people lived in sheltered accommodation with a resident warden and three per cent without a resident warden (elderly people in communal establishments were excluded from the survey). In all, 60 per cent of elderly people said they had a longstanding illness; 41per cent said this limited their activities in some way, while 19 per cent said it did not. Among people aged 65 and over, 14 per cent were unable to walk down the road on their own and 10 per cent were unable to manage stairs and steps. One in twenty elderly people said they were unable to cook a main meal by themselves. Among elderly people who received help with mobility, 58 per cent received help from a spouse or partner, 20 per cent from other household members, eight per cent from a relative who was not living in the household and four per cent from NHS or personal social services. Over half of elderly respondents (52 per cent) reported seeing a doctor or GP at their surgery in the last three months.
Functional and health assessments used in rheumatology occupational therapy: a review and United Kingdom survey
- Author:
- HAMMOND Alison
- Journal article citation:
- British Journal of Occupational Therapy, 59(6), June 1996, pp.254-259.
- Publisher:
- Sage
Reviews a functional and health status outcome measures used in rheumatology therapy research and practice. Looks at the results of a national survey conducted with rheumatology occupational therapies to identity which functional assessments are most used. The majority of respondents considered standardised assessments to be valuable in clinical practice. Over half used a standardised measure, with the Health Assessment Questionnaire (HAQ), Modified HAQ and Barthel Index being the commonest. The reasons for non-use were mainly a lack of knowledge of assessments available or difficulty in accessing these. All departments using standardised assessments did so in conjunction with a non-standardised activities of daily living assessment, because the former were not considered to provide sufficient detail for treatment planning purposes.