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Formal and informal care: trajectories of home care use among Danish older adults
- Authors:
- KJAER Agnete Aslaug, SIREN Anu
- Journal article citation:
- Ageing and Society, 40(11), 2020, pp.2495-2518.
- Publisher:
- Cambridge University Press
To adjust future care policies for an ageing population, policy makers need to understand when and why older adults rely on different sources of care (e.g. informal support versus formal services). However, previous scholars have proposed competing conceptualisations of the link between formal and informal care, and empirical examinations have often lacked a dynamic approach. This study applied an analytical method (sequence analysis), allowing for an exploratory and dynamic description of care utilisation. Based on 15 years of data from 473 community-dwelling older individuals in Denmark, this study identified four distinct clusters of care trajectories. The probability of belonging to each cluster varied with predisposing factors (such as age and gender), needs factors (such as dependence in activities of daily living and medical conditions) and enabling factors (such as co-habitation and contact with adult children). A key finding was that trajectories characterised by sporadic use of informal care were associated with low needs and strong social relations, whereas trajectories characterised by reliance on formal care were associated with high needs and limited contact with children. Taken together, the findings provide new evidence on the associations between care use and multiple determining factors. The dynamic approach to studying care use reveals that sources of individual care utilisation change over time as the individual and societal determinants change. (Edited publisher abstract)
Older adults’ perspectives on the process of becoming users of assistive technology: a qualitative systematic review and meta-synthesis
- Authors:
- LARSEN Stina Meyer, et al
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 14(2), 2019, pp.182-193.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: To identify, synthesize, and evaluate existing literature concerning the process of becoming a user of assistive technology (AT). Method: A systematic review and meta-synthesis were carried out. Five bibliographic databases (MEDLINE via PubMed, CINAHL, Web of Science, PsycINFO and SocINDEX) were systematically searched up to 13th of March 2017, using two sets of search terms: (i) elderly and synonyms and (ii) assistive technology and similar words, and combined with a qualitative research filter. Articles were screened, read and critically assessed. The meta-synthesis was guided by Ricoeur’s theory of interpretation. Results: Seventeen out of 4645 articles were included. Five phases emerged relating to the process of becoming a user of AT: phase A: Evaluating need, phase B: Acknowledging need, phase C: Incorporating the AT into daily life, phase D: Using the AT, and phase E: Future use. Three transitions, describing factors essential to moving from one phase to the next, were identified; from phase A–B: Valued activities are threatened, from phase B–C: Obtaining the AT and from phase C–D: Trust in the AT. No transition was identified from phase D–E. Conclusion: The meta-synthesis led to a deeper understanding of the process of older adults becoming users of AT, by exploring findings across the included articles. The identified phases and transitions in the systematic review serve as an analytical framework for understanding the process from the older adult’s perspective. This review advocates for using a client-centred approach throughout the entire delivery process. (Edited publisher abstract)
Preventive home visits to older home-dwelling people in Denmark: are invitational procedures of importance?
- Authors:
- EKMANN A., VASS M., AVLUND K.
- Journal article citation:
- Health and Social Care in the Community, 18(6), November 2010, pp.563-571.
- Publisher:
- Wiley
All municipalities in Denmark are required by law to offer two annual preventive home visits to all home-dwelling citizens aged 75 or over. This study investigated whether different invitational procedures were associated with first preventive home visit acceptance rates. Two thousand three hundred and ninety nine participants provided complete data for the main analyses. Invitational procedures were categorised as: a letter with a proposed date and time for the visit; a visitor telephone call; and a letter with encouragement to phone the visitor for appointment. Covariates included sex, age, experience with preventive interventions, functional ability, self-rated health, social relations and psychosocial characteristics. Different invitational procedures were associated with first preventive home visit acceptance rates. Significantly more men (75.1%) than women (62.8%) declined the first preventive home visit regardless of the invitational procedure. Compared to `letter with a proposed date', men had an odds ratio of 1.78 for declining visits when `telephone call' was used and an odds ratio 2.81 when `letter without a proposed date' was used as the invitational procedure. In women the odds ratios were 1.23 and 1.87 respectively.
Older people's views of falls-prevention interventions in six European countries
- Authors:
- YARDLEY Lucy, et al
- Journal article citation:
- Gerontologist, 46(5), October 2006, pp.650-660.
- Publisher:
- Oxford University Press
This study conducted semi-structured interviews to assess perceived advantages and barriers to taking part in falls-related interventions were carried out in six European countries (Denmark, the Netherlands, Germany, Greece, Switzerland and United Kingdom) with 69 people aged 68 to 97 years. The sample was selected to include people with very different experiences of participation or nonparticipation in falls-related interventions, but all individuals were asked about interventions that included strength and balance training. The results found attitudes were similar in all countries and contexts. People were motivated to participate in strength and balance training by a wide range of perceived benefits (interest and enjoyment, improved health, mood, and independence) and not just reduction of falling risk. Participation also was encouraged by a personal invitation from a health practitioner and social approval from family and friends. Barriers to participation included denial of falling risk, the belief that no additional falls-prevention measures were necessary, practical barriers to attendance at groups (e.g., transport, effort, and cost), and a dislike of group activities. Implications: Because many older people reject the idea that they are at risk of falling, the uptake of strength and balance training programs may be promoted more effectively by maximizing and emphasizing their multiple positive benefits for health and well-being. A personal invitation from a health professional to participate is important, and it also may be helpful to provide home-based programs for those who dislike or find it difficult to attend groups.