Aging at Home: A Portrait of Home-Based Primary Care across Canada

Akhtar, Sabrina; Loganathan, Mayura; Nowaczynski, Mark; Sinha, Samir K.; Condon, Amanda; Ewa, Vivian; Kirk, John; Pham, Thuy-Nga

doi:10.12927/hcq.2019.25839

Cited by 13 publications

(16 citation statements)

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“…Our findings are consistent with previous studies identifying an association between parkinsonism and falls [10,35] and between multiple sclerosis, wheelchair use, and falls [36]. Our findings are also generalizable to the literature on home care and supporting older adults in their home because as more Canadian older adults are homebound [37], the likelihood of falls in the home increases. Understanding the associations with rates of falls among older adults in the home is important for identifying ways in which falls can be prevented to support healthy aging in the home and avert unnecessary emergency department use attributed to injuries.…”

Section: Principal Findingssupporting

confidence: 92%

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

2020

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Background: Accidental falls among older adults are a leading cause of injury-related hospitalizations. Reducing falls is an ongoing quality improvement priority for home care, given that many home care clients experience falls. In this study, we identify factors associated with the rate of falls among home care clients. Methods: We conducted a population-based, cross-sectional study using secondary data from the Hamilton, Niagara, Haldimand, and Brant health region of Ontario, Canada from January 1-March 31, 2018. We captured person-level characteristics with falls from the Resident Assessment Instrument-Home Care (RAI-HC). Negative binomial regression was used to model the rate of falls. Results: Functional characteristics of home care clients had strong, statistically significant associations with the rate of falls. Declines in activities of daily living, assistive device use for locomotion indoors, polypharmacy, and health conditions, such as dizziness or lightheadedness, and parkinsonism, were associated with a higher rate of falls. Males who used assistive devices had a higher rate of falls compared to females; however, males with neurological and cardiovascular health conditions had a decrease in the rate of falls compared to females. Home care clients with parkinsonism who used a cane and took eight or more drugs had stronger associations with an increased rate of falls compared to those who do not have parkinsonism. Conclusions: Functional characteristics, polypharmacy, and health conditions are associated with increased rates of falls among home care clients. Home care clients who are at a greater risk of falls may require environmental adjustments in their home to reduce or eliminate the possibility of falling.

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Section: Principal Findingssupporting

confidence: 92%

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

2020

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Section: Principal Findingssupporting

confidence: 92%

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

Manis

McArthur

Costa

2020

Preprint

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Background Accidental falls among older adults are a leading cause of injury-related hospitalizations. Reducing falls is an ongoing quality improvement priority for home care, given that many home care clients experience falls. In this study, we identify factors associated with the rate of falls among home care clients.Methods We conducted a population-based, cross-sectional study using secondary data from the Hamilton, Niagara, Haldimand, and Brant health region of Ontario, Canada from January 1 – March 31, 2018. We captured person-level characteristics with falls from the Resident Assessment Instrument – Home Care (RAI-HC). Negative binomial regression was used to model the rate of falls.Results Functional characteristics of home care clients had strong, statistically significant associations with the rate of falls. Declines in activities of daily living, assistive device use for locomotion indoors, polypharmacy, and health conditions, such as dizziness or lightheadedness, and parkinsonism, were associated with a higher rate of falls. Males who used assistive devices had a higher rate of falls compared to females; however, males with neurological and cardiovascular health conditions had a decrease in the rate of falls compared to females. Home care clients with parkinsonism who used a cane and took eight or more drugs had stronger associations with an increased rate of falls compared to those who do not have parkinsonism.Conclusions Functional characteristics, polypharmacy, and health conditions are associated with increased rates of falls among home care clients. Home care clients who are at a greater risk of falls may require environmental adjustments in their home to reduce or eliminate the possibility of falling.

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“…Com efeito, esses achados corroboram o 'retrato' da atenção primária no Canadá, o qual destaca a potencialidade da assistência no contexto do domicílio, salientando as experiências aprimoradas para os pacientes e cuidadores. Esse fato leva à redução de custos com assistência médica, principalmente quando o cuidado é fornecido por equipes interprofissionais ampliadas 46 .…”

Section: Discussionunclassified

Desafios e possibilidades dos profissionais de saúde no cuidado ao idoso dependente

Silva

Brasil

Bezerra

et al. 2021

Ciênc. saúde coletiva

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Resumo Investiga desafios e possibilidades de profissionais de saúde para a gestão do cuidado de idosos dependentes na Atenção Primária à Saúde. Recorreu-se à abordagem qualitativa fundamentada na fusão hermenêutica dialética. Efetivou-se entrevista com 38 profissionais de saúde, nos meses de junho a dezembro de 2019, em oito cidades das cinco regiões brasileiras. Dos resultados, emergiram temáticas sobre os desafios que os profissionais enfrentam na gestão do cuidado ao idoso, as estratégias por eles utilizadas e suas sugestões para elevar a qualidade do cuidado aos idosos que dependem deste. Falhas na gestão, fatores estruturais, barreiras de acesso, escassez de insumos, desarticulação da rede e falta de segurança foram apontados como dificuldades para direcionar as ações de proteção, prevenção e promoção da saúde. Fortalecer o acolhimento, estimular a consulta domiciliar, mobilizar grupos de apoio e realizar educação em saúde figuraram entre as práticas integrativas sugeridas pelos participantes. Os profissionais reconhecem as deficiências nos serviços de saúde e enfrentam situações indesejadas pela ausência de pessoal qualificado nas equipes, bem como em razão da insuficiência de materiais e de transporte.

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Aging at Home: A Portrait of Home-Based Primary Care across Canada

Cited by 13 publications

References 0 publications

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

Desafios e possibilidades dos profissionais de saúde no cuidado ao idoso dependente

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