Behavioral, Social and Mental Health Aspects of Home Care for Older Americans

Harper, Mary S.

doi:10.1300/j027v09n04_05

Cited by 12 publications

(6 citation statements)

References 75 publications

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“…Unmet Health Care Needs functional well-being was defined as the ability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL). It has been shown that 56% of those over age 75 are limited in one or more ADL because of chronic conditions, and 86% of all elderly suffer from one or more chronic conditions (Harper, 1988). Rabiner (1995), in a secondary analysis of the National Long Term Care Survey (NLTCS), reported an average of 1.02 ADL limitations and 3.62 IADL limitations in a sample of 4,182 adults aged 65-108 years (rn = 76.15 years).…”

Section: Individualmentioning

confidence: 99%

Identification of Needs of and Utilization of Resources by Rural and Urban Elders After Hospital Discharge to the Home

Schultz

1997

Public Health Nursing

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The recent reductions in lengths of hospital stays may particularly affect the elderly in rural communities where resources may be scarce. The purpose of this descriptive, comparative study was to assess and evaluate the match of formal and informal resources with individual functional, behavioral, knowledge, and skilled care needs of rural and urban elderly during a 21-day transition period following hospital discharge to the home. Eighty-one elderly patients discharged to one urban and two frontier rural counties were selected. There were no significant differences in demographic variables between rural and urban participants. The Comprehensive Health Care Needs Assessment (CHCNA) questionnaire was used to assess needs and utilization of resources at 3 days and 3 weeks after discharge. Using repeated measure analyses of variance, there were significantly fewer needs identified at 3 weeks than at 3 days after discharge. Rural dwellers identified significantly more skilled care needs than their urban counterparts; however, none were highly technical in nature. Unexpectedly, at 3 weeks after discharge, considerably more functional needs were met by families in the urban setting than in the rural setting. Although only a small number of participants reported unmet needs in multiple domains, the complexity of the unmet needs requires further exploration.

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Section: Individualmentioning

confidence: 99%

Identification of Needs of and Utilization of Resources by Rural and Urban Elders After Hospital Discharge to the Home

Schultz

1997

Public Health Nursing

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“…B y no means a new phenomenon, the homebound elderly have become more prevalent and visible as life expectancy and the subsequent size of the elderly population have increased 1 . The growth of this population has focused considerable attention on their health care needs and has resulted in substantial increases in the use of home care health services 2 .…”

mentioning

confidence: 99%

Psychiatric Status among the Homebound Elderly: An Epidemiologic Perspective

Bruce¹,

McNamara²

1992

J American Geriatrics Society

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Objective To compare the prevalence of specific psychiatric disorders in the homebound elderly to other elders, controlling for demographic, physical health, and socio‐economic factors. Design Survey. Setting Epidemiologic Catchment Area (ECA) project in New Haven, CT. Participants 2,553 non‐institutionalized elders representing the total elderly population of the greater New Haven area. Intervention None Main Measures Homebound status determined by self‐report; psychiatric status according to DSM III by the Diagnostic Interview Schedule (DIS); cognitive status by Mini‐Mental Status Examination. Results Cognitive impairment (21.8% vs 11.0%, P < 0.001), depression (2.3% vs 0.7%, P < 0.01), dysthymia (3.9% vs 1.7%, P < 0.01), and anxiety disorders (2.2% vs 0.4%, P < 0.001) were each at least twice as prevalent among elders confined to a bed or chair as among non‐homebound elders. Most of this increase was consistent with the poorer physical health status of the homebound; after controlling for health status, only dysthymia (Odds ratio = 2.1, P < 0.01) was significantly more prevalent among elders confined to a bed or chair. Conclusions The higher prevalence of disorders among the homebound support recommendations that psychiatric assessments become routine in primary care examinations of homebound elders and that the availability of preventive and therapeutic psychiatric services to the homebound increase.

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“…Clinical epidemiological studies document high rates of current and lifetime disorders for children in the child welfare system (Auslander et al, 2002; Landsverk et al, 1992; McMillen et al, 2005; Stiffman et al, 1997), adults who are homeless (Pollio, North, Eyrich, Foster, & Spitznagel, 2003), runaway youths (S. J. Thompson, Maguin, & Pollio, 2003), and clients served by home health agencies (Bruce et al, 2002; Harper, 1988). …”

Section: Mental Disorder Among Social Service Clientsmentioning

confidence: 99%

Notation of Depression in Case Records of Older Adults in Community Long-Term Care

Proctor¹,

Morrow‐Howell²,

Choi³

et al. 2008

Social Work

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Although significant numbers of social service clients experience mental health problems, virtually no research has examined the responsiveness of social service agencies to mental disorder. This article examines the extent to which client depression is reflected in records of a public social service agency, community long-term care (CLTC). Researchers assessed new, consenting CLTC clients for depression using standardized research criteria in a telephone interview. Agency case records were abstracted to determine the extent to which client depression was noted. Sensitivity and specificity of depression notation were 25.21 percent and 92.80 percent, respectively, indicating that agency records reflected depression for about one in four clients meeting depression criteria. Factors associated with accurate depression notation included cognitive impairments, low social support, psychotropic medications, and mental health treatment. The depression notation rates found are comparable to those in medical settings. Structured screening and assessment might enhance detection of mental disorder for social service clients.

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Behavioral, Social and Mental Health Aspects of Home Care for Older Americans

Cited by 12 publications

References 75 publications

Identification of Needs of and Utilization of Resources by Rural and Urban Elders After Hospital Discharge to the Home

Identification of Needs of and Utilization of Resources by Rural and Urban Elders After Hospital Discharge to the Home

Psychiatric Status among the Homebound Elderly: An Epidemiologic Perspective

Notation of Depression in Case Records of Older Adults in Community Long-Term Care

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