Can They Keep Going on Their Own? A Four-Year Randomized Trial of Functional Assessments of Community Residents

Abstract

Objectives:Are people 75 or over enabled to stay at home longer through annual assessments and referrals to health/social services than through assessments only or without assessments?Design:randomized controlled trialParticipants:520 people 75 or over living in their own homesIntervention:Four annual RAI-HC computerized functional assessments. Intervention group 1: elders and primary caregivers received the results and were invited to take appropriate actions. Intervention group 2: elders and primary caregivers were offered referrals to health/social services.Measurements/Outcomes:death, institutionalization, home care services, RAI-HC scores, self-rated health, perceived self-efficacy, caregiver burdenResults:By the end of the study, annual functional assessment and offers of referrals to health/social services led to a greater use of home care (6.3%) than did assessment alone (1.8%), but there were no significant differences in death rates, institutionalization, perceived self-efficacy, self-rated health status, or caregiver burden scores between groups.Conclusion:We discovered that this was a group of healthy seniors. Multi-dimensional functional assessment is time- and labour-intensive and should be targeted at the minority of least self-reliant seniors.

The evidence for services to avoid or delay residential aged care admission: a systematic review

“… Single focus interventions. Eleven RCTs, with a total of n = 8,926 participants [22, 26, 31–33, 36, 37, 45–48]. Re-enablement or restorative care.…”

“…Self-efficacy was measured in two trials. Thomas and colleagues [48], reported no significant group differences in self-efficacy outcomes in their minimal intervention trial, while Scott et.al. [50] reported a better self-efficacy rating only for ‘communication with their physician’ for the intervention group compared to controls ( p = 0.03).…”

Challenges in Synthesizing and Interpreting the Evidence from a Systematic Review of Multifactorial Interventions to Prevent Functional Decline in Older Adults

“…Twenty‐four of the 70 trials included unselected or general‐risk populations . Although the majority of trials targeted older adults “at risk” for functional decline, high‐risk designations were based on widely varying criteria: primary care physician identification as high risk, recently hospitalized, recently in the emergency department, recent fall or at high fall risk, screened positive for risk of functional decline or hospitalization, high healthcare users, low income, minimally care assisted, multiple chronic health conditions, frail seniors, mild dementia, and other multifaceted approaches . These populations represented a heterogeneous group of at‐risk older adults.…”

Understanding Older Adults’ Perceptions of Internet Use: An Exploratory Factor Analysis

“…For example, Nauck and Suckow (2006) examined older adults' behavior in seeking intergenerational relationships and found that such relationships relate closely to the constructs of social connection and psychological well-being. Thomas, Worrall, and Elgar (2007) noted that active ageing-like developing hobbies and searching for entertainmentilluminates older adults' efforts in developing self-efficacy and confidence in their later life. The current study is interested in understanding the relationship between these constructs and older adults' perceptions on Internet use as well as the predictive power of demographic, computer experience, and other related variables on their perceptions.…”