Factors associated with risk of care dependency in disabled geriatric patients

Abstract

Factors associated with risk of care dependency in disabled geriatric patients Introduction: The growing number of elderly people results in the intensification of disability, reduced level of independency and quality of life as well as augmented demand on medical and social services. The aim of the study was to identify factors associated with probability of care dependency in disabled geriatric patients. Materials and methods: The study involved 200 patients aged 60 or over, consecutively admitted to the Geriatrics Unit. A cross-sectional quantitative study design. The study carried out using the questionnaire evaluating the patients' biopsychosocial needs and level of care dependency: the Polish version of the Care Dependency Scale (CDS). Data regarding the patients' self-care, locomotor function, emotional status, cognitive function, vision, hearing, the risk of pressure sores or falls, self-assessed health status and the sense of loneliness were obtained from medical documentation using selected elements of the CGA (Comprehensive Geriatric Assessment). Results: The mean CDS score (15-75) for all the evaluated patients was 55.3 AE 15.1-43.4 AE 11.9 in the category of dependent patients and 67.5 AE 4.6 in the category of independent of care, respectively (p < 0.001). The participants' mean age was 81.8 AE 6.6 (in the dependent category, 83.3, and in the independent category, 80.2). The final model produced statistically significant independent factors: cognitive ability, Instrumental-ADL performance, locomotive ability and age. Conclusions: The progressing care dependency increased with the worsening of cognitive functions, difficulties performing I-ADL, locomotion impairment and advanced age. To support independent living of elderly people, healthcare professionals should recognise the situation in the community to carry out interventions aimed at preventing and minimising disability and delaying institutionalisation.

Factors Associated with ADL Dependence in Nursing Home Residents with Korsakoff’s Syndrome and Other Alcohol-Related Disorders: An Explorative Cross-Sectional Study

“…The strong association between ADL dependence and cognitive impairment we found supports and extends the previous literature reporting similar findings [ 16 , 20 , 31 , 32 , 33 ]. However, these previous studies differed in population and study designs: patients with dementia in all kinds of disease stages and elderly people living in nursing homes were studied in both cross-sectional and longitudinal designs.…”

“…It is also somewhat surprising that in our study we found a significant association between female gender and increased ADL dependence, since in previous studies regarding factors associated with ADL dependence, “gender” was not found to be significantly associated. Yet these studies were conducted on community-dwelling elderly, patients with dementia, and elderly care [ 16 , 20 , 21 , 31 ]. On the other hand, a large cross-national study comparing sex differences in ADL in Europe has found that women are more likely to be ADL dependent than men and that this difference increases with age [ 41 ].…”

“…Several studies in elderly care have investigated predictors and factors associated with ADL dependence. Muscle mass, strength, and physical performance were found to be predictors for future ADL dependence [ 19 , 20 ]. Care dependence increased with the worsening of cognitive functions, locomotion impairment, and advanced age, experiencing trouble with pain, taking five or more medications, having a chronic condition, having higher depression scores, and having a lower Mini Mental State Examination (MMSE) score [ 21 ].…”

Nurses' perspectives on caring for and attitudes towards adults aged eighty years and older

“…Especially adults aged 80 years and older can be a vulnerable group regarding perceived negative attitudes or ageism [5], because these individuals are often stereotyped as being frail and dependent [6] and have a higher risk of care dependency [7]. People in this age group are also referred to as people in the so‐called fourth age [8], which is not defined by their chronological age, but is described as a loss of the ability to manage tasks of daily living.…”

Sociodemographic Factors Affecting Older People’s Care Dependency in Their Daily Living Environment According to Care Dependency Scale (CDS)

“…The Care Dependency Scale (CDS) was designed to assess the multidimensional care dependency of older people in their daily living environment, and it is recommended across Europe. The scale has also been adapted to Polish conditions [ 5 , 6 , 7 , 8 ]. The scale was developed following Virginia Henderson’s theory of nursing and includes both physical and psychosocial aspects, which are used to assess care dependency [ 9 , 10 , 11 ].…”