Multidimensional Factors Affecting Homebound Older Adults: A Systematic Review

Suh, Yujin; Kim, Yielin

doi:10.2139/ssrn.3566156

Cited by 4 publications

(4 citation statements)

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“…One of the more extreme examples of the way in which a consumerist model of care can fail to deliver on its ideals relates to the challenges facing ‘frail, homebound and bedridden people’ (FHBP), who are a highly vulnerable cohort, with complex, incapacitating and debilitating illnesses or injuries (particularly myalgic encephalomyelitis, which is also known as ‘chronic fatigue syndrome’). Many also experience significant financial hardship, social isolation and poor mental health (Choi et al, 2014; Lee et al, 2020; Pinero de Plaza, 2021; Pinero de Plaza, Beleigoli, et al, 2021). Being bedridden and/or unable to leave home means they face significant logistical difficulties with accessing and engaging with care services, which in Australia is primarily structured around physical attendance (Buchanan, 2018).…”

Section: On Persons As Consumersmentioning

confidence: 99%

The trouble with personhood and person‐centred care

et al. 2022

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The phrase 'person-centred care' (PCC) reminds us that the fundamental philosophical goal of caring for people is to uphold or promote their personhood.However, such an idea has translated into promoting individualist notions of autonomy, empowerment and personal responsibility in the context of consumerism and neoliberalism, which is problematic both conceptually and practically. From a conceptual standpoint, it ignores the fact that humans are social, historical and biographical beings, and instead assumes an essentialist or idealized concept of personhood in which a person is viewed as an individual static object. From a practical standpoint, the application of such a concept of personhood can lead to neglect of a person's fundamental care needs and exacerbate the problems of social inequity, in particular for older people and people with dementia. Therefore, we argue that our understanding of PCC must instead be based on a dynamic concept of personhood that integrates the relevant social, relational, temporal and biographical dimensions. We propose that the correct concept of personhood in PCC is one in which persons are understood as socially embedded, relational and temporally extended subjects rather than merely individual, autonomous, asocial and atemporal objects. We then present a reconceptualization of the fundamental philosophical goal of PCC as promoting selfhood rather than personhood. Such a reconceptualization avoids the problems that beset the concept of personhood and its application in PCC, while also providing a philosophical foundation for the growing body of empirical literature that emphasizes the psychosocial, relational, subjective and biographical dimensions of PCC.

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Section: On Persons As Consumersmentioning

confidence: 99%

The trouble with personhood and person‐centred care

et al. 2022

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“…The prevalence of homebound status varied depending on different definitions. As suggested by Lee et al [ 23 ], we measured the frequency of leaving the house and functional difficulty simultaneously and classified it as “semi-homebound” to differentiate it from homebound status. Based on measures developed by Ornstein and colleagues [ 4 ], in this study, homebound status was measured using four questions based on the reported frequency of outdoor mobility and functional difficulties.…”

Section: Methodsmentioning

confidence: 99%

The bidirectional relationship between homebound status and falls among older adults: a longitudinal study

et al. 2022

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Background Previous research has shown an association between homebound status and falls among older adults. However, this association was primarily drawn from cross-sectional studies. This study aimed to determine the bidirectional relationship between homebound status and falls among older adults in the community. Methods We used data of the community-dwelling older adults from 2011 to 2015 of the National Health and Aging Trends Study, a nationally representative survey of Medicare Beneficiaries in the United States (Sample 1 [No falls at baseline]: N = 2,512; Sample 2 [Non-homebound at baseline]: N = 2,916). Homebound status was determined by the frequency, difficulty, and needing help for outdoor mobility. Falls were ascertained by asking participants whether they had a fall in the last year. Generalized estimation equation models were used to examine the bidirectional association between homebound status and falls longitudinally. Results Participants with no falls at baseline (n = 2,512) were on average, 76.8 years old, non-Hispanic whites (70.1%), and female (57.1%). After adjusting for demographics and health-related variables, prior year homebound status significantly contributed to falls in the following year (Odds ratio [OR], 1.28, 95% CI: 1.09–1.51). Participants who were non-homebound at baseline (n = 2,916) were on average, 75.7 years old, non-Hispanic white (74.8%), and female (55.8%). Previous falls significantly predicted later homebound status (OR, 1.26, 95% CI: 1.10–1.45) in the full adjusted model. Conclusion This is the first longitudinal study to determine the bidirectional association between homebound status and falls. Homebound status and falls form a vicious circle and mutually reinforce each other over time. Our findings suggest the importance of developing programs and community activities that reduce falls and improve homebound status among older adults.

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“…Eventually, HB leads to negative health outcomes such as mortality [ 8 , 9 ] and a low quality of life [ 10 ]. HB adversely affects health [ 8 ], and when health deteriorates, it causes HB again [ 11 ]. To avoid this vicious cycle of HB and poor health, it is necessary to explore the causes and status of HB.…”

Section: Introductionmentioning

confidence: 99%

A Scoping Review of Homebound Older People: Definition, Measurement and Determinants

Noh

2021

IJERPH

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Being homebound (HB) can affect people’s physical and mental health by decreasing movement, which can itself be exacerbated by the deterioration of people’s health. To break this vicious cycle of HB and being in poor health, it is necessary to identify and address the factors influencing HB status. Thus, we used a scoping review to identify an HB trend, focusing on the definition, measurements, and determinants of HB status. We analyzed 47 studies according to the five-stage methodological framework for scoping reviews. The common attribute of definitions of HB status was that the boundaries of daily life are limited to the home. However, this varied according to duration and causes of becoming HB; thus, the understanding of HB shifted from the presence or absence of being HB to the continuum of daily activity. Various definitions and measurements have been used to date. Many studies have focused on individual factors to analyze the effect of HB. In the future, it will be necessary to develop a standardized measurement that reflects the multidimensional HB state. In addition, it is necessary to utilize a theoretical framework to explore the social and environmental factors affecting HB.

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Multidimensional Factors Affecting Homebound Older Adults: A Systematic Review

Cited by 4 publications

References 0 publications

The trouble with personhood and person‐centred care

The trouble with personhood and person‐centred care

The bidirectional relationship between homebound status and falls among older adults: a longitudinal study

A Scoping Review of Homebound Older People: Definition, Measurement and Determinants

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