Who Lives Where and Does It Matter? Changes in the Health Profiles of Older People Living in Long Term Care and the Community over Two Decades in a High Income Country

Matthews, Fiona E.; Bennett, Holly; Wittenberg, Raphael; Jagger, Carol; Dening, Tom; Brayne, Carol

doi:10.1371/journal.pone.0161705

Cited by 47 publications

(41 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on the qualitative and quantitative findings, no adverse effects were noted such as an increase in medication use or distress in family caregivers. The quantitative results were congruent with the qualitative results and showed a trend toward improvement on all These results were based on a sample of older people who had characteristics similar (severity of cognitive impairment, age) to the ones found in LTCF of various countries (Cohen-Mansfield & Werner, 1997;Matthews et al, 2016;Røen et al, 2017), except for gender. In these studies, 64 to 81% of participants were women.…”

Section: Discussionsupporting

confidence: 74%

Effects of an Intervention Approach Based on the Meanings of Vocal Behaviours in Older People Living with a Major Neurocognitive Disorder: A Pilot Study

Bourbonnais

Ducharme

Landreville

et al. 2019

Science of Nursing and Health Practices - Science infirmière et

View full text Add to dashboard Cite

Effets d'une démarche d'interventions basée sur les sens des comportements vocauxEffets d'une démarche d'interventions basée sur les sens des comportements vocaux de personnes âgées vivant avec un trouble neurocognitif majeur : une étude pilote de personnes âgées vivant avec un trouble neurocognitif majeur : une étude pilote Abstract Introduction: Vocal behaviours (VB) are frequent in long-term care facilities (LTCF) and have many negative consequences. Interventions to decrease VB have limited clinical impact. Objective: This pilot study aimed to provide preliminary evidence on the effects of an intervention approach based on the meanings of VB in older people living with a neurocognitive disorder in LTCF. Methods: A mixed methods action research study was used. Fourteen triads (n=43) made up of an older person who manifested VB, a family member, and formal caregivers were included. An approach based on the meanings of VB was implemented in five LTCF. Semistructured interviews took place with some participants. Tools were used at four-time points to measure five variables: the frequency of VB, the well-being of older people, the perceived disruptiveness of VB, the partnership-based decision-making and the empowerment felt by family and formal caregivers. Results: The approach improved the perception of family and formal caregivers toward older people. This led to habit changes that influenced positively the frequency of VB and the well-being of older people. Formal and family caregivers also perceived VB as less disturbing and felt more empowered relatively to VB. The attitude of formal caregivers toward families evolved positively. No other changes were noted on partnership-based decisionmaking. Discussion and conclusion: This study indicates the potential of this approach to improve the well-being of older people who manifested VB, their families, and formal caregivers. This approach could be implemented in LTCF, tested and adapted for other behaviours.

show abstract

Section: Discussionsupporting

confidence: 74%

Effects of an Intervention Approach Based on the Meanings of Vocal Behaviours in Older People Living with a Major Neurocognitive Disorder: A Pilot Study

Bourbonnais

Ducharme

Landreville

et al. 2019

Science of Nursing and Health Practices - Science infirmière et

View full text Add to dashboard Cite

show abstract

“…The past two decades have seen reductions in the overall numbers in care homes but higher prevalence of functional and cognitive impairments among residents. 30 Our findings showed that more years were spent with high dependency, and that older people with substantial dependencies are now more likely to live supported in the community. If dependency prevalence remains constant, we estimate that by 2025 there will be an additional 353 000 older people with substantial dependencies; they will have complex care needs that require sustained input from family carers or community health or social care teams to support independent living.…”

Section: Discussionmentioning

confidence: 58%

Is late-life dependency increasing or not? A comparison of the Cognitive Function and Ageing Studies (CFAS)

et al. 2017

Self Cite

View full text Add to dashboard Cite

SummaryBackgroundLittle is known about how the proportions of dependency states have changed between generational cohorts of older people. We aimed to estimate years lived in different dependency states at age 65 years in 1991 and 2011, and new projections of future demand for care.MethodsIn this population-based study, we compared two Cognitive Function and Ageing Studies (CFAS I and CFAS II) of older people (aged ≥65 years) who were permanently registered with a general practice in three defined geographical areas (Cambridgeshire, Newcastle, and Nottingham; UK). These studies were done two decades apart (1991 and 2011). General practices provided lists of individuals to be contacted and were asked to exclude those who had died or might die over the next month. Baseline interviews were done in the community and care homes. Participants were stratified by age, and interviews occurred only after written informed consent was obtained. Information collected included basic sociodemographics, cognitive status, urinary incontinence, and self-reported ability to do activities of daily living. CFAS I was assigned as the 1991 cohort and CFAS II as the 2011 cohort, and both studies provided prevalence estimates of dependency in four states: high dependency (24-h care), medium dependency (daily care), low dependency (less than daily), and independent. Years in each dependency state were calculated by Sullivan's method. To project future demands for social care, the proportions in each dependency state (by age group and sex) were applied to the 2014 England population projections.FindingsBetween 1991 and 2011, there were significant increases in years lived from age 65 years with low dependency (1·7 years [95% CI 1·0–2·4] for men and 2·4 years [1·8–3·1] for women) and increases with high dependency (0·9 years [0·2–1·7] for men and 1·3 years [0·5–2·1] for women). The majority of men's extra years of life were spent independent (36·3%) or with low dependency (36·3%) whereas for women the majority were spent with low dependency (58·0%), and only 4·8% were independent. There were substantial reductions in the proportions with medium and high dependency who lived in care homes, although, if these dependency and care home proportions remain constant in the future, further population ageing will require an extra 71 215 care home places by 2025.InterpretationOn average older men now spend 2·4 years and women 3·0 years with substantial care needs, and most will live in the community. These findings have considerable implications for families of older people who provide the majority of unpaid care, but the findings also provide valuable new information for governments and care providers planning the resources and funding required for the care of their future ageing populations.FundingMedical Research Council (G9901400) and (G06010220), with support from the National Institute for Health Research Comprehensive Local research networks in West Anglia and Trent, UK, and Neurodegenerative Disease Research Network in Newcastle, UK.

show abstract

“…We are uncertain whether the results from tertiary health care settings or nursing homes can be generalized to primary health care settings, considering that the patients in primary care can differ in their health profiles and comorbidities. 11,12 To this end, we sought to conduct a systematic review with meta-analysis to pool the adverse outcomes of PIP reported in the literature, specifically focusing on older persons in primary care.…”

mentioning

confidence: 99%

Potentially Inappropriate Prescribing Among Older Persons: A Meta-Analysis of Observational Studies

et al. 2019

View full text Add to dashboard Cite

PURPOSE Potentially inappropriate prescribing (PIP) is a common yet preventable medical error among older persons in primary care. It is uncertain whether PIP produces adverse outcomes in this population, however. We conducted a systematic review with meta-analysis to pool the adverse outcomes of PIP specific to primary care. METHOD We searched PubMed, Embase, CINAHL, Web of Science, Scopus, PsycINFO, and previous review articles for studies related to "older persons," "primary care," and "inappropriate prescribing." Two reviewers selected eligible articles, extracted data, and evaluated the risk of bias. Meta-analysis was conducted to pool studies with similar PIP criteria and outcome measures. RESULTS Of the 2,804 articles identified, we included 8 articles with a total of 77,624 participants. All included studies had cohort design and low risk of bias. Although PIP did not affect mortality (risk ratio [RR] 0.98; 95% CI, 0.93-1.05), it was significantly associated with the other available outcomes, including emergency room visits (RR 1.63; 95% CI, 1.32-2.00), adverse drug events (RR 1.34; 95% CI, 1.09-1.66), functional decline (RR 1.53; 95% CI, 1.08-2.18), health-related quality of life (standardized mean difference-0.26; 95% CI,-0.36 to-0.16), and hospitalizations (RR 1.25; 95% CI, 1.09-1.44). A majority of the pooled estimates had negligible heterogeneity. CONCLUSIONS This meta-analysis provides consolidated evidence on the wideranging impact of PIP among older persons in primary care. It highlights the need to identify PIP in primary care, calls for further research on PIP interventions in primary care, and points to the need to consider potential implications when deciding on the operational criteria of PIP.

show abstract

Who Lives Where and Does It Matter? Changes in the Health Profiles of Older People Living in Long Term Care and the Community over Two Decades in a High Income Country

Cited by 47 publications

References 25 publications

Effects of an Intervention Approach Based on the Meanings of Vocal Behaviours in Older People Living with a Major Neurocognitive Disorder: A Pilot Study

Effects of an Intervention Approach Based on the Meanings of Vocal Behaviours in Older People Living with a Major Neurocognitive Disorder: A Pilot Study

Is late-life dependency increasing or not? A comparison of the Cognitive Function and Ageing Studies (CFAS)

Potentially Inappropriate Prescribing Among Older Persons: A Meta-Analysis of Observational Studies

Contact Info

Product

Resources

About