Quality of life among older people in Sweden receiving help from informal and/or formal helpers at home or in special accommodation
TL;DR: A need for greater help with ADLs, and a higher number of self-reported diseases and complaints determined low quality of life, whilst a social network (contact with more than three people) and a greater age determined high QoL.
Abstract: The present study describes and compares quality of life (QoL) and factors which predict QoL among people aged 75 years and over who receive help with activities of daily living (ADLs) from formal and/or informal helpers. The subjects were living at home or in special accommodation in Sweden. A postal questionnaire was sent to a randomly selected and age-stratified sample of 8500 people. The response rate was 52.8% (n = 4337), and 1247 people [mean age (+/- SD) = 86.4 +/- 5.9 years] received help and indicated who helped them with ADLs. The findings suggest that a greater age, being a woman, being a widow/widower, a higher number of health-related complaints, needing more help with ADLs and a lower QoL were found among those receiving help in special accommodation in comparison with those receiving help at home. The extent of help was highest among those receiving help in special accommodation. Having help with ADLs every day at home indicated having help from both informal and formal helpers, while respondents receiving help from only informal or only formal helpers received the smallest amount of help with ADLs. A need for greater help with ADLs, and a higher number of self-reported diseases and complaints determined low QoL, whilst a social network (contact with more than three people) and a greater age determined high QoL. However, who the helpers were did not have a significant influence on QoL; it was the extent of help with ADLs that influenced QoL negatively and the density of the social network that influenced QoL positively.
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01 Jan 2005
TL;DR: In this paper, the authors investigate type, degree and patterns of health complaints, need for help and health-related quality of life across gender among persons aged 75?105 as well as identify how patterns related to the need to seek medical help with daily activities.
Abstract: Aim: The aim of this thesis was to investigate type, degree and patterns of health complaints, need for help and health-related quality of life across gender among persons aged 75?105 as well as to identify how patterns of health complaints, gender, age and socio-economic factors related to need for help with daily activities and quality of life (Paper I). The aim was also to investigate the prevalence of self-reported symptoms of urinary, faecal and double incontinence among men and women aged 75 and above, and to identify how other health complaints and quality of life relate to incontinence symptoms (Paper II). Furthermore urinary symptoms and their influence on daily life among elderly (75+) women and men were compared in a sample that previously reported having incontinence and/or other urinary symptoms. A further aim was to find underlying structures of urinary symptoms and to identify symptoms which had an impact on seeking medical help and need for help in daily activities (Paper III). The aim of the fourth study was to compare faecal incontinence and related bowel symptoms in relation to gender and being dependent or not (aged 75 and above) and to identify which bowel symptoms predicted help seeking, dependency and low quality of life (Paper IV).
Design: A cross-sectional design in a randomly selected sample of 8500 persons 75 years and above in four age groups of five-year intervals. They received a postal questionnaire including questions about health, socio-economy, quality of life and need for help in daily activities. In the follow-up persons received another postal questionnaire with focused questions depending on previous reported health complaints. Those needing help in daily activities once a week or more were visited in their own homes and interviewed face to face. The first sample (Papers I, II) included 4277 persons, mean age for women 84.3 and for men 82.7 years. The second sample (Paper III) included 771 persons who had reported difficulties controlling urine or other urinary problems. The sample in Paper IV included 248 persons who had reported difficulties controlling stool.
Result: Coexisting health complaints, i.e. multi-complaints, had impact on QoL as well as on dependency. The patterns of health complaints could be understood from a functional perspective. Problems in communication, mobility and psychosocial functions were those most common and with the highest severity. Women were especially affected as they had more health complaints in functions that were related to help in ADL and to low QoL. Furthermore the prevalence of urinary, faecal and double incontinence was high in all age groups and higher with more advanced age. Incontinence had a negative impact on quality of life and increased need for help in daily activities, and those with double incontinence were the most affected. Among those with urinary problems the character of symptoms differed in storage or voiding symptoms among men and women. However, the influence on social life, avoidance of places and situations and the impact on the whole life seemed equal. Less than 50% had sought medical help for their symptoms and few wore protective aids, especially men. Diarrhoea, constipation, incomplete emptying and laxative use were common among those who reported faecal incontinence, and few had sought medical help or wore protection.
Conclusion: Patterns of health complaints indicated problems on a functional level of importance for need for help in daily activities as well as quality of life. Mobility, psychosocial, communication and elimination problems were strongly related to dependency and low health-related QoL. Women seem to be more at risk as they were more often affected in three of these functions and thus more often dependent and had lower QoL. Women also seemed to have more additional negative socio-economic factors. Dysfunctions that were most common should be focused on and interventions aiming to reduce such complaints are of high priority. Overall urinary and bowel functions seem to be equally as important as incontinence per se and therefore a wider perspective when investigating these symptoms would benefit decisions about investigations and help. Men and women have different needs and none of them should be overlooked. There is a risk that men are neglected as incontinence is regarded as a female problem. Urinary, faecal and double incontinence were common conditions but also other urinary and bowel problems, and few had sought help although they reported considerable problems. All urinary problems as well as bowel-related problems seemingly interacted and had equal effect on daily life and quality of life. Therefore those areas should preferably be seen together and not separately.
7 citations
01 Jan 2017
TL;DR: The timing of the transition from work to retirement is important for older individuals for economic, personal and family reasons, as well as for aging societies contemplatin... as mentioned in this paper. But it is not a simple transition.
Abstract: Retirement transition is a major life event in later adult life. Its timing is important for older individuals for economic, personal and family reasons, as well as for aging societies contemplatin ...
7 citations
TL;DR: The GPs’ opinion and ISCOPE-score improve this prediction model for functional decline based on readily available variables, and could identify older patients for further assessment with their clinical judgement.
Abstract: A first step to offer community-dwelling older persons proactive care is to identify those at risk of functional decline within a year. This study investigates the predictive value of registered information, questionnaire and GP-opinion on functional decline. In this cohort study, embedded within the ISCOPE-trial, participants (≥75 years) completed the ISCOPE-screening questionnaire on four health domains. GPs gave their opinion on vulnerability of participants. Functional status was measured at baseline and 12 months (Groningen Activities Restriction Scale [GARS]). The outcome was functional decline (death, nursing home admission, 10% with greatest functional decline). The predictive value of pre-selected variables (age, sex, polypharmacy, multimorbidity, living situation; GPs’ opinion on vulnerability, number of domains with problems [ISCOPE-score]) was compared with the area under the curves (AUC) for logistic regression models. 2018 of the 2211 participants (median age 82.1 years [IQR 78.8–86.5], 68.0% female, median GARS 31 [IQR 24–41]) were visited at 12 months (median GARS 34 [IQR 26–44]). 394 participants (17.8%) had functional decline (148 died, 45 nursing home admissions, 201 with greatest functional decline). The AUC for age and sex was 0.602, increasing to 0.620 (p = 0.029) with polypharmacy, multimorbidity and living situation. The GPs’ opinion added more (AUC 0.672, p < 0.001) than the ISCOPE-score (AUC 0.649, p = 0.007). AUC with all variables was 0.686 (p = 0.016), and 0.643 for GPs’ opinion alone. The GPs’ opinion and ISCOPE-score improve this prediction model for functional decline based on readily available variables. GPs could identify older patients for further assessment with their clinical judgement. Netherlands trial register, NTR1946
. Registered 10 August 2009.
6 citations
Cites background from "Quality of life among older people ..."
...Previous research has shown that being independent has a positive effect on the quality of life [1, 2]....
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Dissertation•
09 Dec 2006
TL;DR: In this paper, the authors explore the quality of life experience of older recipients of home based services by exploring in particular the QL experience of nine older people who live at home and access low level home support services (between one and three hours of home support per week for six months or more) in a selected locale in New Zealand.
Abstract: Quality of life is a concept that has been subject to considerable academic gaze from mainly a quantitative perspective. Qualitative descriptions have been limited to conceptualising quality of life from a health perspective. Little attention has been paid to understanding quality of life as it is experienced, perceived and interpreted by older people. Still missing in the great quality of life debate is the voice of older people. This is an interesting predicament considering the assumptions made about population ageing and ageing in place. This phenomenological study breaks the silence on the quality of life experience of older recipients of home based services by exploring in particular the quality of life experience of nine older people who live at home and access low level home support services (between one and three hours of home support per week for six months or more) in a selected locale in New Zealand. It also sheds light on the role home support plays at the "lower" end of health resource allocation to elderly recipients' quality of life. As well as providing valuable insights on elders' perceptions of current national policy that advocates for ageing in place. Through face to face interviews using a semi-structured format this study found that while quality of life as a notion remains evasive to academics and professionals its meaning is well understood and easily expressed by elders themselves. Giving meaning to quality of life for the elders in this study were six key features: the good people in their lives, taking care of day to day life, keeping healthy, living with loss, thinking of the future and being the age that they are. They confirmed that quality of life is a dynamic concept made up of multiple interconnected realities that are both positive and negative in nature but where the whole is greater than the sum of its parts. As an experience quality of life was influenced by events over the life course and viewed relative to other older people's lives. Home helpers made a vital contribution to these elders' quality of life experience but ageing in place as a policy construct extended no further than the current provision of low level home support they accessed.
6 citations
TL;DR: It was found that the majority respondents had visual impairment and blindness in compare with normal vision and the subjects with visual impairment had poorer quality of life than subjects without visual impairment.
Abstract: The purpose of this study was to determine factors are associated to visual impairment and assess quality of life among two welfare home residents. A cross-sectional design was employed to determine the factors that are associated with visual impairment among elderly people. A total of 150 subjects were selected by simple random sampling from two welfare homes (Cheras in Selangor, and Seremban) in Malaysia. The socio-demographic variables (age, gender, ethnicity, income), health behavior (smoking) and self-reported medical condition (diabetic, eye disease, hypertension, heart disease, and stroke) were examined in relationship with visual impairment. Instruments used in this study included eye exam test by Snellen E Chart and a list of questions about socio-demographic factors, health behavior and self-reported medical conditions and disease. Data analyzes were carried out using SPSS, 20. Descriptive analysis such as mean, standard deviation (SD) and frequency were utilized to describe the characteristics of the respondents. The mean age of respondents was 69 years (SD = 7.31). A chi-square test (Pd” 0.05) and multiple linear regression (R2=0.64) analyzes were utilized to determine predictors of visual impairment. Also independent t test were utilized to determine quality of life among elderly people. It was found that the majority respondents had visual impairment (46%) and blindness (28%) in compare with normal vision (26%).Sociodemographic factors (age,gender,ethnicity,income) health behavior (smoking) and disease (diabetic,eye disease, heart disease, hypertension and stroke) were associated to visual impairment. Also the subjects with visual impairment had poorer quality of life than subjects without visual impairment. The results indicated the important role of visual impairment on quality of life among elderly people. Health care providers are in position to prevent and control of visual impairment. Visual impairment should be acknowledged and emphasized in policy and intervention programs are needed to improve quality of life in older Malaysians. Key word: visual impairment, quality of life, welfare homes, elderly.
5 citations
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TL;DR: A 36-item short-form survey designed for use in clinical practice and research, health policy evaluations, and general population surveys to survey health status in the Medical Outcomes Study is constructed.
Abstract: A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.
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TL;DR: Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions.
Abstract: Regression methods were used to select and score 12 items from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to reproduce the Physical Component Summary and Mental Component Summary scales in the general US population (n=2,333). The resulting 12-item short-form (SF-12) achieved multiple R squares of 0.911 and 0.918 in predictions of the SF-36 Physical Component Summary and SF-36 Mental Component Summary scores, respectively. Scoring algorithms from the general population used to score 12-item versions of the two components (Physical Components Summary and Mental Component Summary) achieved R squares of 0.905 with the SF-36 Physical Component Summary and 0.938 with SF-36 Mental Component Summary when cross-validated in the Medical Outcomes Study. Test-retest (2-week)correlations of 0.89 and 0.76 were observed for the 12-item Physical Component Summary and the 12-item Mental Component Summary, respectively, in the general US population (n=232). Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the 12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions, acute symptoms, age and aging, self-reported 1-year changes in health, and recovery for depression. In 14 validity tests involving physical criteria, relative validity estimates for the 12-item Physical Component Summary ranged from 0.43 to 0.93 (median=0.67) in comparison with the best 36-item short-form scale. Relative validity estimates for the 12-item Mental Component Summary in 6 tests involving mental criteria ranged from 0.60 to 107 (median=0.97) in relation to the best 36-item short-form scale. Average scores for the 2 summary measures, and those for most scales in the 8-scale profile based on the 12-item short-form, closely mirrored those for the 36-item short-form, although standard errors were nearly always larger for the 12-item short-form.
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TL;DR: The 22-item Philadelphia Geriatric Center Morale Scale was subjected to a series of principal component analyses utilizing different item pools and rotating differing numbers of factors, suggesting three consistently reproduced factors.
Abstract: The 22-item Philadelphia Geriatric Center (PGC) Morale Scale was subjected to a series of principal component analyses utilizing different item pools and rotating differing numbers of factors. Subjects were 1086 tenants of federally-assisted housing for the elderly and older people living in the community. Results were compared with analyses of the PGC Scale done by Morris and Sherwood. Consideration of factors defined by the analyses suggested three consistently reproduced factors: Agitation, Attitude Toward Own Aging, and Lonely Dissatisfaction, utilizing 17 of the original items. These results were compared with other multi-dimensional measures of morale: the Bradburn Affect Balance Scale, and morale scales reported by Pierce and Clark, and Schooler. In addition to the dimensions derived from the current study related domains of self-rated health, social accessibility, generalized attitude toward aging, and positive affect were suggested as worthy of further exploration as dimensions of morale.
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TL;DR: Empirical evidence is yielded supporting the feasibility of a non-English language reproduction of the SF-36 Health Survey in Sweden and tests of scaling assumptions including hypothesized item groupings were consistently favorable across subgroups, although lower rates were noted in the oldest age group.
1,344 citations