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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Dissertation•
01 Jan 2006
TL;DR: The essential meaning of the lived experience of getting cancer in old age was shown to be illness as a turning point marking old age, and clinical practice needs to pay specific attention to the most vulnerable groups of elderly persons with cancer.
Abstract: Over the coming decades, the numbers of elderly will increase, and through improved lifestyles and better treatment longevity has increased, and with it, the risk of contracting cancer. How elderly people live with cancer has until now attracted limited research. The overall aim of this thesis was to investigate the QoL of elderly persons from the time of a cancer diagnosis through the following six months. The aim was further to investigate changes in QoL over time in relation to type of cancer, age, socio-economic conditions, ability to perform Activities of Daily Living (ADL), contact with the health-care system, social network and support, and hope. Moreover, the aim was to illuminate the lived experience of getting cancer in old age. The study had both a quantitative and a qualitative part. The quantitative part was a follow-up study of 101 individuals (65+) recently diagnosed with cancer (74 women, 27 men), but was reduced to 75 (57 women, 18 men) by the six-month investigation point. QoL of newly diagnosed persons with cancer aged 65 years were investigated at baseline, and three and six months after using: EORTC QLQ-C30, Katz ADL-Index, Nowotny's Hope Scale and the Interview Schedule for Social Interaction (ISSI). The follow-up study was based on an interview schedule performed as three structured interviews. In the qualitative study, a descriptive phenomenological method was used to investigate ?the lived experience of getting cancer in old age?. In total, 16 persons, all recruited from the follow-up study, (aged 65+, mean age 76 (range 68-83)) with cancer were interviewed based on open-ended interview.
Factors associated with low QoL at baseline were ?no other incomes than retirement pension?, ?low level of hope?, and ?lung cancer?. In addition, ?needing more help in activities of daily living?, ?getting help from grown-up children? and ?needing help with PADL (Personal Activities in Daily Living)? were associated with low QoL. No significant changes were found in QoL from baseline to three months, while perceived social network deteriorated significantly. Dependency, reduced financial circumstances, and low level of hope were significantly associated with low QoL at the three-month follow-up. Fatigue was the most reported symptom at baseline and at three and six months. Emotional function improved significantly during the six first months, and complaints of nausea and vomiting decreased significantly. Support from grandchildren increased significantly. 'Contact with district nurse' at baseline predicted deteriorated QoL from baseline following six months, as well as 'low level of hope' and 'needing more help in daily living'. About 30% of the total sample deteriorated in QoL from baseline to 6-month follow-up. The findings in the qualitative study showed the essential meaning of the lived experience to be ?Illness as a turning point marking old age?. This was represented by three essences: ?Illness means losing control?, ?Disturbing the family balance? and ?Life and death suddenly apparent?. These three essences were signified in seven constituents: getting cancer meant being forced into the role of a patient, losing control, and being dependent on health care. Balancing one's own needs and burdens with the needs and uncertainties of family members became essential; as a parallel to being conscious of dying and death, hope and enjoyment of life became vital.
The majority of the participants showed an ability to adjust to the new condition. However, about one third had deteriorated in QoL by the significant ?10 units at six-month follow-up, and clinical practice needs to pay specific attention to the most vulnerable groups of elderly persons with cancer. The most vulnerable stood out as those with advanced disease and decreased hope, those with increased need of both formal and informal assistance, those with reduced financial means and those with lung cancer, and thus they need specific attention from health care professionals. In addition, health care professionals need to be conscious that the elderly with cancer are a heterogeneous group. Therefore, it is important to identify the specific meaning that the cancer has for the individual, and to understand the particular abilities he or she has to adapt to the illness and the process of growing old as a part of their life.
2 citations
Cites background from "Quality of life among older people ..."
...A study by Hellström (2004) among old people (age 75+, n=1247), receiving help in ADL, showed that a high level of help, more than other factors such as type of housing and age, in PADL particularly affected QoL negatively (Hellstrom et al., 2004)....
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TL;DR: Depression, pain, and leg muscle strength are related toquality of life in elderly users of day care rehabilitation services when evaluating quality of life using health-related quality oflife and subjective well-being as a single construct.
Abstract: Aim: We aimed to clarify the physical, mental and social factors related to the quality of life of the elderly adults who require long-term care. Methods: The physical functions of 123 users of day care rehabilitation services were measured. Survey and measurement items were the physical and mental component summaries of the 8-item Short-Form Health Survey, Life Satisfaction Index K, 30-Second Chair-Stand Test, 5-meter walking time maximum, pain, Geriatric Depression Scale-15, K-I Scale, Japanese version of the abbreviated Lubben Social Network Scale, age, gender, nursing care level, living arrangements, residence history, educational level, and hobbies. Canonical correlation analysis was used to clarify factors related to quality of life. Results: The Geriatric Depression Scale-15 was found to be related to the Life Satisfaction Index K and mental component summary. The 30-Second Chair-Stand and pain were found to be related to the physical component summary. Conclusions: Depression, pain, and leg muscle strength are related to quality of life in elderly users of day care rehabilitation services when evaluating quality of life using health-related quality of life and subjective well-being as a single construct. Hirosaki Med.J. 70:130―138,2020
1 citations
Abstract: Home and community care is an important way to actively respond to population aging and to promote healthy aging. This study aims to estimate the effect of using home and community care services on the multidimensional health of older adults. We used data from the China Health and Retirement Longitudinal Study conducted in 2018 and relied mainly on the propensity score matching method for data analysis. The results showed that using home and community care increased the probability of maintaining and improving physical health by 2.9%, decreased the score of depression by 0.471, and improved the score of cognitive function by 0.704. Using home and community care also increased the probability of actively participating in life by 4.1% and elevated the score of life satisfaction by 0.088. The heterogeneity analysis showed that the use of home and community care had a significant effect on promoting all health indicators in rural older adults and a more obvious promoting effect on the social adaptation of urban older adults. Using home and community care significantly promoted the multidimensional health of people aged 60 to 79 years but had no impact among people aged ≥ 80 years. The use of home and community care significantly improved all health indicators in non-disabled older adults. Whereas, it only improved the levels of cognitive function and life satisfaction in disabled older people. Using this form of care significantly improved all health indicators in those with low socio-economic status, but it only had a partial positive effect on the multidimensional health of those with high socio-economic status. Our results are of importance to the government as they may be used to further improve the quality of home and community care services for the targeted older population.
1 citations
TL;DR: In this paper , the authors outline the research framework of a scoping review designed to map the available evidence of the effects of multicomponent rehabilitation on the independence and functional capacity of elderly patients hospitalised for age-related diseases in four main medical specialties beyond geriatrics.
Abstract: Introduction Elderly patients after hospitalisation for acute events on account of age-related diseases (eg, joint or heart valve replacement surgery) are often characterised by a remarkably reduced functional health. Multicomponent rehabilitation (MR) is considered an appropriate approach to restore the functioning of these patients. However, its efficacy in improving functioning-related outcomes such as care dependency, activities of daily living (ADL), physical function and health-related quality of life (HRQL) remains unclarified. We outline the research framework of a scoping review designed to map the available evidence of the effects of MR on the independence and functional capacity of elderly patients hospitalised for age-related diseases in four main medical specialties beyond geriatrics. Methods and analysis The biomedical databases (PubMed, Cochrane Library, ICTRP Search Platform, ClinicalTrials) and additionally Google Scholar will be systematically searched for studies comparing centre-based MR with usual care in patients ≥75 years of age, hospitalised for common acute events due to age-related diseases (eg, joint replacement, stroke) in one of the specialties of orthopaedics, oncology, cardiology or neurology. MR is defined as exercise training and at least one additional component (eg, nutritional counselling), starting within 3 months after hospital discharge. Randomised controlled trials as well as prospective and retrospective controlled cohort studies will be included from inception and without language restriction. Studies investigating patients <75 years, other specialties (eg, geriatrics), rehabilitation definition or differently designed will be excluded. Care dependency after at least a 6-month follow-up is set as the primary outcome. Physical function, HRQL, ADL, rehospitalisation and mortality will be additionally considered. Data for each outcome will be summarised, stratified by specialty, study design and type of assessment. Furthermore, quality assessment of the included studies will be performed. Ethics and dissemination Ethical approval is not required. Findings will be published in a peer-reviewed journal and presented at national and/or international congresses. Trial registration number https://doi.org/10.17605/OSF.IO/GFK5C.
01 Jan 2014
TL;DR: This licentiate thesis is based on the growing interest in Swedish elderly care and aims to investigate what generates satisfaction with elderly care among older persons.
Abstract: This licentiate thesis is based on the growing interest in Swedish elderly care. The aim of this thesis is to investigate what generates satisfaction with elderly care among older persons. The domi ...
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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.
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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.
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14,793 citations
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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.
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