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 Nov 2017
TL;DR: A recent NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers.
Abstract: This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference.
158 citations
TL;DR: This study confirms theories suggesting that the last phase of life in old age meant focusing inwards, reflecting on the entire life as a way of completing it as well as enjoying small things and also viewing oneself in the perspective of contributing to the future.
99 citations
TL;DR: Quality control standards, which can guide measurement assessment and subsequent data interpretation, are needed to enhance more consistent reporting of the psychometric properties of QoL instruments utilized.
Abstract: Instruments with acceptable measurement properties that support their application to older adults across a range of settings need to be identified. A narrative literature review of empirical studies investigating the conceptualization and measurement of quality of life (QoL) among older adults from 1994 to 2006 was performed. The review focused on evidence provided for conceptual frameworks, QoL definitions, types of measurements utilized and their psychometric properties. Two searches were conducted. The first search conducted in 2004 used Cinahl, Medline, PsycInfo, Embase and Cochrane databases. A supplemental search was conducted in December 2006, which included these bases from 2004 to 2006, and Sociological Abstracts and Anthropological literature base. The review included 47 papers. A total of 40 different measurements were applied in the studies, assessing most frequently functional status and symptoms. The most extensive psychometric evidence was documented for the SF-36. Although construct validity was reported in the majority of studies, minimal empirical evidence was given for other psychometric properties. Further, 87% of the studies lacked a conceptual framework and 55% did not report any methodological considerations related to older adults. Quality control standards, which can guide measurement assessment and subsequent data interpretation, are needed to enhance more consistent reporting of the psychometric properties of QoL instruments utilized. Future work on the development of common QoL assessment models that are both person-centered, causal and multidimensional based on collaborative efforts from professionals interested in QoL from the international gerontological research community are needed.
91 citations
TL;DR: A research agenda is suggested that attempts to tease out causal relationships for family involvement, differentiate family roles, and implement longitudinal analyses for a range of family outcomes.
Abstract: PURPOSE: Despite growing research on assisted living (AL) as a residential care option for older adults, the social ramifications of residents' transitions to assisted living is relatively unexplored. This article examines family involvement in AL, including family structures of residents, types of involvement from family members living outside the AL, and outcomes for these family members. DESIGN AND METHODS: We reviewed current literature utilizing the MEDLINE, PSYCINFO, and CINAHL databases to identify AL studies that examined issues pertaining to families or informal care. Following the screening of abstracts, 180 reports were retrieved for further review, and 62 studies were selected for inclusion. RESULTS: Families visit residents frequently and provide a wide range of instrumental assistance but provide only minimal personal care. Studies of family outcomes indicated relatively high satisfaction, but potential care burden as well. IMPLICATIONS: How family care and involvement occurs in AL in relation to formal care provision and whether various types of formal-informal care integration influence family outcomes remains unclear. We suggest a research agenda that attempts to tease out causal relationships for family involvement, differentiate family roles, and implement longitudinal analyses for a range of family outcomes.
64 citations
TL;DR: A dyadic approach seems most suitable for dementia care, as focus of care is on the person with dementia and their informal caregivers, and a trusting relationship and a specific person or organization to contact seem to be indicators of best practice.
Abstract: To investigate persons with dementia and their informal caregivers' views of inter-sectoral information, communication and collaboration throughout the trajectory of dementia care, in eight European countries.
60 citations
References
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TL;DR: The results support the idea that various personality characteristics are related to various life quality dimensions in the investigated group, increasing the understanding of unique experience of life quality for each individual.
Abstract: Quality of life has various dimensions with multiple meanings for people. One vital issue is whether a person's subjective experienced quality of life correlates with his or her personality. Several studies show a correlation between personality and quality of life, life satisfaction or well-being. The aim of this study was to examine the relationship between personality and life quality, in particular the way in which multi-dimensional conceptualization of personality relates to a multi-dimensional definition of life quality. Seventy-eight elderly individuals completed a quality of life questionnaire, the Lund Gerontology Centre's Life Quality Questionnaire (LGC), and a personality questionnaire, the Gordon Personal Profile Inventory (GP:A). Discriminant analysis showed that various personality characteristics relate to different aspects of life quality. Vigour alone predicted current quality of life, while emotional stability was related to psychological well-being and satisfaction with significant relationships. Ascendancy and ability to maintain personal relations were related to an optimistic outlook on life and absence of psychosomatic symptoms. Original thinking and sociability related to increased psychosomatic symptoms and sociability also correlated negatively with satisfaction with significant relationships. The results support the idea that various personality characteristics are related to various life quality dimensions in the investigated group, increasing the understanding of unique experience of life quality for each individual.
29 citations
TL;DR: The Sickness impact Profile was used to assess functional ability and various sociodemographic characteristics of 553 elderly persons on their need for domestic assistance.
Abstract: We examined the effects of functional ability and various sociodemographic characteristics of 553 elderly persons on their need for domestic assistance. The Sickness impact Profile was used to assess functional ability. Multiple logistic regression identified the following statistically significant determinants of informal home help (including various practical activity of daily living [ADL] chores): poor physical status, age greater than 85 years, male gender, not living alone, and living in a rural district. The following determinants of formal home help manifested themselves: poor physical status, male gender, and living alone. Physical status, age, gender, and district of domicile were independently associated with overall use of home help.
25 citations
Journal Article•
TL;DR: In a representative, nationwide sample of non-institutionalized elderly in Sweden the bulk of help with basic and instrumental ADL came from informal sources, with the preference for formal services being strongest among the elderly with the greatest need of care.
Abstract: In a representative, nationwide sample of non-institutionalized elderly in Sweden the bulk of help with basic and instrumental ADL came from informal sources. Formal services played a complementary role and were primarily associated with advanced age and living alone. The findings also indicated a strong preference among the elderly for informal support,with the preference for formal services being strongest among the elderly with the greatest need of care.
21 citations
TL;DR: The findings suggest that age, the amount of instrumental support needed, and perceptions of physical health are important indicators of the psychological well-being of elderly care-recipients.
Abstract: The purpose of this study was to examine the association of the quality of caregiver relationships with the psychological well-being of elderly care-recipients. Sociodemographic variables and characteristics of the care-recipient situation (e.g., self-rated physical health, amount of instrumental support needed) were explored as potential predictors of the psychological well-being of elderly individuals. A secondary analysis of data collected during in-home interviews with 37 community-dwelling older adults revealed no significant correlations between the quality of the primary intimate relationship and any dimension of psychological well-being. However, better self-rated health was associated with fewer depressive symptoms, higher morale, greater life satisfaction, and better quality of life. The more instrumental support needed by an individual, the greater their depressive symptoms and the lower their morale. The findings also revealed that the older the individual was, the greater the depressive symptoms were and the lower life satisfaction became. Self-rated physical health predicted each dimension of psychological well-being. The findings suggest that age, the amount of instrumental support needed, and perceptions of physical health are important indicators of the psychological well-being of elderly care-recipients.
18 citations
TL;DR: There were many similarities between the recipients of high-extent home help, and the residents in service houses, concerning the care they receive and their care-givers.
Abstract: This article describes and compares public home-help services and institutional care of the elderly in Sweden, regarding the care-recipients, the care they receive and their care-givers. Interviews were carried out on 364 elderly (65+) care receivers, living in the community or in different institutions. Proxy interviews were used when direct interviews were impossible because of mental impairment or poor health. The institutionalized elderly were older and more often functionally disabled, especially cognitively impaired. They received more care and in more different forms than the elderly living in the community. However, the picture was not unambiguous. The occurrence of health problems, and the daily use of medication was rather similar in the two types of care. Half the home-help recipients received a great deal of help frequently, and sometimes even around the clock. There were many similarities between the recipients of high-extent home help, and the residents in service houses, concerning...
14 citations