An exploration of help-seeking behaviour in older people with unmet needs

Walters, Kate; Iliffe, Steve; Orrell, Martin

doi:10.1093/fampra/18.3.277

Cited by 98 publications

(108 citation statements)

References 2 publications

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“…These ''apparently healthy'' older people are often overlooked within general practice. However, they may fail to seek help or care for their unmet problems or complaints for various reasons (Walters et al 2001). Therefore, this purposive sample might be particularly interesting for GPs as the results of the geriatric assessment might add to their current knowledge of the older person's health and well-being.…”

Section: Selection Of Older Peoplementioning

confidence: 99%

Development of a home visitation programme for the early detection of health problems in potentially frail community-dwelling older people by general practices

Stijnen

Jansen²,

Vrijhoef

et al. 2012

Eur J Ageing

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The integration within existing health care systems of preventive initiatives to maintain independent living among older people is increasingly emphasized. This article describes the development and refinement of the [G]OLD home visitation programme: an eight-step programme, including a comprehensive geriatric assessment, for the early detection of health and well-being problems among older people (C75 years) by general practices. A single group post-test study using a mixed model design is performed to evaluate (a) the feasibility of the home visitation programme in general practice, (b) the practical usefulness of the geriatric assessment instrument, and (c) programme implementation with respect to reinventions introduced by general practitioners (GPs) and practice nurses (PNs). Within 3 months time, 22 PNs of 18 participating general practices visited 240 community-dwelling older people (mean age = 82.0 years; SD 4.2) who had not been in contact with their general practice for more than 6 months. Mean time investment of the programme per older person was 118.1 min (SD 27.0) for GPs and PNs combined. Evaluation meetings revealed that GPs and PNs considered the home visitation programme to be feasible in daily practice. They judged the geriatric assessment to be useful, although minor adjustments are needed (e.g., layout, substitution of tests). PNs often failed to register follow-up actions for detected problems in a care and treatment plan. Future training for PNs should address this issue. No reinventions were introduced that threatened fidelity of implementation. The findings are used to improve the home visitation programme before its evaluation in a large-scale controlled trial.

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Section: Selection Of Older Peoplementioning

confidence: 99%

Development of a home visitation programme for the early detection of health problems in potentially frail community-dwelling older people by general practices

Stijnen

Jansen²,

Vrijhoef

et al. 2012

Eur J Ageing

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show abstract

“…Further, UI is considered to be a social taboo and stigmatizing, which is often another reason for women to not seek healthcare or delay in seeking healthcare services for their UI (Hagglund et al, 2003;Howard & Steggall, 2010). Walters et al (2001) cited that withdrawal, resignation and low expectations were found to be dominant reasons for women not seeking assistance for their UI. Further, Horrocks et al (2004) in a grounded theory study of twenty participants over 65 years old added that reasons for not seeking help for UI were independent management of UI, reactions to incontinence and attitudes to ageing and health.…”

Section: The Marginalization Of Elderly Womenmentioning

confidence: 99%

Elderly Women and Urinary Incontinence in Long-Term Care

Macdonald¹

2012

Urinary Incontinence

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“…17 A health diary study among older people in rural areas also reported that most symptoms were ignored or managed by responders themselves (that is, selfmedication), and when others are consulted these are most likely to be friends and relatives rather than health professionals. 23 The present findings, however, did not support this view.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…14 Other studies have noted that older people may have a reluctance to seek treatment, 15 for example, due to the 'normalisation' of their symptoms in terms of age, even if these symptoms remain highly disruptive; 16 this has also been termed 'age attribution'. 17 This body of work has contributed to the prevailing view of the stoical older person, who may be less likely than other age groups to seek medical intervention. Separately, it has been suggested that women do not identify their symptoms as relating to CHD, as CHD is viewed as largely a male disease.…”

Section: Introductionmentioning

confidence: 99%

Age and sex interaction in reported help seeking in response to chest pain

Adamson

Donovan²,

Ben-Shlomo³

et al. 2008

Br J Gen Pract

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There is a growing literature suggesting that access to cardiology services is affected by age. However, there is a dearth of studies that have considered age and sex in conjunction. AimThis study aims to examine the impact of age, and its interaction with sex, on reported healthcare seeking, based on responses to symptom vignettes, in an attempt to standardise symptomatology across all responders. Design of studyA cross-sectional survey design was utilised. SettingPrimary care. MethodA random sample of 911 individuals, stratified by sex, was selected from one practice in the UK. Participants were invited to state how they would react in response to the chest pain symptoms presented. Patterns of response were examined, by age and sex, using χ 2 and logistic regression models. ResultsThis study identified differences by age and sex in a general practice population in the propensity to seek health care. In particular, men aged 60-69 years and women aged 70 years and over were more likely to report healthcare seeking than younger responders. For example, women aged 70 years and over had over three times greater odds of reporting contact with the GP compared to the reference category. Evidence for an interaction effect between age and sex was observed. ConclusionThe results suggest that the inequity that has been demonstrated in access to cardiology services by age is not likely to be due to the patient's illness behaviour as, overall, older people are more likely than younger people to be willing to consult their doctors. Keywordsaged; gender identity; heart; patient acceptance of health care.

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An exploration of help-seeking behaviour in older people with unmet needs

Abstract: The majority of older people and their carers do not appear to seek help for their unmet needs for a range of complex reasons, often involving issues of withdrawal, resignation and low expectations. This complexity has implications for the commissioning of services for older people.

Cited by 98 publications

References 2 publications

Development of a home visitation programme for the early detection of health problems in potentially frail community-dwelling older people by general practices

Development of a home visitation programme for the early detection of health problems in potentially frail community-dwelling older people by general practices

Elderly Women and Urinary Incontinence in Long-Term Care

Age and sex interaction in reported help seeking in response to chest pain

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