Formal home-care utilisation by older adults in Ireland: evidence from the Irish Longitudinal Study on Ageing (TILDA)

Murphy, Catríona; Whelan, Brendan J.; Normand, Charles

doi:10.1111/hsc.12157

Cited by 42 publications

(49 citation statements)

References 30 publications

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Section: Introductionmentioning

confidence: 99%

“…An estimated 8.2% of community dwelling Irish older adults aged 65 and over, utilise formal home help according to data from the Irish Longitudinal study of Aging (TILDA) [12]. The utilisation of these formal home help services increases gradually with age, from 1.6% of adults aged 65–69 up to 30.3% of those 85 years and older [12]. Access to formal government funded home help services varies across countries; in Ireland, provision is determined by an assessment of need conducted by a health professional and is not at present income assessed.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of frailty among community dwelling older adults in receipt of low level home support: a cross-sectional analysis of the North Dublin Cohort

et al. 2017

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BackgroundThere is increasing demand for formal government funded home help services to support community-dwelling older people in Ireland, yet limited information exists on the health profiles of this group, especially regarding frailty. Our aim was to profile a large cohort of adults in receipt of low level home help and to determine the prevalence of frailty.MethodsA total 1312 older adults, (≥ 65 years) in receipt of low level home help (< 5 h per week) were reviewed by community nurses and frailty was assessed using the Clinical Frailty Scale (CFS) in this cross-sectional study. Characteristics of the group were compared between males and females and prevalence of frailty was reported according to gender and principal care. Associations between frailty and a number of variables were explored using bivariate and regression analysis.ResultsThe cohort of low level home-help users was a mean age of 82.1 (SD 7.3) years, predominantly female (70.6%) and over half (69.2%) lived alone. The prevalence of frailty in this population was 41.5%, with subjects primarily considered mildly (23.2%) or moderately frail (14.5%) by the CFS. A further 38.4% were classed as vulnerable. The degree of frailty did not differ significantly across the younger categories aged 65–84 years. However, in the oldest age groups, namely 90–94 and >95 years, moderate frailty was significantly higher relative to the younger groups (21% and 34%, p < 0.05, p < 0.01 respectively). Home help hours significantly correlated with frailty (rs = 0.371, p < 0.001) and functional dependency (rs = 0.609, p < 0.001), but only weakly with age (rs = 0.101, p = 0.034). Based on regression analysis, determinants of frailty included greater dependency (Barthel score), higher home help hours, non-self-caring and communication difficulty, all of which significantly contributed to the model, with a r squared value of 0.508.ConclusionA high prevalence of frailty (41.5%) was documented in this population which associated with higher home help utilisation. Frailty was associated with greater functional dependency, but not strongly with chronological age, until after 90 years. These findings highlight opportunities for developing intervention strategies targeted at ageing in place among home help users.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-017-0508-2) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of frailty among community dwelling older adults in receipt of low level home support: a cross-sectional analysis of the North Dublin Cohort

et al. 2017

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“…A higher economic status is also associated with a greater probability of using formal care [9, 10]. Other variables such as age, gender, self-reported health, and chronic diseases were found to be significantly related in some studies [5, 6, 11–15]. The substitution or complement effects between formal and informal care have been discussed for a long time [16–21].…”

Section: Introductionmentioning

confidence: 99%

Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China

Fang

Gao

et al. 2017

PLoS ONE

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The need for formal care among the elderly population has been increasing due to their greater longevity and the evolution of family structure. We examined the determinants of the use and expenses of formal care among in-home elderly adults in Shanghai. A two-part model based on the data from the Shanghai Long-Term Care Needs Assessment Questionnaire was applied. A total of 8428 participants responded in 2014 and 7100 were followed up in 2015. The determinants of the probability of using formal care were analyzed in the first part of the model and the determinants of formal care expenses were analyzed in the second part. Demographic indicators, living arrangements, physical health status, and care type in 2014 were selected as independent variables. We found that individuals of older age; women; those with higher Activities of Daily Living (ADL) scores; those without spouse; those with higher income; those suffering from stroke, dementia, lower limb fracture, or advanced tumor; and those with previous experience of formal and informal care were more likely to receive formal care in 2015. Furthermore, age, income and formal care fee in 2014 were significant predictors of formal care expenses in 2015. Taken together, the results showed that formal care provision in Shanghai was not determined by ADL scores, but was instead more related to income. This implied an inappropriate distribution of formal care among elderly population in Shanghai. Additionally, it appeared difficult for the elderly to quit the formal care once they begun to use it. These results highlighted the importance of assessing the need for formal care, and suggested that the government offer guidance on formal care use for the elderly.

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“…In Ireland, an estimated 8.2% of older people living in the community avail of state-funded home help (Murphy et al 2015). Currently, the prevalence of dementia and cognitive impairment (CI) in this cohort remains undetermined, although it is anticipated that the level would be higher than in the general older population.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of dementia among community dwelling older adults in receipt of state funded home care packages: implications for health care planning

O’Brien¹,

Smuts²,

Fan

et al. 2017

Ir. j. psychol. Med.

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Objectives. The majority of people living with dementia in Ireland reside in their own homes, some supported by formal or informal home care. This audit aimed to estimate the prevalence of dementia and suspected cognitive impairment (CI) among older adults, 65+ years, in receipt of formal home care (domiciliary care) in a defined health service area in North Dublin. A secondary objective of the audit was to explore factors associated with dementia or CI in this cohort. Methods.A cross-sectional audit was conducted on all clients aged 65+ years actively receiving publicly funded home care packages (HCPs) during May 2016 in Healthcare Service Executive CHO9 Dublin North Central. A total of 935 urban community dwelling older adults were included in the study [mean age 83.7 (S.D. 7.4) years and 65% female]. Basic socio-demographic and health data were extracted from common summary assessment reports. Service users were categorised as having (a) dementia if a diagnosis of dementia or cognitive decline which impacts on independent living, was documented by a health professional or (b) suspected CI where a validated cognitive screening tool was applied and the score was indicative of mild CI.Results. Overall, the estimated prevalence of dementia and suspected CI was 37.1% and 8.7%, respectively. Factors significantly associated with dementia and suspected CI were higher dependency and home care hours, communication difficulty and being non-self-caring (p < 0.001). Notably, half (51.6%) of those with either dementia or suspected CI group lived alone.Conclusions. Our findings suggest a high prevalence dementia among HCP users, highlighting a need and opportunity for dementia-specific approaches to support older people in their homes.

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Formal home-care utilisation by older adults in Ireland: evidence from the Irish Longitudinal Study on Ageing (TILDA)

Cited by 42 publications

References 30 publications

Prevalence of frailty among community dwelling older adults in receipt of low level home support: a cross-sectional analysis of the North Dublin Cohort

Prevalence of frailty among community dwelling older adults in receipt of low level home support: a cross-sectional analysis of the North Dublin Cohort

Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China

High prevalence of dementia among community dwelling older adults in receipt of state funded home care packages: implications for health care planning

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