Physical and Mental Health of Homebound Older Adults: An Overlooked Population

Qiu, Wei Qiao; Dean, Michael J.; Liu, Timothy; George, Linda A.; Gann, Margery; Cohen, Joshua T.; Bruce, Martha L.

doi:10.1111/j.1532-5415.2010.03161.x

Cited by 232 publications

(293 citation statements)

References 39 publications

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“…[19][20][21][22] The comparisons between the results with previous research are complicated due to the considerable differences in the study populations and the heterogeneity of the definitions of homebound status. 6 Not surprisingly, increasing age was significantly associated with being a homebound person, consistent with previous research conducted with older people. 1,4,9,13 Regarding mobility skills, the multivariate analysis showed that independence in walking activity is a crucial element in the task of going outside.…”

Section: Discussionsupporting

confidence: 88%

“…6,17 However, this study focused on people who remained inside the home during the previous week. The findings showed that the homebound status was a highly prevalent problem in the study population.…”

Section: Discussionmentioning

confidence: 99%

“…Being homebound was associated with older age, 1,4,9,13 female gender, 1,3,8,9,13 and being widowed. 4,8 Other studies have reported more chronic health conditions 4,6 and cognitive 1,6 or sensory 1 impairments in the homebound group. However, relatively little is known regarding the role of environmental factors.…”

mentioning

confidence: 90%

“…Clinical experience suggests that home confinement is a common problem in the everyday life of people with major disabilities, particularly in people with limited basic ADLs. Homebound status has been associated with loneliness, 1 depression, [1][2][3][4][5] comorbidity, 1,6 hospitalization, 4,7 and worse self-reported health status 1,8 ; moreover, it is a risk factor for mortality. 3,7,8 Previous research has estimated the prevalence of homebound status in the older population, 1,4,[8][9][10][11] using diverse definitions.…”

mentioning

confidence: 99%

“…3,7,8 Previous research has estimated the prevalence of homebound status in the older population, 1,4,[8][9][10][11] using diverse definitions. 6 Several studies have defined being homebound as going out of the house once a week or less, with a prevalence ranging between 7.5% and 19% 1,4,9,11 ; the prevalence was below 5% when this frequency was less than once a week. 8,12 In a community sample of older people, 3.5% of the participants remained inside the home in the last month.…”

mentioning

confidence: 99%

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Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors

Celeiro

Santos-del-Riego

Muñiz

2017

Disability and Health Journal

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Background. Homebound status is associated with poor health, comorbidity, and mortality and represents a major challenge for health systems. However, its prevalence among people with disabilities in the basic activities of daily living (ADLs) is unknown. Objectives. The objectives were to: (1) examine the prevalence of the homebound status among middle-aged and older adults with disabilities in ADLs, and (2) identify its clinical, functional, and environmental determinants.Methods. This study included 221 community-dwelling subjects, aged ≥50 years, who applied for long-term care services at the Office for Legal Certification of Long-term Care Need of Coruña (Spain). Each subject had a disability in ADLs and was interviewed by a trained examiner in the subject's home. The participants were considered homebound if they remained inside their home during the previous week. Measures. Demographic, clinical, functional, and environmental factors. Multiple logistic regression was used to determine the factors associated with homebound status. Results. The prevalence of homebound status was 39.8%. A multivariate analysis revealed that the presence of architectural barriers at the home entrance (stairs [OR: 6.67, p < 0.001] or a heavy door [OR: 2.83, p = 0.023]), walking ability limitations (OR: 3.26, p = 0.006), and higher age (OR: 1.05, p = 0.04) were associated with homebound status. Conclusions. Homebound status is a highly prevalent problem among middle-aged and older adults with disabilities in ADLs. Architectural factors in the home and walking ability limitations seem to be important predictors, suggesting that health care interventions should target home adaptations and mobility skills as a means to preventing or decreasing homebound status.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 90%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors

Celeiro

Santos-del-Riego

Muñiz

2017

Disability and Health Journal

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Epidemiology of the Homebound Population in the United States

et al. 2015

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Increasing numbers of older, community-dwelling adults have functional impairments that prevent them from leaving their homes. It is uncertain how many people who live in the United States are homebound.OBJECTIVES To develop measures of the frequency of leaving and ability to leave the home and to use these measures to estimate the size of the homebound population in the US population. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional data from the National Health and Aging Trends Study collected in 2011 in the contiguous United States. Participants were a nationally representative sample of 7603 noninstitutionalized Medicare beneficiaries 65 years and older. MAIN OUTCOMES AND MEASURESWe defined homebound persons as those who never (completely homebound) or rarely (mostly homebound) left the home in the last month. We defined semihomebound persons as those who only left the home with assistance or had difficulty or needed help leaving the home. We compared demographic, clinical, and health care utilization characteristics across different homebound status categories. RESULTSIn 2011, the prevalence of homebound individuals was 5.6% (95% CI, 5.1%-6.2%), including an estimated 395 422 people who were completely homebound and 1 578 984 people who were mostly homebound. Among semihomebound individuals, the prevalence of those who never left home without personal assistance was 3.3% (95% CI, 2.8%-3.8%), and the prevalence of those who required help or had difficulty was 11.7% (95% CI, 10.9%-12.6%). Completely homebound individuals were more likely to be older (83.2 vs 74.3 years, P < .001), female (67.9% vs 53.4%, P < .006), and of nonwhite race (34.1% vs 17.6%, P < .001) and have less education and income than nonhomebound individuals. They also had more chronic conditions (4.9 vs 2.5) and were more likely to have been hospitalized in the last 12 months (52.1% vs 16.2%) (P < .001 for both). Only 11.9% of completely homebound individuals reported receiving primary care services at home. CONCLUSIONS AND RELEVANCEIn total, 5.6% of the elderly, community-dwelling Medicare population (approximately 2 million people) were completely or mostly homebound in 2011. Our findings can inform improvements in clinical and social services for these individuals.

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Association of the COVID-19 Pandemic With the Prevalence of Homebound Older Adults in the United States, 2011-2020

Ankuda¹,

Leff

Ritchie

et al. 2021

JAMA Intern Med

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Older adults who are homebound, defined as leaving home once a week or less, are often socially isolated, have unmet care needs, and have high mortality. 1,2 In 2011, more older adults in the United States were homebound than living in nursing homes. 1 The COVID-19 pandemic may have led to an increase in the number of homebound older adults who were at heightened risk for infection with SARS-CoV-2. 3 Moreover, although Black non-Hispanic and Hispanic/Latino individuals have disproportionately died from COVID-19, 4 it is unknown whether they were more likely to be homebound during the pandemic. We assessed the size and characteristics of the homebound population in the United States in 2020, including household size, 5 important for disease transmission risks, and digital access, which is important for telemedicine and online vaccination registration.

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Physical and Mental Health of Homebound Older Adults: An Overlooked Population

Cited by 232 publications

References 39 publications

Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors

Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors

Epidemiology of the Homebound Population in the United States

Association of the COVID-19 Pandemic With the Prevalence of Homebound Older Adults in the United States, 2011-2020

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