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A Six-Month Profile of Community Case Coordinated Older Adults Profil sur six mois de personnes âgées coordonnées recevant des services en milieu communautaire

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Abstract:

The purpose of this study was to assess the needs of older case coordinated clients receiving community health services, by examining changes in cognitive status, physical and mental health status, social support, risk for institutionalization, and service use over a 6-month period from initial intake into home care. Significant predictors of professional and supportive home care, as well as emergency room use and hospital days, were also examined. Standardized interviews were conducted with 234 clients at the time of referral; follow-up interviews were conducted with 179 of these clients after 6 months of case coordination. Results reveal that physical and mental health improved, while cognitive status remained stable. Although social interaction and instrumental support decreased, subjective support remained stable. Risk of institutionalization decreased. Occupational therapy, nursing, and homemaking were the most frequently used services. The best predictor of professional and supportive home care was a risk of institutionalization score. The needs of this older adult population changed even within the relatively short span of 6 months. Frequent review of needs in some form may be warranted in order to maintain effective service plans.

French
Cette étude visait à évaluer les besoins de clients âgés coordonnés recevant des services de santé communautaire par l'examen des changements survenus dans l'état cognitif, l'état de santé physique et mentale, le soutien social, le risque de placement en établissement, et l'utilisation des services sur six mois, de l'accueil initial jusqu'aux soins à domicile. Elle a également comporté l'examen d'indicateurs prévisionnels importants des soins de santé professionnels et des soins à domicile, ainsi que du recours aux urgences et des journées d'hospitalisation. Des entrevues dirigées ont été menées auprès de 234 clients au moment de l'orientation; des entrevues de suivi ont été menées auprès de 179 de ces clients après une coordination de cas de six mois. Selon les résultats, une amélioration de la santé physique et mentale a été notée, tandis que l'état cognitif est demeuré stable. Bien que l'interaction sociale et le soutien instrumental aient diminué, le soutien subjectif est demeuré stable. Le risque de placement en établissement a diminué. Les services les plus fréquemment utilisés ont été l'ergothérapie, les soins infirmiers et l'aide familiale. Le barème de risque de placement en établissement a constitué le meilleur indicateur prévisionnel des soins professionnels et des soins de soutien à domicile. Les besoins de cette population de personnes âgées ont changé, même au cours d'une période aussi relativement courte que six mois. Il pourrait être justifié de mettre en place un système d'évaluation fréquente des besoins pour pouvoir maintenir des plans de services efficaces.

Keywords: CASE COORDINATION; HEALTH PROFILE; OLDER ADULTS; RISK OF INSTITUTIONALIZATION; SERVICE USE

Document Type: Research Article

Publication date: September 1, 2006

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