Multidimensional measures validated for home health needs of older persons: A systematic review

The Major Domains of Comprehensive Assessment Tools for Older Adults Requiring Home-Based Aged Care Services: A Systematic Review

BACKGROUND/OBJECTIVES

The global population is aging rapidly, increasing the need for appropriate health care. Older people often prefer to remain in their homes for as long as possible as they age. Therefore, it is crucial to assess their overall health and understand the individualized care needs for developing tailored home care services. This systematic review aims to examine the major domains of a range of assessment tools used for older people receiving home care services.

METHODS

A systematic search of Medline and PsycINFO via Ovid, CINAHL via EBSCO, Web of Science, and Scopus was conducted to identify studies investigating assessment of older people requiring home care services. The literature findings were systematically synthesized and classified using the International Classification of Functioning, Disability and Health (ICF) by the World Health Organization (WHO).

RESULTS

A total of 32 studies were included in the systematic review. Three primary categories were identified based on the WHO ICF classification system: (1) body functions, (2) activities and participation, and (3) environmental factors. Body functions included physical functions and mental functions. Mobility, self-care, and domestic life were three major aspects within the ICF category of activities and participation. Regarding the environmental factors, support, relationships, and services provided to older people were commonly considered in the included studies. Among them, the most assessed domains were physical, psychological, cognitive, functional, and nutritional assessment.

CONCLUSIONS

The synthesis of findings in this review reveals major domains in various assessment tools, contributing to the development of a comprehensive framework to guide the assessment for older people requiring home care services.

Toward developing care outcome quality indicators for home care for older people: A prospective cohort study in Japan

INTRODUCTION

Care quality in Japan's long-term care (LTC) agencies, including home care, is the responsibility primarily of individual agencies, and the evaluation of service processes and outcomes is minimal.

OBJECTIVES

To describe the development of quality indicators for LTC (QIs-LTC) in Japan.

METHODS

QIs-LTC were developed through literature review and expert panel discussions and then were piloted and used in a 2-year longitudinal survey. The survey (launched in September 2019) targeted older people receiving home care (n = 1450), their family members (n = 880), their professional home care providers (n = 577), and managers of home care agencies (n = 122).

RESULTS

Across eight domains (maintaining dignity, minimizing symptoms and disease deterioration, maintaining nutritional status, maintaining bladder/bowel control, encouraging physical activities, experiencing sound sleep, maintaining serenity and contentedness, and maintaining family's well-being), 24 care quality objectives were set with 24 outcome QIs-LTC and 144 process QIs-LTC. In the survey, 84.8% of clients were using home care nursing, 26.3% were living alone, and 39.5% had dementia. In the month preceding the data collection, 13.9% of clients had a new disease or worsening of an existing disease, 8.8% were hospitalized at least once, and 47.9% did not participate in activities of interest. About 20% of clients' families were unable to spend time peacefully, and 52.8% were exhausted from the client's care.

CONCLUSIONS

The QIs-LTC developed in the current study are generic and client- and family-centered. They encompass objective and subjective information and would facilitate standardized monitoring if adopted and comparison between LTC settings, including home care. In addition, future research directives are outlined. Geriatr Gerontol Int 2023; 23: 383-394.

Importancia y generalidades de la valoración geriátrica integral como herramienta de abordaje de la persona mayor en atención domiciliaria

La atención domiciliaria es uno de los niveles asistenciales más populares en los últimos años, permitiendo dar continuidad a la atención de personas hospitalizadas pero también, manejando personas con condiciones crónicas, discapacidad y trastornos neurocognitivos. Con este estudio, resaltamos los objetivos, componentes y beneficios de la valoración geriátrica en el domicilio.

The needs of older people receiving home care: a scoping review

BACKGROUND

Most people in a state of illness or reduced self-sufficiency wish to remain in their home environment. Their physiological needs, and their psychological, social, and environmental needs, must be fully met when providing care in their home environment. The aim of this study is to provide an overview of the self-perceived needs of older people living with illness or reduced self-sufficiency and receiving professional home care.

METHODS

A scoping review of articles published between 2009 and 2018 was conducted by searching six databases and Google Scholar. Inductive thematic analysis was used to analyze data from the articles retrieved.

RESULTS

15 articles were included in the analysis. Inductive thematic analysis identified six themes: coping with illness; autonomy; relationship with professionals; quality, safe and secure care; role in society; environment.

CONCLUSION/DISCUSSION

Older home care patients living with chronic illness and reduced self-sufficiency are able to express their needs and wishes. Care must, therefore, be planned in line with recipients' needs and wishes, which requires a holistic approach.