Social networks and health: impact on returning home after entry into residential care homes

Examining the social networks of older adults receiving informal or formal care: a systematic review

PURPOSE

To address the care needs of older adults, it is important to identify and understand the forms of care support older adults received. This systematic review aims to examine the social networks of older adults receiving informal or formal care and the factors that influenced their networks.

METHODS

A systematic review was conducted by searching six databases from inception to January 31, 2023. The review included primary studies focusing on older adults receiving long-term care, encompassing both informal and formal care. To assess the risk of bias in the included studies, validated appraisal tools specifically designed for different study types were utilized. Network analysis was employed to identify the grouping of study concepts, which subsequently formed the foundation for describing themes through narrative synthesis.

RESULTS

We identified 121 studies relating to the formal and informal care of older adults' networks. A variety of social ties were examined by included studies. The most commonly examined sources of care support were family members (such as children and spouses) and friends. Several factors were consistently reported to influence the provision of informal care, including the intensity of networks, reciprocity, and geographical proximity. In terms of formal care utilization, older age and poor health status were found to be associated with increased use of healthcare services. Additionally, physical limitations and cognitive impairment were identified as factors contributing to decreased social engagement.

CONCLUSION

This review found that older people were embedded within a diverse network. The findings of this review emphasize the importance of recognizing and incorporating the diversity of social networks in care plans and policies to enhance the effectiveness of interventions and improve the overall well-being of older adults.

Measurement Properties of the l Test for Gait in Hospitalized Elderly

OBJECTIVE

Evaluate the reliability, validity, and predictive value of the L test, a performance-based walk test, among older inpatients.

DESIGN

Cross-sectional study involving a consecutive sample of 50 older adults (mean age 84 +/- 5 yrs) admitted to the geriatric unit of a tertiary care hospital. Application of the L test twice and single application of the timed "up and go" test (TUG), and the Frailty and Injuries Cooperative Studies of Intervention Techniques (FICSIT-4) balance scale, were conducted.

RESULTS

Interrater and intrarater reliability (two-way ANOVA intraclass correlation coefficients [ICC]) of the L test was 1.00 (95% confidence interval, CI, 0.99-1.00) and 0.97, respectively (CI, 0.95-0.98). Hypothesized associations with the TUG and FICSIT-4 were observed (Pearson product-moment correlation, r = 0.96 and r = -0.45, respectively; P < 0.01) with regard to magnitude and direction of the relationship. L test times demonstrated a small but statistically significant independent risk factor for discharge destination after hospitalization (odds ratio = 1.05; CI, 1.01-1.09) after adjustment for age, sex, and cognitive status.

CONCLUSIONS

The L test provides reliable, valid data when assessing basic walking skills among older adults in a hospital environment. The L test is potentially an important clinical and research tool to assess the mobility function of older inpatients as they transition back to the community.

Using network variation in practice: identification of support network type

This paper evaluates the use of a support network measurement instrument (PANT) in social work practice, focusing primarily on a study of the introduction and use of the instrument with social work teams. The paper describes practitioners' responses during the training period and during the initial phases of using the instrument in practice. The findings show how growth in familiarity with the new tool and support from managers overcame early resistance and contributed to both practitioners' confidence and understanding of the situations of older people. It allowed them to tailor interventions appropriately. It also contributed to understanding of differences between teams in the area and made it possible to create area profiles of older service users, their carers and their needs. The importance of network type for prediction of outcomes is stressed.

Behavioral management for bladder control: response in selected rural residential care homes

Urinary incontinence is a problem for elders in many settings, including rural residential care homes (RCHs). Behavioral techniques for the management of urinary incontinence have been successful with community-dwelling and nursing home populations. A study was undertaken to evaluate the feasibility of implementing bladder diaries and bladder training to assist RCH residents with bladder control. These techniques were found not to be successful in selected rural RCHs. The characteristics of rural RCHs are explored, and the impediments and incentives to the use of behavioral management techniques for urinary incontinence in these settings are examined.