The aim was to test sampling and explore sample characteristics in a pilot study using a case management intervention for older people with functional dependency and repeated contact with the healthcare services as well as to investigate the effects of the intervention on perceived health and depressed mood after 3 months. The aim was also to explore internal consistency in the life satisfaction index Z, activities of daily living-staircase and Geriatric Depression Scale-20.
This pilot study was carried out in a randomised controlled design with repeated follow-ups. In all, 46 people were consecutively and randomly assigned to either an intervention (n = 23) or a control (n = 23) group. Two nurses worked as case managers and carried out the intervention, which consisted of four parts.
No differences were found between the groups at baseline. The results showed the participants had low life satisfaction (median 14 vs. 12), several health complaints (median 11) and a high score on the Geriatric Depression Scale (median 6) at baseline, indicating the risk of depression. No significant effects were observed regarding depressed mood or perceived health between or within groups at follow-up after 3 months. Cronbach's alpha showed satisfactory internal consistency for group comparisons.
The sampling procedure led to similar groups. The life satisfaction, functional dependency and symptoms of depression measures were reliable to use. No changes in perceived health and symptoms of depression were found after 3 months, indicating that it may be too early to expect effects. The low depression score is noteworthy and requires further research.
Doctoral Student, Department of Health Sciences, Lund University, Lund, Sweden and Faculty of Nursing, University of Iceland, Reykjavik, Iceland and The National University Hospital of Iceland, Reykjavik, Iceland Professor, Department of Health Sciences, Lund University, Lund, Sweden and The Swedish Institute for Health Sciences, Lund, Sweden Lecturer, Department of Health Sciences, Lund University, Lund, Sweden Senior Lecturer, Department of Health Sciences, Lund University, Lund, Sweden.
hjaltadóttir i., hallberg i.r., ekwall a.k. & nyberg p. (2011) Health status and functional profile at admission of nursing home residents in Iceland over 11-year period. International Journal of Older People Nursing doi: 10.1111/j.1748-3743.2011.00287.x Background. The knowledge over time of the health status and changes in care needs of newly admitted nursing home residents is limited. Objectives. To investigate trends in residents' health status and functional profile at admission to nursing homes and compare rural and capital areas in Iceland over an 11-year period. Design. Retrospective analysis of nursing home data over 11 years (1996-2006). Participants. Residents, who had been assessed with the Minimum Data Set assessment within 90 days from admittance (n = 2206). Method. Non-parametric tests for descriptive statistics and linear regressions were used to analyse time trends. Results. The mean age ranged from 80.1 to 82.8, and women accounted for 52.7% to 67.1%. The level of independency indicated intact cognitive performance in 28.6-61.4% and in 42.5-68% in activities of daily living performance. A weak, but significant, linear trend was seen in residents' health becoming less stable, their cognitive performance improving, more pain being reported and greater participation in social activities over the 11 years. Conclusion. Some residents might have stayed at home longer had they been given appropriate home care and the opportunity of rehabilitation. Pain management and social activities are areas where more staff knowledge seems to be needed. Implications for practice. Resources to enable old people to remain at home need to be explored before their entry into nursing homes. Whereas providing services at the appropriate level is important for society as well as older people.
AIM: This paper reports a study investigating quality of life in relation to loneliness, caregiving, social network, gender, age and economic status among caregiving men and women in a population-based sample aged 75 years or older. BACKGROUND: Because of demographic changes, in the future more care for older people will be given by informal caregivers who are themselves older. Being old and caring for another older person may affect various aspects of life, such as physical and emotional health and decreased time for respite, which may affect social life and quality of life. METHOD: A postal questionnaire including the Short Form Health Survey was used. The sample consisted of 4278 people, aged 75 years and over, living in Sweden. Of these, 783 (18%) were caregivers. FINDINGS: Caregivers had a larger social network and reported feelings of loneliness less often than non-caregivers. Forty per cent of caregivers helped every day. There were gender differences in experiences of loneliness during the last year, with the frequency of intense feelings of loneliness being higher among women. Loneliness and a small or non-existent network were significantly associated with low quality of life among caregivers, as well as in the total sample. The results showed significant association between loneliness, weak social network and low mental quality of life. CONCLUSIONS: The fact that loneliness was the most important factor predicting low quality of life among caregivers, as well as older people in general, indicates that it is crucial in the care of older people. From a nursing perspective, the findings indicate the advantage of helping older people to keep up and develop their social networks. Nursing care should involve steps to maintain the social network before an older person becomes too weak, since decreased health status makes social contacts more difficult.