Loneliness of Older Persons in Home Care In Iceland

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnObjective: to explore the association between loneliness and affective, cognitive, physical and social factors for older persons in home care. Design: descriptive cross sectional study. Setting: random sample of home care clients in Reykjavik area. Subjects: 257 individuals were assessed with the Minimum Data Set for Home Care (InterRAI- HC) instrument. Results: 20.3% of home care clients expressed loneliness, 18.3% of men and 20.9% of women with widowed persons being more likely to be lonely than married persons, p=0.013, as were they who assessed their health as being poor, p=0.042 . Women with cognitive impairment were more likely to be lonely, p=0.022 and they were more likely to have depressive symptoms, p=0.025. Women who took more than six medications were more likely to be lonely (79.2% vs. 20.8%, p=0.018). Lonely women took more neuroleptics (p=0.007) but lonely males more hypnotics (p=0.046). Lonely women agreed more with the statement that they would be better of elsewhere (43.5% vs. 12.7%, p<0.0001). Being mostly indoors was not associated with loneliness and there was no association with use of formal care services. Conclusion: Loneliness was identified in one fifth of persons in home care, more often among widowed persons and women with cognitive impairment and among those who assessed their health as being poor. Sex difference was seen with regards to affective symptoms and medication use. Further studies are needed to understand how the needs of lonely persons in home care can be best met. Key words: loneliness, home care, elderly, primary, health carePrimary Health Care, VASS, Icelandic Gerontological Research center

Loneliness of Older Persons in Home Care In Iceland

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnObjective: to explore the association between loneliness and affective, cognitive, physical and social factors for older persons in home care. Design: descriptive cross sectional study. Setting: random sample of home care clients in Reykjavik area. Subjects: 257 individuals were assessed with the Minimum Data Set for Home Care (InterRAI- HC) instrument. Results: 20.3% of home care clients expressed loneliness, 18.3% of men and 20.9% of women with widowed persons being more likely to be lonely than married persons, p=0.013, as were they who assessed their health as being poor, p=0.042 . Women with cognitive impairment were more likely to be lonely, p=0.022 and they were more likely to have depressive symptoms, p=0.025. Women who took more than six medications were more likely to be lonely (79.2% vs. 20.8%, p=0.018). Lonely women took more neuroleptics (p=0.007) but lonely males more hypnotics (p=0.046). Lonely women agreed more with the statement that they would be better of elsewhere (43.5% vs. 12.7%, p<0.0001). Being mostly indoors was not associated with loneliness and there was no association with use of formal care services. Conclusion: Loneliness was identified in one fifth of persons in home care, more often among widowed persons and women with cognitive impairment and among those who assessed their health as being poor. Sex difference was seen with regards to affective symptoms and medication use. Further studies are needed to understand how the needs of lonely persons in home care can be best met. Key words: loneliness, home care, elderly, primary, health carePrimary Health Care, VASS, Icelandic Gerontological Research center

Substantial between-country differences in organising community care for older people in Europe-a review

The European population is aging. The main drivers of public spending on health care for people of 65 years and older are hospital admission and admission to long-term care facilities. High quality community care can be a cost-effective and quality solution to respond to the impact of ageing populations on health-care systems. It is unclear how well countries are equipped to provide affordable and quality community care. The aim of this article is to describe and compare community care delivery with care-dependent older people in Europe.  METHODS: This study is conducted within the European Union-financed IBenC project [Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (FP7)] in which six European countries are involved. To compare the community care delivery with care-dependent older people in these countries, we performed a systematic comparison of macro indicators using metadata complemented with data from multinational surveys.  RESULTS: Data on the following dimensions are described and compared: population of the country, governmental expenditures on health, sources of community health services funding, governmental vision and regulation on community care, community care organisations and care professionals, eligibility criteria for and equity in receiving care and the involvement of informal care.  CONCLUSION: : Because of the variations in the European community care contexts, the growing demand for community care as a cost-effective and quality solution to the care burden of aging populations will have country-specific impacts. When learning from other countries' best practices, in addition to researchers, policy makers should take full account of local and national care contexts