Quality of life in older people receiving ADL help: Help, help providers, and complaints.

The aim of this thesis was to investigate self-reported diseases and complaints, quality of life (QoL), help received with activities of daily living among older people and in relation to who provided the help, and in comparison with those without ADL help. The aim was also to investigate older people’s experiences of receiving help. Data were collected using postal questionnaires in two population samples and one interview study. The first sample (Papers I, II, and III) included 1 248 people (age 75–99 years) living in ordinary homes, where 448 people received help and 793 did not. Of those 448 (mean age 84.2, SD 5.2, women 66%, married 34%, widowed 54%, and living alone 62%) 45.1% received help from only informal helpers, 14.3% from only formal helpers and 39.1% from a combination of informal and formal helpers. The second sample (Paper IV) included 1 247 people (aged 75–104 years, mean age 86.4, SD 5.9, women 73%, married 16%, widowed 68, and living alone 81%) receiving help. It consisted of people who received help either in ordinary homes, 73.7% (48.6% from only informal helpers, 21.2% from only formal helpers, 30.2% from a combination of informal and formal helpers) or in special accommodations, 26.3% (70.4% from only formal helpers and 29.6% from a combination of informal and formal helpers). People receiving help with ADL were mostly women, widowed, and living alone, had higher age, more children and a higher number of self-reported diseases and complaints, and were less able to be alone at home by themselves than those without help. Self-reported diseases were above all mainly musculoskeletal diseases, other circulatory diseases, eye diseases and hypertension and did not differ with regard to age. Complaints among people receiving help were musculoskeletal pain (78.6%), impaired mobility (68.8%), impaired hearing (58%) and impaired sight (57.7%) (Papers I and II). Those receiving help had significantly lower QoL than those without help (Paper II). People receiving help and living in special accommodation had significantly lower global QoL than those living in ordinary homes (Paper IV). Significant predictors of low global QoL among people receiving help were living alone, not managing to be alone at home (Papers I, II, and III), higher numbers of self-reported diseases (Paper IV) and higher number of complaints (Papers I, III, and IV), and help with IADL and PADL (Paper IV). Predictors of low HRQoL were help with PADL and higher number of self-reported diseases (Paper IV) among people receiving help. Higher age (Papers I, III, and IV) and social networks (Paper IV) were predictors of high global QoL and high HRQoL (MCS, SF-12). Predictors of receiving informal help at home were lower age, lower number of complaints, living together with someone, and being able to be alone at home, which was not the case for those receiving informal and formal help (Paper III). Living alone and having fewer children were predictors of receiving formal help, thus differing from receiving only informal help (Paper III). Interviews with 14 people (age 79–98 years, mean age 87.4, SD 6.8, married 28.6%, widowed 71.4%) receiving help either in ordinary homes or in special accommodation showed that in general they disliked the situation of receiving help and viewed themselves as not dependent. In conclusion, the thesis showed high involvement from informal helpers, although this differed from 84% to 79% in the two samples. High number of diseases and complaints, living alone, and not managing to stay alone at home had a negative influence on QoL. However, social network had the opposite influence on QoL among older people. The most frequent help with IADL was in cleaning and shopping and with PADL in bathing or showering

Quality of life and symptoms among older people living at home

Aim. This paper reports a study comparing the socio-demographic data, quality of life (QoL) and symptoms of older people living at home with and without help.Background. Despite growing numbers of older people worldwide, little is know about the differences between older people receiving help to live at home and those not receiving this, especially as regards QoL and symptoms. Not only symptoms but also dependency on others per se may reduce older people's QoL. From a nursing perspective, knowledge about such issues is important because the impact of symptoms may be reducible, even when diseases cannot be cured.Method. A postal questionnaire was sent to an age-stratified random sample of 1866 people aged 75 years or over. Of the respondents (n = 1248) 448 received help and 793 did not.Results. The group receiving help had a significantly higher age, more women, more people widowed and living alone, more children, a higher number of self-reported diseases and symptoms, greater inability to remain alone at home and lower QoL. Loneliness, depressed mood and abdominal pain were significantly related to low QoL in both groups. Living alone, not being able to remain alone at home without help, and fatigue were also predictive of low QoL among those receiving help, and number of diseases and sleep problems in those without.Conclusion. Receiving help with daily living seems to be significantly related to low QoL and goes along with a high number of symptoms that need to be considered in nursing care. Through regular visits, systematic assessment and intervention, especially focusing on older people's symptoms, nurses may contribute to improved QoL for this section of the population

Quality of life and symptoms among older people living at home

Aim. This paper reports a study comparing the socio-demographic data, quality of life (QoL) and symptoms of older people living at home with and without help.Background. Despite growing numbers of older people worldwide, little is know about the differences between older people receiving help to live at home and those not receiving this, especially as regards QoL and symptoms. Not only symptoms but also dependency on others per se may reduce older people's QoL. From a nursing perspective, knowledge about such issues is important because the impact of symptoms may be reducible, even when diseases cannot be cured.Method. A postal questionnaire was sent to an age-stratified random sample of 1866 people aged 75 years or over. Of the respondents (n = 1248) 448 received help and 793 did not.Results. The group receiving help had a significantly higher age, more women, more people widowed and living alone, more children, a higher number of self-reported diseases and symptoms, greater inability to remain alone at home and lower QoL. Loneliness, depressed mood and abdominal pain were significantly related to low QoL in both groups. Living alone, not being able to remain alone at home without help, and fatigue were also predictive of low QoL among those receiving help, and number of diseases and sleep problems in those without.Conclusion. Receiving help with daily living seems to be significantly related to low QoL and goes along with a high number of symptoms that need to be considered in nursing care. Through regular visits, systematic assessment and intervention, especially focusing on older people's symptoms, nurses may contribute to improved QoL for this section of the population

Determinants and characteristics of help provision for elderly people living at home and in relation to quality of life

The aim of this study was to investigate determinants of help from informal or formal caregivers or a combination of both among people aged 75 or more and living at home, and the characteristics of the recipients, the help they received and their quality of life (QoL). The sample for this study was 448 elderly people, 75-99 years of age, living at home and receiving help with activities for daily living, instrumental or both instrumental and personal. Regression analysis showed high QoL not to be significantly related to who was providing the help, whilst it was related to higher age, living with someone, lower number of complaints and managing to be alone at home. Multinomial regression analysis showed age, number of children, number of complaints, the ability to stay alone at home and living alone to predict receiving help from different kinds of caregivers. Recipients receiving help from informal caregivers were younger, more often married and living together with someone, whilst those receiving help from both informal and formal caregivers had more help with instrumental and personal activities for daily living and were not able to stay alone at home as much as those receiving help from other kinds of caregivers. Those receiving help from formal caregivers had fewer children, were single and were living alone more often than the other recipients. Thus the responsibility for help for elderly people rests heavily on informal caregivers, whom it seems essential to support. As public service at home is preferably given to those living alone or able to stay alone at home, those without relatives may not be able to remain at home when their need of help increases

Perspectives of elderly people receiving home help on health, care and quality of life

From a nursing perspective it is important to have information about the type of care needed, the reasons care is needed and quality of life among the most elderly people living in their own homes, in order to support their independence and maximise their quality of life. Thus a study was performed to investigate people aged 75 years and older dependent on care from professionals and/or a next of kin, their functional health, diseases, and complaints in relation to quality of life as perceived by themselves. The sample (n = 448) comprised those who, in an age-stratified randomised sample of adults living in their own homes, responded that they were dependent on help from others. The questionnaire covered sex, age, living conditions, civil status and number of children and cohabitation, respondents' health, diseases, quality of life, help from another person, and the type and amount of help received. The number of elderly persons dependent on help ranged from 18.5 to 79.1% in the different age groups. The help came mainly from informal carers (84.1%), and, in 53.1% of cases, from the home help service and home nursing care. Help from formal caregivers was given in combination with that from a next of kin in 38.8% of the cases. More next of kin than formal carers helped in all instrumental Activities of Daily Living (IADL) and Personal Activities of Daily Living (PADL) tasks, with the exception of cleaning the house and providing a bath/shower. Although the respondents received help themselves, they also helped another person in 6.5% of cases. The elderly reported a median of three diseases and ten different complaints of which pain and impaired mobility: were the most frequent. Between 20 and 40% of the respondents in the different age groups reported restricted ability to be alone and one third of them reported low or very low duality of life. Multiple linear regression analysis showed the number of complaints, restricted ability to be alone, living alone and age to have a significant relationship on low quality of life

Perspectives of elderly people receiving home help on health, care and quality of life

From a nursing perspective it is important to have information about the type of care needed, the reasons care is needed and quality of life among the most elderly people living in their own homes, in order to support their independence and maximise their quality of life. Thus a study was performed to investigate people aged 75 years and older dependent on care from professionals and/or a next of kin, their functional health, diseases, and complaints in relation to quality of life as perceived by themselves. The sample (n = 448) comprised those who, in an age-stratified randomised sample of adults living in their own homes, responded that they were dependent on help from others. The questionnaire covered sex, age, living conditions, civil status and number of children and cohabitation, respondents' health, diseases, quality of life, help from another person, and the type and amount of help received. The number of elderly persons dependent on help ranged from 18.5 to 79.1% in the different age groups. The help came mainly from informal carers (84.1%), and, in 53.1% of cases, from the home help service and home nursing care. Help from formal caregivers was given in combination with that from a next of kin in 38.8% of the cases. More next of kin than formal carers helped in all instrumental Activities of Daily Living (IADL) and Personal Activities of Daily Living (PADL) tasks, with the exception of cleaning the house and providing a bath/shower. Although the respondents received help themselves, they also helped another person in 6.5% of cases. The elderly reported a median of three diseases and ten different complaints of which pain and impaired mobility: were the most frequent. Between 20 and 40% of the respondents in the different age groups reported restricted ability to be alone and one third of them reported low or very low duality of life. Multiple linear regression analysis showed the number of complaints, restricted ability to be alone, living alone and age to have a significant relationship on low quality of life

Quality of life among older people in Sweden receiving help from informal and & or formal helpers at home or in special accommodation

The present study describes and compares quality of life (QoL) and factors which predict QoL among people aged 75 years and over who receive help with activities of daily living (ADLs) from formal and/or informal helpers. The subjects were living at home or in special accommodation in Sweden. A postal questionnaire was sent to a randomly selected and age-stratified sample of 8500 people. The response rate was 52.8% (n = 4337), and 1247 people [mean age (+/- SD) = 86.4 +/- 5.9 years] received help and indicated who helped them with ADLs. The findings suggest that a greater age, being a woman, being a widow/widower, a higher number of health-related complaints, needing more help with ADLs and a lower QoL were found among those receiving help in special accommodation in comparison with those receiving help at home. The extent of help was highest among those receiving help in special accommodation. Having help with ADLs every day at home indicated having help from both informal and formal helpers, while respondents receiving help from only informal or only formal helpers received the smallest amount of help with ADLs. A need for greater help with ADLs, and a higher number of self-reported diseases and complaints determined low QoL, whilst a social network (contact with more than three people) and a greater age determined high QoL. However, who the helpers were did not have a significant influence on QoL; it was the extent of help with ADLs that influenced QoL negatively and the density of the social network that influenced QoL positively

Quality of life and symptoms among older people living at home

Aim. This paper reports a study comparing the socio-demographic data, quality of life (QoL) and symptoms of older people living at home with and without help. Background. Despite growing numbers of older people worldwide, little is know about the differences between older people receiving help to live at home and those not receiving this, especially as regards QoL and symptoms. Not only symptoms but also dependency on others per se may reduce older people's QoL. From a nursing perspective, knowledge about such issues is important because the impact of symptoms may be reducible, even when diseases cannot be cured. Method. A postal questionnaire was sent to an age-stratified random sample of 1866 people aged 75 years or over. Of the respondents (n = 1248) 448 received help and 793 did not. Results. The group receiving help had a significantly higher age, more women, more people widowed and living alone, more children, a higher number of self-reported diseases and symptoms, greater inability to remain alone at home and lower QoL. Loneliness, depressed mood and abdominal pain were significantly related to low QoL in both groups. Living alone, not being able to remain alone at home without help, and fatigue were also predictive of low QoL among those receiving help, and number of diseases and sleep problems in those without. Conclusion. Receiving help with daily living seems to be significantly related to low QoL and goes along with a high number of symptoms that need to be considered in nursing care. Through regular visits, systematic assessment and intervention, especially focusing on older people's symptoms, nurses may contribute to improved QoL for this section of the population