Böttcher-Völcker , S.

Dapp, Ulrike

Kleinhans, E.

Neumann, L.

von Renteln-Kruse, Wolfgang

German

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BACKGROUND References Funding: City of Hamburg, Department for Health and Consumer Protection [1] Meinck et al. Gesundheitswesen 2004; 66:732-738       [2] Legal document City of Hamburg, statute 21/10874, 07.11.2017       [3] Neumann L et al. Z Gerontol Geriat 2021 · 54:471–478. https://doi.org/10.1007/s00391-021-01878-8 Acceptance Of The “Hamburg Home Visit For Older Citizens” In 4,716 Older People In 15 Months  Neumann L1, Dapp U1, Böttcher-Völcker S2, Kleinhans E2, von Renteln-Kruse W1    1 Albertinen-Haus, Geriatrics Centre, Scientific Department at the University of Hamburg, Sellhopsweg 18-22, D-22459 Hamburg, Germany 2 City of Hamburg, Department for Health and Consumer Protection, Hamburg, Billstr. 80, D-20539 Hamburg, Germany (until 30.06.2020) Preventive home visits for seniors are heterogeneous considering target groups, content, professional qualification and aims. Effectiveness has not been shown [1]. Nonspecific positive impulses are described in the development of communal structures and in the way participants feel valued. The City of Hamburg, Department of Health and Consumer Protection (BGV) promoted the pilot “The Hamburg home visit for older citizens” in two districts to provide information, to identify need of help and to initiate contact for support if wanted. The visit is voluntary, free-of-charge and offered to all persons on their 80th birthday and performed by visitors (background healthcare/social work) but do not include a comprehensive geriatric assessment (CGA). Aim is to promote active and independent living. Within a personal consultation, information is provided on the manifold health promoting and caring services in Hamburg [2].  Hamburg home visits Sellhopsweg 18-22, 22459 Hamburg  METHODS RESULTS DISCUSSION 59 visitors were recruited (Tab. 1). From 09/2018-12/2019 4,716 (100%) persons were contacted, of whom 1,636 (35%) were visited. Acceptance rate over the pilot phase did not fluctuated and was comparable in both pilot districts (Fig 2). Relevant topics were general health (51%), mobility (43%), housing conditions (42%) and social contacts (41%) (Fig 3). Need of support was documented in 399/ 1,636 visits, and contacts for support were initiated as required by 55 persons [3].   Two different Hamburg districts were defined as pilot region: Eimsbüttel is a high density urban district and Harburg is a rather rural district, incl. less health-care infra-structure. The pilot phase covered 15 months from September 2019 to December 2020. The structural and administrative prerequisites were defined with officials of the city of Hamburg and the two city districts (Fig 1). Preliminary works included: data safety concept, provision of addresses, birthday letter, information to be provided (e.g. mobility/falls, nutrition, loneliness), recruitment, qualification and training of the visitors, guideline how to perform and communicate during the visit, documentation, quarterly reports. All persons who celebrated their 80th birthday within the pilot phase were offered a Hamburg home visit. In addition, even younger or older persons living in the two pilot-districts could also called for a home visit [3]. The acceptance-rate was 10% higher as had been expected. As CGA is not included, it must be checked in the further project development, whether it is necessary to refer to appropriate medical clarification in case of noticeable findings during the visits, e.g. geriatric outpatient clinics. Due to acceptance-rate of 35% the “Hamburg home visit” is now offered to all 15,000 Hamburg citizens/year with 80th birthday in all Hamburg districts [3]. N female visitors  48/59 (81%) N male visitors  11/59 (19%) Mean age visitors  57 years (range: 27 – 79) Professional background visitors  Social pedagogy, social work, pedagogy, gerontology (n=11)  Nursing care, medical-technical staff, rescue assistance (n=11)  Voluntary background (e.g. physical activity, senior citizens' meeting places, residential/care facilities, dementia care, palliative care) (n=11)  Commercial activity in a welfare association (n=10)  Medicine (n=4)  Other: Legal care, senior support, alter. medicine (n=12)  Tab 1:  Visitors characteristics Performed Hamburg Home Visits Declined Hamburg Home Visits Open results* 32% 42% 32% 35% 33% 34% 33% 41% 35% 37% 30% 31% 36% 32% 32% 35% 67% 57% 67% 65% 67% 66% 67% 59% 65% 63% 70% 69% 64% 67% 65% 65% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Sep 2018 Oct 2018 Nov 2018 Dec 2018 Jan 2019 Feb 2019 Mar 2019 Apr 2019 May 2019 Jun 2019 Jul 2019 Aug 2019 Sep 2019 Oct 2019 Nov 2019 Total 2018-19 *Calculating deviations result from rounding differences a) 37% 24% 41% 42% 28% 39% 34% 37% 35% 29% 33% 35% 30% 38% 40% 36% 33% 38% 37% 30% 31% 31% 31% 37% 35% 30% 34% 30% 37% 34% 35% 61% 76% 59% 56% 71% 60% 66% 61% 65% 70% 67% 65% 70% 62% 58% 60% 64% 67% 62% 63% 70% 68% 69% 69% 63% 64% 70% 64% 68% 59% 66% 64% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 42% Sep 2018 Oct 2018 Nov 2018 Dec 2018 Jan 2019 Feb 2019 Mar 2019 Apr 2019 May 2019 Jun 2019 Jul 2019 Aug 2019 Sep 2019 Oct 2019 Nov 2019 Total 2018-19 E    H E    H E    H E    H E    H E    H E    H E    H E    H E    H E    H E    H E    H E    H E    H E    H E = District Eimsbüttel     H = District Harburg b) Fig 2:  Acceptance of the Hamburg Home visit over 15 months Notes: Number of performed home visits : Total: n = 1,636, Eimsbüttel: n = 1,003, Harburg: n = 633; multiple choices possible 0% 10% 20% 30% 40% 50% 60% Voluntary work Nutrition Caregiver Loneliness Need for Nursing Care Physical function/Falls Social participation Household help Living Environment Social contacts Housing conditions Mobility General health  Total Eimsbüttel Harburg Fig 3:  Relevant topics in Hamburg Home Visits Department of Health and Consumer Protection  Pilot Districts: Hamburg Eimsbüttel and Harburg Office Hamburg Home Visit For Older Citizens Visitors (honorary workers) Adress and base data Documentation Invoices Qualification Expert Monitoring If necessary incl. written consent for referral Performing  Hamburg Home Visit Preliminary work Reports Reports District Harburg District Eimsbüttel Older Citizens in Hamburg District Harburg District Eimsbüttel Residential Registration Office Of all persons  with 80th birthday Preliminary work Birthday letter inkl. date for Hamburg home visit and information broschure Postponement of visits Cancelling of visits Fig 1:  Structure of the Hamburg Home Visit E-Mail: lilli.neumann@immanuelalbertinen.de  Internet: www.hamburg.de/hamburger-hausbesuch.de  

Acceptance Of The “Hamburg Home Visit For Older Citizens” In 4,716 Older People In 15 Months

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Acceptance Of The “Hamburg Home Visit For Older Citizens” In 4,716 Older People In 15 Months

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