Abstract
BackgroundPolicymakers advocate extended residence in private homes as people age, rather than relocation to long-term care facilities. Consequently, it is expected that older people living in their own homes will be frailer and have more complex health problems over time. Therefore, community care for aging people is becoming increasingly important to facilitate prevention of decline in physical and cognitive abilities and unnecessary hospital admission and transfer to a nursing home. The aim of this study was to examine changes in the characteristic of home care clients and home care provided in five European countries between 2001 and 2014 and to explore whether home care clients who are most in need of care receive the care required.MethodsThis descriptive study used data from two European research projects, Aged in Home Care (AdHOC; 2001–2002) and Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care (IBenC; 2014–2016). In both projects, the InterRAI-Home Care assessment tool was used to assess a random sample of home care clients 65 years and older in five European countries. These data facilitate a comparison of physical and cognitive health and the provided home care between countries and study periods.ResultsIn most participating countries, both cognitive (measured on the Cognitive Performance Scale) and functional ability (measured on the Activities of Daily Living Hierarchy scale) of home care clients deteriorated over a 10-year period. Home care provided increased between the studies. Home care clients who scored high on the physical and cognitive scales also received home care for a significantly higher duration than those who scored low.ConclusionOlder people in several European countries remain living in their own homes despite deteriorating physical and cognitive skills. Home care services to this group have increased. This indicates that the government policy of long-term residence at own home among older people, even in increased frailty, has been realised.
Highlights
Policymakers advocate extended residence in private homes as people age, rather than relocation to long-term care facilities
The proportion of female participants was higher (p < 0,05) 73,0% in the Aged in Home Care (AdHOC) study but 66.9% in the IBenC study; in the latter study, the proportion was similar between countries but was by far the lowest in Italy (57.3%)
The majority of participants in both studies lived alone— 54.3% in the AdHOC study and 59.4% in the IBenC study—but a great variance was observed between countries, from 16.4% in Italy to 80.9% in Finland in the
Summary
Policymakers advocate extended residence in private homes as people age, rather than relocation to long-term care facilities. Community care for aging people is becoming increasingly important to facilitate prevention of decline in physical and cognitive abilities and unnecessary hospital admission and transfer to a nursing home. Policymakers in most countries advocate extended residence in private homes as people age, rather than relocation to long-term care facilities. Community care for aging people is becoming increasingly important as it facilitates postponement of transfer to a nursing home and prevention of unnecessary hospital admissions [2]. This policy has a number of benefits for older people. Some older people may have unsuitable housing or may feel isolated, while some may need increased assistance or home care services due to their deteriorating health [4]
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