Abstract
The majority of people living with dementia in Ireland reside in their own homes, some supported by formal or informal home care. This audit aimed to estimate the prevalence of dementia and suspected cognitive impairment (CI) among older adults, 65+ years, in receipt of formal home care (domiciliary care) in a defined health service area in North Dublin. A secondary objective of the audit was to explore factors associated with dementia or CI in this cohort. A cross-sectional audit was conducted on all clients aged 65+ years actively receiving publicly funded home care packages (HCPs) during May 2016 in Healthcare Service Executive CHO9 Dublin North Central. A total of 935 urban community dwelling older adults were included in the study [mean age 83.7 (s.d. 7.4) years and 65% female]. Basic socio-demographic and health data were extracted from common summary assessment reports. Service users were categorised as having (a) dementia if a diagnosis of dementia or cognitive decline which impacts on independent living, was documented by a health professional or (b) suspected CI where a validated cognitive screening tool was applied and the score was indicative of mild CI. Overall, the estimated prevalence of dementia and suspected CI was 37.1% and 8.7%, respectively. Factors significantly associated with dementia and suspected CI were higher dependency and home care hours, communication difficulty and being non-self-caring (p<0.001). Notably, half (51.6%) of those with either dementia or suspected CI group lived alone. Our findings suggest a high prevalence dementia among HCP users, highlighting a need and opportunity for dementia-specific approaches to support older people in their homes.
Highlights
It is estimated that just over 50 000 older adults aged 65 or over are living with dementia in Ireland with this number expected to more than triple by 2046 (Pierce et al 2014)
Factors significantly associated with dementia and suspected cognitive impairment (CI) were higher dependency and home care hours, communication difficulty and being non-self-caring (p < 0.001)
Our findings suggest a high prevalence dementia among home care packages (HCPs) users, highlighting a need and opportunity for dementia-specific approaches to support older people in their homes
Summary
It is estimated that just over 50 000 older adults aged 65 or over are living with dementia in Ireland with this number expected to more than triple by 2046 (Pierce et al 2014). The increase in prevalence of dementia represents a significant challenge for patients and families as well as existing health and social care systems. Home and communitybased supports have been recognised as critical to enabling older people with dementia to remain living as active citizens in their own homes for as long as possible, as highlighted in the Irish National Dementia Strategy (Department of Health, 2014). Given the progressive nature of dementia, community services need to be accessible and adaptable to the changing needs of the individual (Pierce et al 2014). In Ireland, an estimated 8.2% of older people living in the community avail of state-funded home help (Murphy et al 2015).
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