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Functional Assessment of Elderly Clients of a Rural Community-Based Long-Term Care Program: A 10-Year Cohort Study*

Published online by Cambridge University Press:  31 March 2010

Frank J. Elgar ,
Graham Worrall  and
John C. Knight
Frank J. Elgar*
Affiliation:
Dalhousie University
Graham Worrall
Affiliation:
Memorial University of Newfoundland
John C. Knight
Affiliation:
Memorial University of Newfoundland
*
Requests for offprints should be sent to: / Les demandes de tirés-a-part doivent être adressées à : Frank Elgar, Department of Psychology, Dalhousie University, Halifax, NS, B3H 4J1. (fjelgar@is2.dal.ca)
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Abstract

As the demand for home care services increases, health care agencies should be able to predict the intake capacity of community-based long-term care (CBLTC) programs. Two hundred and thirty-seven clients entering a CBLTC program were assessed for activities of daily living (ADL) and cognitive and affective functioning and were then followed to monitor attrition and reasons why clients left the program. Compromised ADL functioning at baseline increased likelihood of death and institutionalization by 2 per cent each year. Over a 10-year period, reduced cognitive functioning at baseline increased the risk of death by 9 per cent and decreased the likelihood of leaving the program due to improvement by 18 per cent. Reduced affective functioning at baseline increased the risk of institutionalization during the course of the study by 3 per cent. Routine functional assessments with the elderly may help in the management of similar home care programs.

Résumé

Puisque la demande en soins à domicile augmente, les organismes de santé publique devraient être en mesure de prévoir la capacité d'accueil de ces programmes de longue durée. À leur admission à un tel programme, 237 personnes âgées furent évaluées par rapport à leurs activités journalières ainsi que leur fonctionnement cognitif et affectif. Puis, les causes de départs ont été archivées. Une quantité restreinte d'activités journalières au moment de l'évaluation d'admission a accru de 2 pour cent les probabilités annuelles de décès et d'institutionnalisation. Durant cette période de 10 ans, une capacité cognitive affaiblie à l'admission a augmenté de 9 pour cent le risque de décès, et a diminué de 19 pour cent les probabilités de quitter le programme suite à un rétablissement. Un fonctionnement affectif amoindri à l'admission a accru de 3 pour cent le risque d'institutionnalisation. Une évaluation fonctionnelle régulière des personnes âgées serait profitable à la gestion des programmes de maintien à domicile.

Keywords

agingrural elderlyhome carefunctional assessmentcohort studyvieillissementrésidents ruraux âgéssoins à domicileévaluation fonctionnelleétude de cohorte
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 21 , Issue 3 , Fall/Automne 2002 , pp. 455 - 463
Copyright
Copyright © Canadian Association on Gerontology 2002

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Footnotes

*

This research was supported by a Douglas M. Robb Research Award of the College of Family Physicians of Canada and a research grant from the St. John's General Hospital Research Foundation and Nova Scotia Reseearch Foundation awarded to Graham Worrall and doctoral fellowship from the Hospital for Sick Children Foundation and Nova Scotia Research Foundation awarded to Frank Elgar. We acknowledge the assistance of the staff and nurses at the Gander and District Continuing Care Programme and the community nurses in 15 offices throughout the region. We also thank Ms. Denise Bernier for preparing the French version of the Abstract.

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