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Seniors at Risk: The Association between the Six-Month Use of Publicly Funded Home Support Services and Quality of Life and Use of Health Services for Older People*

Published online by Cambridge University Press:  31 March 2010

M. Markle-Reid ,
G. Browne ,
R. Weir ,
A. Gafni ,
J. Roberts  and
S. Henderson
M. Markle-Reid*
Affiliation:
School of Nursing McMaster University
G. Browne
Affiliation:
School of Nursing McMaster University Ontario Training Centre in Health Services and Policy Research
R. Weir
Affiliation:
Faculty of Health Science, McMaster University
A. Gafni
Affiliation:
Health Economics, McMaster University
J. Roberts
Affiliation:
Faculty of Health Science, McMaster University
S. Henderson
Affiliation:
School of Nursing McMaster University
*
Requests for offprints should be sent to:/Les demandes de tirés-à-part doivent être adressées à: Dr. Maureen Markle-Reid, McMaster University, School of Nursing, 1200 Main Street West, HSC 3N28H, Hamilton, ON L8N 3Z5, ([email protected])
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Abstract

This study examines the baseline characteristics and changes in health status and cost of use of health services associated with use of publicly funded home support services. The analysis includes 122 people 75 years of age or more who were eligible for home support services. Over a 6-month period, one third of the sample used home support services for more than 1hr/week; these seniors had higher rates of depression and cognitive impairment, lower levels of physical and emotional functioning, and less effective coping styles than those who used fewer services. Cognitive impairment explained 17 per cent of the variation in use of home support services. At 6 months, use of home support services for more than 1hr/week by seniors with higher levels of need was associated with lower cost of use of health services and lower levels of improvement in health status. These findings suggest the need for further research to identify efficacious ways of providing home support services to this population to enhance their health status using available resources.

Résumé

La présente étude évalue les caractéristiques de base et les changements dans l'état de santé et le coût des services de soins de santé utilisés en association avec les services de soutien à domicile subventionnés par l'État. l'analyse comprend 122 personnes de ≥75ans admissibles aux services de soutien à domicile. Au cours d’une période de six mois, un tiers des personnes faisant partie de l'échantillon ont utilisé des services de soutien à domicile pendant ≥1 heure par semaine. Le taux de dépression et de déficience cognitive, le degré réduit de fonctionnement physique et émotionnel, et une capacité d’adaptation moins efficace étaient plus élevés chez ces aînés que chez ceux qui utilisaient moins de services. La déficience cognitive a expliqué 17 pour cent de la variation dans l'utilisation des services de soutien à domicile. Pour la période de six mois, l'utilisation de services de soutien à domicile pendant ≥1 heure par semaine par des aînés ayant des besoins plus importants était associée à un coût plus faible d’utilisation pour les services de soins de santé et à un niveau d’amélioration plus faible de l'état de santé. Ces résultats suggèrent qu’il faut accélérer la recherche visant à déterminer des méthodes plus efficaces pour la prestation des services de soutien à domicile à ces personnes afin d’améliorer leur état de santé à l'aide des ressources disponibles.

Keywords

vieillissementpersonnes âgéessoins à domicileservices d’aide familialemaladie chroniqueefficacité cliniquecoûtagingelderlyhome carehomemaker serviceschronic illnessclinical effectivenesscosts
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 27 , Issue 2 , Summer/Été 2008 , pp. 207 - 224
Copyright
Copyright © Canadian Association on Gerontology 2008

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Footnotes

*

We are grateful to the following agencies for funding this project: Canadian Health Services Research Foundation, Ontario Ministry of Health and Long-Term Care, Community Care Access Centre of Halton, and McMaster University System-Linked Research Unit on Health and Social Services Utilization. Maureen Markle-Reid is a Career Scientist, Ontario Ministry of Health and Long-Term Care, Health Research Personnel Development Fund. This research was possible through the ongoing support of the Community Care Access Centre of Halton, Halton Victorian Order of Nurses, Para-Med Home Health Care, and the Halton Canadian Red Cross Homemakers. We are also grateful to the following individuals: Maria Wong and May Wong (data analysis), Karen Auld (project coordination), and Leah Macdonald (data entry).

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