|Title||Predictive Factors Leading to Not Living at Home in a Very Frail Community Dwelling Older Population|
|Publication Type||Journal Article|
|Year of Publication||2019|
|Authors||de SMatthieu, Emmanuel B, Valérie C, Elodie L, Quentin A, Philippe A, Claude HJean, Joel A|
|Journal||International Journal of Gerontology|
|Keywords||Case Management, not living at home, predictive factors, target population|
Background: Case management has focused on care coordination reinforcement for the very frail community-dwelling older people in order to allow them to stay at home as long as possible. However the definition of the target population eligible to have a case manager is not clear. The purpose of this study was to identify predictive factors leading to not living at home over one year in a very frail community dwelling older population. Methods: A secondary analysis from a prospective cohort of 428 very frail older people, aged 65 years and over, living at home in Paris were set up. Patients were assessed using RAI-HC 2.0 (Resident Assessment Instrument - Home care) tool. Not living at home at one year was identified in relation with admission characteristics using logistic regressions. Results: At baseline, a large majority of the patients lived alone with cognitive impairments and functional limitations. In one year, 48.6% (n = 208) did not live at home anymore. Among them 40.5% were dead, 36% were institutionalized and 23.5% were hospitalized and moved away. Functional disabilities for meal preparation (p = 0.04) and eating (p = 0.08), bladder incontinence (p = 0.07) and prior hospitalization (p = 0.08) increased the risk of not living at home over one year. Cognitive impairment, socio-demographic characteristics and number of home-based services were not related with the primary outcome. Conclusion: Functional limitations and prior hospitalizations were predictive factors leading to not living at home in a very frail community dwelling older population. Results could help for identifying the population eligible to have a case manager.
|interRAI Member Link to Full Text Article|