Different kinds of services and informal support in the daily life activities in a community-based elderly population.
ABSTRACT As part of the well-known population study of 70-year olds in Gothenburg, 1239 persons at the age of 70 were invited to participate in an extensive investigation and Inter-Vention program of the Elderly in Gothenburg (IVEG). The probands were examined at the ages of 70, 73 and 76 years. The purpose of this study is to describe different kinds of services and informal support in the daily life activities among three large groups of people in their seventies. A cross-sectional study design was chosen in order to get as large groups as possible. A home call was made by an experienced occupational therapist, who interviewed and observed the probands' performance in the daily life activities. The probands and their relatives were asked about the extent of different services and informal support. Personal and home assistance care given by relatives almost doubled between the age of 70 and 76 years. Help organized by the Social Welfare Services only increased marginally. Of the personal activities of daily living (ADL), getting in/out of a bathtub was the activity that caused most problems. The most common walking aid was a stick or a crutch, while use of a wheelchair was quite uncommon. Between the age of 70 and 76 years, the use of the Handicap Transport Service more than doubled. This study shows that at the age of about 73 years the elderly should be offered formal support, such as the supply of assistive devices. What is noteworthy is that the help from relatives and friends increased much more than the help from the Social Welfare Services between the age of 70 and 76 years. At present, relatives and friends assist the elderly in their homes to a large extent, and frequently. Relatives are doing an important job for their elderly and for society, and should be given every possible kind of public support and relief in order to have the strength to continue.
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ABSTRACT: Participation restriction is defined as "problems an individual may experience in involvement in life situations" and refers to the personal and societal consequences of health conditions. There is a growing interest in participation restriction because (i) problems with work or looking after others may be more concerning to individuals than the signs and symptoms of health conditions and (ii) even when poor health persists, participation may still be maintained. The natural history of participation restriction in the general population is unknown and the aim of this report is to describe change in status of person-perceived participation restriction over three years in community-dwelling adults aged 50 years and over. Prospective cohort study (baseline and 3-year follow-up) using postal questionnaires mailed to a population-based sample of older adults. Responders were included in this study if they completed all items of the Keele Assessment of Participation at baseline (n = 6965). Estimates of onset and persistence of person-perceived participation restriction at 3-year follow-up were calculated for any and for each aspect of life in the sample as a whole, and then by age and gender using attrition re-weighted logistic regression to take account of sample attrition. In the whole sample of 6965 persons, overall participation status at three years was unchanged in 69%, and changed in 31%. Of 3431 persons with no restriction at baseline, it is estimated that 29.8% (95% confidence interval: 27.6%, 32.0%) would report restriction in at least one aspect of life at 3-year follow-up. Of 3534 persons who had baseline restriction, it is estimated that 68.8% (66.2%, 71.3%) would report continuing restriction in at least one aspect of life after 3 years. Onset and persistence both increased with age, and were most frequently recorded for restricted mobility outside the home. Although most older persons do not change their overall participation status during a three-year period, change does occur which implies that population approaches to improving participation can be sought. Both onset and persistence of person-perceived participation restriction are more common the older the age-group.Health and Quality of Life Outcomes 12/2008; 6:92. · 2.27 Impact Factor
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ABSTRACT: To investigate the links between knee pain characteristics and restricted mobility outside the home, and how these are influenced by mobility-specific activity limitation, age, sex, socioeconomic status, environmental factors, and comorbidity. We conducted a cross-sectional survey of community-dwelling adults age > or = 50 years. A total of 2,252 responders reporting pain in and around the knee in the last year were eligible. The primary outcome was self-reported restricted mobility outside the home in the previous 4 weeks (dichotomized as present or absent). Knee pain severity was strongly associated with restricted mobility outside the home, an association largely mediated by perceived limitation in walking. After adjusting for demographic and socioeconomic characteristics, individual contributions from selected comorbidities, knee pain severity, limitation in walking, and specific environmental factors remained. These environmental factors included perceived need of aids and assistance (adjusted odds ratio [OR] 3.1, 95% confidence interval [95% CI] 2.2-4.4), poor access to public transportation (adjusted OR 2.3, 95% CI 1.4-3.9), and having no access to a car (adjusted OR 1.6, 95% CI 1.1-2.4). There are a range of potential health and social targets that, if addressed, might reduce restricted mobility outside the home in middle-aged and older individuals with knee pain. Our results suggest that, in addition to treating the knee symptoms, such targets might include comorbidity, walking ability, and environmental barriers such as poor access to public transportation. Moreover, removing environmental barriers may reduce immobility outside the home even in the continued presence of osteoarthritis symptoms and specific activity limitations.Arthritis & Rheumatism 01/2008; 57(8):1381-9. · 7.48 Impact Factor
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ABSTRACT: The relationship between perceived health and walker use has seldom been addressed. Concerns over falls and falls risk are precursors to walker use. We compared the SF-36 scores of 26 women and 14 men, mean age 86.8 +/- 6.0 years based on walker use and faller status. An analysis of covariance (ANCOVA) with age as the covariate, compared groups for the SF-36 constructs and totals score. Significant differences were noted between walker users and nonusers in physical functioning, role limitations due to physical problems, general health, and the total SF-36 score. Pairwise comparisons favored nonusers, while no differences were seen due to faller status. Walker use is associated with lower self-perceptions of physical functioning, role limitations due to physical problems, and general health in assisted-living residents. Faller status is not associated with self-perceived health status. Although walker use aids mobility and lowers the probability of falls, further research is needed to determine if the prescription of assistive devices has a more negative impact on self-perceived health than does falling. This possibility could be explained, in part, by the greater activity levels of those individuals who do not depend on walkers.Clinical Interventions in Aging 02/2007; 2(1):123-37. · 2.65 Impact Factor