Perpetuating harms from isolation among older adults with cognitive impairment: observed discrepancies in homecare service documentation, assessment and approval practices

Autor: Anne-Marie Boström, Ingeborg Nilsson, Lena Borell, Linda Sandberg, Lena Rosenberg, Mark Luborsky
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Gerontology
Hälso- och sjukvårdsorganisation
hälsopolitik och hälsoekonomi

Documentation
03 medical and health sciences
Interpersonal relationship
0302 clinical medicine
Dementia diseases
Humans
Medicine
Cognitive Dysfunction
Interpersonal Relations
030212 general & internal medicine
Social isolation
Aged
Sweden
Eligibility
Social network
business.industry
Health Policy
lcsh:Public aspects of medicine
Loneliness
lcsh:RA1-1270
Health Care Service and Management
Health Policy and Services and Health Economy

Social participation
Social engagement
Home Care Services
MCI
Cognitive impairment
Social Isolation
Homecare services
Needs assessment
Female
medicine.symptom
business
Goals
Needs Assessment
030217 neurology & neurosurgery
Research Article
Social status
Qualitative research
Compliance
Zdroj: BMC Health Services Research, Vol 18, Iss 1, Pp 1-9 (2018)
BMC Health Services Research
ISSN: 1472-6963
Popis: Background Older persons with cognitive impairment (CI) risk social isolation. Strong evidence shows that perceived loneliness, or inadequate social networks, triggers and increases health problems. How homecare systems address social participation remains unknown; anecdotal data suggests there are significant gaps. This study’s objective was to identify and describe how the assessors of homecare needs document social participation among persons with CI and how their documentation corresponds with the services actually provided to meet social needs. The research questions were: How and what kinds of social participation needs are documented on need assessment forms? What types of homecare services (with a social focus) are documented and approved? How are specified needs in social participation profiles addressed by a homecare service? Methods Descriptive data from need assessment forms and their attached care plans for all applicants aged 65+ were collected during a 2 month period from a large homecare agency serving a municipality in Sweden. Persons with documented CI (n = 43) in the group were identified. Qualitative data analysis was conducted to examine the research questions. Results Social participation factors were not documented consistently. The relationship between recognition of limitations to social participation and approval of service eligibility was not consistent. Social participation was designated by references to social status, sometimes by social network size, and occasionally by limitations to social participation. The range of approved homecare services (with social focus) covered services such as day care center visits or companionship. Three profiles of social participation were identified: clients with, (a) no participation limitations; (b) potential limitations; and (c) marked limitations. Conclusion Given the known health harms from social isolation and the high risk of isolation among older persons with CI, this novel study’s documentation of inadequate and inconsistent information in homecare social need assessments and services is sobering. The findings suggest a pressing need for initiatives to formulate best practices and standards to ensure alignment of care service systems to the health needs of the growing group of aging individuals with CI.
Databáze: OpenAIRE