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Can They Keep Going on Their Own? A Four-Year Randomized Trial of Functional Assessments of Community Residents*

Published online by Cambridge University Press:  31 March 2010

Roger Thomas ,
Graham Worrall ,
Frank Elgar  and
John Knight
Roger Thomas*
Affiliation:
University of Calgary
Graham Worrall
Affiliation:
Memorial University of Newfoundland
Frank Elgar
Affiliation:
Carleton University, Ottawa
John Knight
Affiliation:
Newfoundland & Labrador Centre for Health Information
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Dr Roger Thomas, Department of Family Medicine, University of Calgary. ([email protected])
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Abstract

Objectives: Are people 75 or over enabled to stay at home longer through annual assessments and referrals to health/social services than through assessments only or without assessments?

Design: randomized controlled trial

Participants: 520 people 75 or over living in their own homes

Intervention: Four annual RAI-HC computerized functional assessments. Intervention group 1: elders and primary caregivers received the results and were invited to take appropriate actions. Intervention group 2: elders and primary caregivers were offered referrals to health/social services.

Measurements/Outcomes: death, institutionalization, home care services, RAI-HC scores, self-rated health, perceived self-efficacy, caregiver burden

Results: By the end of the study, annual functional assessment and offers of referrals to health/social services led to a greater use of home care (6.3%) than did assessment alone (1.8%), but there were no significant differences in death rates, institutionalization, perceived self-efficacy, self-rated health status, or caregiver burden scores between groups.

Conclusion: We discovered that this was a group of healthy seniors. Multi-dimensional functional assessment is time- and labour-intensive and should be targeted at the minority of least self-reliant seniors.

Résumé

Objectif: Des personnes âgées de 75 ans et plus peuvent-elles demeurer plus longtemps à domicile si elles sont l'objet d'évaluations annuelles ou sont dirigées vers des services sociaux ou de santé plutôt que si elles sont l'objet d'évaluations seulement ou d'aucune évaluation?

Concept: Essais cliniques aléatoires

Participants: 520 personnes de 75 ans et plus demeurant dans leur propre maison

Interventions: Un IEP (Instrument d'évaluation du pensionnaire) - soins à domicile (RAI-HC/Resident Assessment Instrument for Home Care) a informatisé des évaluations fonctionnelles. Groupe d'intervention 1: les aînés et les principaux dispensateurs de soins ont reçu les résultats et étaient invités à prendre les mesures appropriées. Groupe d'intervention 2: les aînés et les principaux dispensateurs de soins étaient dirigés vers des services sociaux ou de santé.

Mesures/effets: décès, institutionnalisation, soins à domicile, résultats de l'IÉP - soins à domicile, santé autoévaluée par l'aîné, et charge du dispensateur de soins.

Résultats: À la fin de l'étude, l'évaluation fonctionnelle annuelle et les offres de réacheminement vers des services sociaux ou de santé ont permis d'utiliser davantage les services à domicile (6,3%) que les évaluations annuelles seules (1,8%), mais il n'y avait aucune différence importante entre les groupes en taux de mortalité, degré d'instutionalisation, l'autoefficacité, perçue, l'autoévaluation de santé, ou le fardeau du dispensateur de soins.

Conclusions: Nous avons constaté que ce groupe d'aînés était en bonne santé. Le système multidimensionnel d'évaluation fonctionnelle exige beaucoup de temps et de main-d'oeuvre et doit être réservé au petit nombre d'aînés les moins autonomes.

Keywords

agingrandomized trialelderly over 75functional assessmentcare needsremain in own homevieillissementessais aléatoirespersonnes âgées de plus de 75 ansévaluation des capacités fonctionnellesbesoins en soins de santévie autonome à domicile
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 26 , Issue 4 , Winter/Hiver 2007 , pp. 379 - 389
Copyright
Copyright © Canadian Association on Gerontology 2007

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Footnotes

*

Dr. John Hirdes and Dr. Jeff Poss of the University of Waterloo were consultants in the use of the RAI-HC and in training the research nurses. Glenda Sweetland, Phyllis Reid, and Verna Clouston were the research nurses who cheerfully did the field work for this study. For part of the study, Ms. Barbara Young was the research study coordinator. Ms. Theresa Kerrivan and Mr. Joseph Griffiths entered and organized most of the study data. Trial registration: Canadian Institutes of Health Research # 10576.

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