Larsson Kristina, Thorslund Mats, Kåreholt Ingemar
Department of Social Work, Stockholm University/Aging Research Center, Karolinska Institutet/Stockholm University, Box 6401, 113 82 Stockholm, Sweden.
Stockholm Gerontology Research Center, Box 6401, 113 82 Stockholm, Sweden.
Eur J Ageing. 2006 Jan 27;3(1):22-33. doi: 10.1007/s10433-006-0017-1. eCollection 2006 Mar.
The objectives were to identify factors that predict the use of home help services and transition into institutional care and to study to what extent care services were targeted according to the individuals' needs. A further objective was to study whether people who had moved into institutional care facilities had received home help prior to institutionalisation. A community-dwelling sample (=502) aged 81-100 was twice interviewed and assessed with medical examinations. Their use of public elderly care between 1994/1996 and 2000 was studied using survival analyses. , according to the Andersen Behavioural Model, were the most important predictors for the use of elderly care. Among people living alone, dementia, functional limitations, and depressive symptoms predicted the use of home help services and institutionalisation. Among non-demented cohabiting people, depressive symptoms and dependence in ADLs increased the likelihood of both home help and institutionalisation. Among cohabiting people with dementia, the effect of dementia was difficult to separate from the effects of ADL limitations and depression. were of importance among cohabiting people. A high level of education increased the likelihood of moving into institutional care, and informal extra-residential care increased the likelihood of both outcomes indicating that elderly care resources had not been targeted solely according to need. such as age and gender were of importance only among people living alone. Basically the same factors predicted both the receipt of home help and institutionalisation. Only 4% of people living alone and 5% of those cohabiting moved to institutions without previously receiving home help.
研究目的是确定预测家庭帮助服务使用情况及向机构护理过渡的因素，并研究护理服务在多大程度上根据个人需求提供。另一个目的是研究入住机构护理设施的人在入住机构之前是否接受过家庭帮助。对一个年龄在81至100岁之间的社区居住样本（=502人）进行了两次访谈，并进行了医学检查评估。使用生存分析研究了他们在1994/1996年至2000年期间使用公共老年护理的情况。根据安德森行为模型，是老年护理使用的最重要预测因素。在独居者中，痴呆、功能受限和抑郁症状可预测家庭帮助服务的使用情况及向机构护理的过渡。在未患痴呆症的同居者中，抑郁症状和日常生活活动依赖增加了接受家庭帮助和入住机构护理的可能性。在患有痴呆症的同居者中，痴呆的影响难以与日常生活活动受限和抑郁的影响区分开来。在同居者中很重要。高学历增加了入住机构护理的可能性，非正式的院外护理增加了这两种结果的可能性，这表明老年护理资源并非仅根据需求提供。诸如年龄和性别等因素仅在独居者中具有重要意义。基本上相同的因素既预测了接受家庭帮助的情况，也预测了入住机构护理的情况。只有4%的独居者和5%的同居者在未接受过家庭帮助的情况下入住了机构。
