School of Public Health and Health Systems, University of Waterloo, Ontario.
Hamilton Niagara Haldimand Brant Local Health Integration Network, Ontario.
Can J Aging. 2020 Sep;39(3):421-431. doi: 10.1017/S0714980819000473. Epub 2019 Aug 15.
Long-stay home care clients mostly reside in private homes or retirement homes, and the type of residence may influence risk factors for long-term care placement. This multi-state analytic study uses RAI-Home Care and administrative data from the Hamilton Niagara Haldimand Brant Local Health Integration Network to model conceptualized states of risk at baseline through a 13-month follow-up period. Modifiable risk factors in these states were client loneliness or depressive symptoms, and caregiver distress. A higher adjusted likelihood of being discharged deceased was found for the lowest-risk clients in retirement homes. Adjusting for client, service, and caregiver characteristics, retirement home residency was associated with higher likelihood of placement in a long-term care home; reduced caregiver distress; and increased client loneliness/depression. As an alternative to private home settings as the location for aging in place among these long-stay home care clients, retirement home residency represents some trade-offs between client and informal caregiver.
长期居家护理客户大多居住在私人住宅或退休之家，居住类型可能会影响长期护理安置的风险因素。这项多州分析研究使用 RAI-Home Care 和汉密尔顿-尼亚加拉-哈尔迪曼德-布兰特地方卫生整合网络的管理数据，通过 13 个月的随访期，对基线时的概念化风险状态进行建模。这些状态中的可修改风险因素是客户的孤独或抑郁症状以及照顾者的痛苦。在退休之家，风险最低的客户被发现死亡出院的可能性更高。在调整了客户、服务和照顾者特征后，退休之家的居住与更高的长期护理安置可能性、降低的照顾者痛苦以及增加的客户孤独/抑郁有关。作为这些长期居家护理客户在私人住宅环境中就地老龄化的替代方案，退休之家的居住代表了客户和非正式照顾者之间的一些权衡。
