Faculty of Nursing, University of Iceland, Eiríksgata 34, 101, Reykjavík, Iceland.
Home Care center, The Capital Area Primary Care, Álfabakki 16, 109, Reykjavík, Iceland.
BMC Health Serv Res. 2021 Oct 29;21(1):1177. doi: 10.1186/s12913-021-07197-3.
Policymakers advocate extended residence in private homes as people age, rather than relocation to long-term care facilities. Consequently, it is expected that older people living in their own homes will be frailer and have more complex health problems over time. Therefore, community care for aging people is becoming increasingly important to facilitate prevention of decline in physical and cognitive abilities and unnecessary hospital admission and transfer to a nursing home. The aim of this study was to examine changes in the characteristic of home care clients and home care provided in five European countries between 2001 and 2014 and to explore whether home care clients who are most in need of care receive the care required.
This descriptive study used data from two European research projects, Aged in Home Care (AdHOC; 2001-2002) and Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care (IBenC; 2014-2016). In both projects, the InterRAI-Home Care assessment tool was used to assess a random sample of home care clients 65 years and older in five European countries. These data facilitate a comparison of physical and cognitive health and the provided home care between countries and study periods.
In most participating countries, both cognitive (measured on the Cognitive Performance Scale) and functional ability (measured on the Activities of Daily Living Hierarchy scale) of home care clients deteriorated over a 10-year period. Home care provided increased between the studies. Home care clients who scored high on the physical and cognitive scales also received home care for a significantly higher duration than those who scored low.
Older people in several European countries remain living in their own homes despite deteriorating physical and cognitive skills. Home care services to this group have increased. This indicates that the government policy of long-term residence at own home among older people, even in increased frailty, has been realised.
政策制定者提倡随着人们年龄的增长，延长在私人住宅中的居住时间，而不是搬迁到长期护理机构。因此，预计随着时间的推移，居住在自己家中的老年人会变得更加脆弱，并且会出现更多复杂的健康问题。因此，为了促进预防身体和认知能力下降以及不必要的住院和转移到养老院，为老年人提供社区护理变得越来越重要。本研究旨在检查五个欧洲国家在 2001 年至 2014 年间，家庭护理客户和家庭护理的特征变化，并探讨最需要护理的家庭护理客户是否获得了所需的护理。
本描述性研究使用了来自两个欧洲研究项目的数据，Aged in Home Care (AdHOC; 2001-2002) 和 Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care (IBenC; 2014-2016)。在这两个项目中，都使用了 InterRAI-Home Care 评估工具来评估五个欧洲国家的 65 岁及以上的随机抽样家庭护理客户。这些数据有助于比较国家和研究期间的身体和认知健康状况以及提供的家庭护理。
在大多数参与的国家中，家庭护理客户的认知能力（通过认知表现量表测量）和功能能力（通过日常生活活动等级量表测量）在十年期间都有所下降。研究期间，提供的家庭护理有所增加。在身体和认知量表上得分较高的家庭护理客户接受的家庭护理时间也明显长于得分较低的客户。
尽管身体和认知技能下降，几个欧洲国家的老年人仍居住在自己的家中。为这一群体提供的家庭护理服务有所增加。这表明，政府让老年人长期居住在自己家中的政策，即使在身体虚弱增加的情况下，也已经得到了实现。
