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Article: Usage of community services and domestic helpers predicted institutionalization of elders having functional or cognitive impairments: A 12-month longitudinal study in Hong Kong

TitleUsage of community services and domestic helpers predicted institutionalization of elders having functional or cognitive impairments: A 12-month longitudinal study in Hong Kong
Authors
KeywordsCognitive impairment
Community services
Domestic helpers
Functional impairment
Hong Kong
Institutionalization
Issue Date2012
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jmda
Citation
Journal Of The American Medical Directors Association, 2012, v. 13 n. 2, p. 169-175 How to Cite?
Abstract
Objectives: To estimate the 12-month institutionalization rate and to identify the associated predictors among functionally impaired elders with or without cognitive impairment. Methods: A cohort of Hong Kong community-dwelling elders aged 65 or older with functional and/or cognitive impairments was recruited and interviewed from 2007 to 2008. Twelve months after the baseline interview, the family caregivers or elders were interviewed to update the residence status of the elders. Logistic regressions were used to examine the association between institutionalization and the baseline variables. Results: Eighty elders (of 749 respondents) had been institutionalized within 12 months from baseline. The institutionalization rates were 6.2% (95% confidence interval (CI): 4.0%-8.5%) for elders with functional impairment only and 17.3% (95% CI: 13.0%-21.6%) for elders with both functional and cognitive impairments. Stepwise multiple logistic regressions found that more usage of community services was the single predictor to institutionalization in 1 year for the elders with functional impairment only. The risk was doubled (odd ratio = 2.166, 95% CI: 1.286-3.647) for usage in 1 more community service. For elders with both functional and cognitive impairments, the institutionalization risk was reduced by about 70% with employment of a domestic helper (odd ratio = 0.268, 95% CI: 0.120-0.598), despite increased risk being associated with advancing age of caregiver, caregiver being male, and deteriorating functional status of the elder. Conclusion: Among the functionally impaired elders, more usage of community services predicted increased institutionalization, whereas among the functionally and cognitively impaired elders, employment of a domestic helper predicted reduced institutionalization. Innovative services and care models are needed to prevent unnecessary institutionalization and to postpone premature institutionalization. Furtherresearch needs to be conducted to investigatethe long term care needs of the elders from the perspectiveof both the elders and their caregivers. © 2012 American Medical Directors Association, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/138114
ISSN
2013 Impact Factor: 4.781
2013 SCImago Journal Rankings: 1.229
ISI Accession Number ID
Funding AgencyGrant Number
Hong Kong Jockey Club Charities Trust
Funding Information:

This study is part of the project entitled "CADENZA: A Jockey Club Initiative for Seniors," funded by The Hong Kong Jockey Club Charities Trust.

References

 

DC FieldValueLanguage
dc.contributor.authorChau, PHen_HK
dc.contributor.authorWoo, Jen_HK
dc.contributor.authorKwok, Ten_HK
dc.contributor.authorChan, Fen_HK
dc.contributor.authorHui, Een_HK
dc.contributor.authorChan, KCen_HK
dc.date.accessioned2011-08-26T14:40:49Z-
dc.date.available2011-08-26T14:40:49Z-
dc.date.issued2012en_HK
dc.identifier.citationJournal Of The American Medical Directors Association, 2012, v. 13 n. 2, p. 169-175en_HK
dc.identifier.issn1525-8610en_HK
dc.identifier.urihttp://hdl.handle.net/10722/138114-
dc.description.abstractObjectives: To estimate the 12-month institutionalization rate and to identify the associated predictors among functionally impaired elders with or without cognitive impairment. Methods: A cohort of Hong Kong community-dwelling elders aged 65 or older with functional and/or cognitive impairments was recruited and interviewed from 2007 to 2008. Twelve months after the baseline interview, the family caregivers or elders were interviewed to update the residence status of the elders. Logistic regressions were used to examine the association between institutionalization and the baseline variables. Results: Eighty elders (of 749 respondents) had been institutionalized within 12 months from baseline. The institutionalization rates were 6.2% (95% confidence interval (CI): 4.0%-8.5%) for elders with functional impairment only and 17.3% (95% CI: 13.0%-21.6%) for elders with both functional and cognitive impairments. Stepwise multiple logistic regressions found that more usage of community services was the single predictor to institutionalization in 1 year for the elders with functional impairment only. The risk was doubled (odd ratio = 2.166, 95% CI: 1.286-3.647) for usage in 1 more community service. For elders with both functional and cognitive impairments, the institutionalization risk was reduced by about 70% with employment of a domestic helper (odd ratio = 0.268, 95% CI: 0.120-0.598), despite increased risk being associated with advancing age of caregiver, caregiver being male, and deteriorating functional status of the elder. Conclusion: Among the functionally impaired elders, more usage of community services predicted increased institutionalization, whereas among the functionally and cognitively impaired elders, employment of a domestic helper predicted reduced institutionalization. Innovative services and care models are needed to prevent unnecessary institutionalization and to postpone premature institutionalization. Furtherresearch needs to be conducted to investigatethe long term care needs of the elders from the perspectiveof both the elders and their caregivers. © 2012 American Medical Directors Association, Inc.en_HK
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jmdaen_HK
dc.relation.ispartofJournal of the American Medical Directors Associationen_HK
dc.subjectCognitive impairmenten_HK
dc.subjectCommunity servicesen_HK
dc.subjectDomestic helpersen_HK
dc.subjectFunctional impairmenten_HK
dc.subjectHong Kongen_HK
dc.subjectInstitutionalizationen_HK
dc.titleUsage of community services and domestic helpers predicted institutionalization of elders having functional or cognitive impairments: A 12-month longitudinal study in Hong Kongen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1525-8610&volume=&spage=&epage=&date=2010&atitle=Usage+of+community+services+and+domestic+helpers+predicted+institutionalization+of+the+elders+having+functional+or+cognitive+impairments:+a+12-month+longitudinal+study+in+Hong+Kong-
dc.identifier.emailChau, PH: phpchau@hku.hken_HK
dc.identifier.authorityChau, PH=rp00574en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jamda.2010.07.011en_HK
dc.identifier.pmid21450198en_HK
dc.identifier.scopuseid_2-s2.0-84856112788en_HK
dc.identifier.hkuros190120en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84856112788&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume13en_HK
dc.identifier.issue2en_HK
dc.identifier.spage169en_HK
dc.identifier.epage175en_HK
dc.identifier.isiWOS:000300733600016-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChau, PH=7102266397en_HK
dc.identifier.scopusauthoridWoo, J=36040369400en_HK
dc.identifier.scopusauthoridKwok, T=7006475934en_HK
dc.identifier.scopusauthoridChan, F=54913448800en_HK
dc.identifier.scopusauthoridHui, E=15123893300en_HK
dc.identifier.scopusauthoridChan, KC=35274389700en_HK

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