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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
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TitleUsage of community services and domestic helpers predicted institutionalization of elders having functional or cognitive impairments: A 12-month longitudinal study in Hong Kong
 
AuthorsChau, PH1
Woo, J1 3
Kwok, T3
Chan, F1
Hui, E2
Chan, KC1
 
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
 
CitationJournal Of The American Medical Directors Association, 2012, v. 13 n. 2, p. 169-175 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.jamda.2010.07.011
 
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.
 
ISSN1525-8610
2012 Impact Factor: 5.302
2012 SCImago Journal Rankings: 0.841
 
DOIhttp://dx.doi.org/10.1016/j.jamda.2010.07.011
 
ISI Accession Number IDWOS:000300733600016
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.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorChau, PH
 
dc.contributor.authorWoo, J
 
dc.contributor.authorKwok, T
 
dc.contributor.authorChan, F
 
dc.contributor.authorHui, E
 
dc.contributor.authorChan, KC
 
dc.date.accessioned2011-08-26T14:40:49Z
 
dc.date.available2011-08-26T14:40:49Z
 
dc.date.issued2012
 
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.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationJournal Of The American Medical Directors Association, 2012, v. 13 n. 2, p. 169-175 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.jamda.2010.07.011
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.jamda.2010.07.011
 
dc.identifier.epage175
 
dc.identifier.hkuros190120
 
dc.identifier.isiWOS:000300733600016
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.

 
dc.identifier.issn1525-8610
2012 Impact Factor: 5.302
2012 SCImago Journal Rankings: 0.841
 
dc.identifier.issue2
 
dc.identifier.openurl
 
dc.identifier.pmid21450198
 
dc.identifier.scopuseid_2-s2.0-84856112788
 
dc.identifier.spage169
 
dc.identifier.urihttp://hdl.handle.net/10722/138114
 
dc.identifier.volume13
 
dc.languageeng
 
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jmda
 
dc.publisher.placeUnited States
 
dc.relation.ispartofJournal of the American Medical Directors Association
 
dc.relation.referencesReferences in Scopus
 
dc.subjectCognitive impairment
 
dc.subjectCommunity services
 
dc.subjectDomestic helpers
 
dc.subjectFunctional impairment
 
dc.subjectHong Kong
 
dc.subjectInstitutionalization
 
dc.titleUsage of community services and domestic helpers predicted institutionalization of elders having functional or cognitive impairments: A 12-month longitudinal study in Hong Kong
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Shatin Hospital
  3. Chinese University of Hong Kong