Journal of the American Medical Directors Association
Original StudyUsage of Community Services and Domestic Helpers Predicted Institutionalization of Elders Having Functional or Cognitive Impairments: A 12-Month Longitudinal Study in Hong Kong
Section snippets
Methods
From June 2007 to March 2008, a cohort of community-dwelling elders aged 65 or older was recruited at public hospitals, social centers, and day care centers for the elderly in Hong Kong. Details of the baseline survey are presented elsewhere.6 In brief, the elders in the cohort were dependent in at least 1 basic activity of daily living, with or without cognitive impairment. At baseline survey, functional impairment of the elders was assessed by the Chinese version of the Multi-dimensional
Results
Figure 1 shows the flow chart of the recruitment and follow-up of the cohort. The cohort was composed of 945 functionally impaired elders, with or without cognitive impairment, recruited in 2007–2008 through interviewing the elders themselves and/or their caregivers. Contact information was available from 642 caregivers. Among the elders whose caregiver contact information was unavailable, contact information was available from 155 elders without cognitive impairment. In the 12-month follow-up
Discussion
Based on a 1-year cohort, this study identified predictors of institutionalization among elders who were more prone to institutionalization. Results showed that community support, in the form of community services or domestic helpers, was associated with institutionalization. Usage of community services increased institutionalization risk of elders with functional impairment only, whereas employment of domestic helpers reduced institutionalization risk of elders with both functional and
Conclusion
A longitudinal study was conducted to show that predictors to institutionalization within 1 year were different in elders with functional impairment only and elders with both functional and cognitive impairments. For elders with functional impairment only, more usage of community services was associated with increased risk; whereas for elders with both functional and cognitive impairments, employment of a domestic helper was associated with reduced risk. Innovative services and care models are
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This study is part of the project entitled “CADENZA: A Jockey Club Initiative for Seniors,” funded by The Hong Kong Jockey Club Charities Trust.