Experience with evaluating self-sufficiency: the views of frail seniors and their care-givers.

Czech version

Authors: K. Macháčová; I. Holmerová
Published in: Geriatrie a Gerontologie 2016, 5, č. 3: 117-121
Category:

Overview

The article presents experiences with evaluation of abilities to perform activities of daily living (ADL). It is focused on differences between ratings of ADL abilities by older adults and by their care providers. Presented data comes from results of the study aimed on the quality of care conducted in long-term care settings. The total of 164 nursing home residents participated in the study. The foci of attention were frail older adults who are often recipients of financial support for care. The decision about the provided care allowance is commonly based on data provided by older adults themselves which does not always reflect actual status. Statistical procedures included t-tests, intra-class correlations (ICC) and analysis of variance (ANOVA). It appeared that frail older adults generally overestimate their functional abilities and that the level of this overestimation is associated with cognitive deterioration. Although the results of a substantial subset of older adults with milder cognitive were similar to those of their care providers, it is crucial to understand that the ratings provided by frail older adults in advanced age, especially by those with more severe cognitive deficits, might not reflect the actual status accurately. The results of the study proved that the differences between the ratings may be very high which is very important for clinical practice.

KEYWORDS:
functional fitness – frail older adults – care providers – assessment discrepancies

Sources

1. Gerstenecker A, Mast BT, Shah S, Meeks S. Tracking the cognition of nursing home residents. Clinical Gerontologist 2014; 37: 286-297.

2. Hofmann H, Hahn S. Characteristics of nursing home residents and physical restraint: a systematic literature review. J Clin Nurs 2014; 23(21-22): 3012-3024.

3. Vaňková H, Hradcová D, Jedlinská M, Holmerová I. Prevalence kognitivních poruch v pobytových zařízeních pro seniory v ČR. Geriatrie a gerontologie 2013; 2(3): 111-114.

4. Valk M, Post MW, Cools HJ, Schrijvers GA. Measuring disability in nursing home residents: validity and reliability of a newly developed instrument. J Gerontol B Psychol Sci Soc Sci 2001; 56(3): 187-191.

5. Morris JN, Hawes C, Fries BE, Phillips CD, Mor V, Katz S, et al. Designing the national resident assessment instrument for nursing homes. The Gerontologist 1990; 30(3): 293-307.

6. Onder G, Carpenter I, Finne-Soveri H, Gindin J, Frijters D, Henrard JC, et al. Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study. BMC health services research 2012; 12: 5-12.

7. Jiang S, Li P. Current Development in Elderly Comprehensive Assessment and Research Methods. BioMed research international 2016; 2016: 352-358.

8. Šnejdrlová M, Kalvach Z. Funkční stav v pokročilém stáří a genetická dispozice k dlouhověkosti. Med pro praxi 2008; 5(4): 157-159.

9. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of Illness in the Aged. The Index of Adl: A Standardized Measure of Biological and Psychosocial Function. JAMA 1963; 185: 914-919.

10. Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Md State Med J 1965; 14: 61-65.

11. Morris JN, Belleville-Taylor P, Fries BE, Hawes C, Murphy K, Mor V, et al. InterRAI Long-Term Care Facilities (LTCF) Assessment Form and User‘s Manual. Version 9.1: Washington DC: interRAI; 2009. 132 p.

12. Branch LG, Meyers AR. Assessing physical function in the elderly. Clin Geriatr Med 1987; 3(1): 29-51.

13. Li M, Harris I, Lu ZK. Differences in proxy-reported and patient-reported outcomes: assessing health and functional status among medicare beneficiaries. BMC medical research methodology 2015; 15: 62-69.

14. Magaziner J, Bassett SS, Hebel JR, Gruber-Baldini A. Use of proxies to measure health and functional status in epidemiologic studies of community-dwelling women aged 65 years and older. Am J Epidemiol 1996; 143(3): 283-292.

15. Rubenstein LZ, Schairer C, Wieland GD, Kane R. Systematic biases in functional status assessment of elderly adults: effects of different data sources. J Gerontol 1984; 39(6): 686-961.

16. Ostbye T, Tyas S, McDowell I, Koval J. Reported activities of daily living: agreement between elderly subjects with and without dementia and their caregivers. Age and ageing 1997; 26(2): 99-106.

17. Farias ST, Mungas D, Jagust W. Degree of discrepancy between self and other-reported everyday functioning by cognitive status: dementia, mild cognitive impairment, and healthy elders. Int J Geriatr Psychiatry 2005; 20(9): 827-834.

18. Miller LS, Brown CL, Mitchell MB, Williamson GM. Activities of daily living are associated with older adult cognitive status: caregiver versus self-reports. Journal of applied gerontology: the official journal of the Southern Gerontological Society 2013; 2(1): 3-30.

19. Weinberger M, Samsa GP, Schmader K, Greenberg SM, Carr DB, Wildman DS. Comparing proxy and patients‘ perceptions of patients‘ functional status: results from an outpatient geriatric clinic. J Am Geriatr Soc 1992; 40(6): 585-588.

20. Kiyak HA, Teri L, Borson S. Physical and functional health assessment in normal aging and in Alzheimer‘s disease: self-reports vs family reports. The Gerontologist 1994; 34(3): 324-330.

21. Folstein MF, Folstein SE, McHugh PR. „Mini-mental state“. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12(3): 189-198.

22. Sheikh J, Yesavage J. Geriatric Depression Scale: recent findings and development of a short version. In: T B, editor. Clinical Gerontology: A Guide to Assessment and Intervention. New York: Howarth Press; 1986.

23. Jirak R. Evaluation of psychological functioning in the elderly. In: Kalvach Z, Zadak Z, Jirak R, editors. Geriatrics and gerontology. Prague (in Czech): Grada Publishing 2004.

24. Nunnally JC, Bernestein iH. Psychometric theory. New York: McGraw-Hill Inc 1994.

25. Neumann PJ, Araki SS, Gutterman EM. The use of proxy respondents in studies of older adults: lessons, challenges, and opportunities. J Am Geriatr Soc 2000; 48(12): 1646-1654.

26. Santos-Eggimann B, Zobel F, Berod AC. Functional status of elderly home care users: do subjects, informal and professional caregivers agree? J Clin Epidemiol 1999; 52(3): 181-186.

27. Snow AL, Cook KF, Lin PS, Morgan RO, Magaziner J. Proxies and other external raters: methodological considerations. Health services research 2005; 40: 1676-1693.

28. Loewenstein DA, Arguelles S, Bravo M, Freeman RQ, Arguelles T, Acevedo A, et al. Caregivers‘ judgments of the functional abilities of the Alzheimer‘s disease patient: a comparison of proxy reports and objective measures. J Gerontol B Psychol Sci Soc Sci 2001; 56(2): 78-84.