Abstract
Objective
To assess the prevalence, severity, and change in health-related problems in a sample
of older adults who received individual care and support from Embrace, for the whole
sample, per subgroup based on complexity of care needs and frailty, and for those
who had at baseline a health-related problem.
Design
A pretest-posttest study with assessments at baseline and after 12 months.
Setting
Community.
Participants
Older adults aged 75 years and older (N=136) who are frail (n=56) or who have complex
care needs (n=80).
Intervention
Participants received care and support by Embrace, a person-centered and integrated
care service for community-living older adults supporting them to age in place. A
multidisciplinary team provided care and support, with intensity depending on the
older adults' risk profile.
Main Outcome Measure
Health-related problems as perceived by older adults and measured with the Geriatric
International Classification of Functioning, Disability and Health Core Set.
Results
Health-related problems were related to 6 coherent clusters: (1) Mental Functions;
(2) Physical Health; (3) Mobility; (4) Personal Care; (5) Nutrition; and (6) Support.
The most prevalent and most severe problems at baseline were related to Mental Functions
and Mobility. Changes in the prevalence of problems after 12 months varied. Severity
scores decreased or remained stable, except for Mobility items which showed a varying
changing pattern in participants with complex care needs. Prevalence and severity
of problems for those with a problem at baseline decreased after 12 months. Frail
participants with a problem had higher baseline severity scores than those with complex
care needs experiencing a problem, but differences in changes between individuals
who are frail and those with complex care needs were small.
Conclusions
The results are encouraging and may indicate that individual, person-centered and
integrated care and support from Embrace offers a route to counteracting the decline
in physical, cognitive and social functioning associated with aging.
Keywords
List of abbreviations:
GeriatrICS (Geriatric International Classification of Functioning, Disability and Health Core Set), GFI (Groningen Frailty Indicator), ICF (International Classification of Functioning, Disability and Health), Intermed-E-SA (Intermed for the Elderly Self-Assessment)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 12, 2019
Footnotes
Supported by the Netherlands Organization for Health Research and Development (grant no. 314010201) and the Dutch Healthcare Authority (grant no. 300-1021). The funding agencies had no influence on the design of the study, the analysis, or the writing of this article.
Clinical Trial Registration No.: NTR3039.
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
