Who Lives Where and Does It Matter? Changes in the Health Profiles of Older People Living in Long Term Care and the Community over Two Decades in a High Income Country
Who Lives Where and Does It Matter? Changes in the Health Profiles of Older People Living in Long Term Care and the Community over Two Decades in a High Income Country
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DOI：
10.1371/journal.pone.0161705
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发表时间：
2016-09-02
期刊：
影响因子：
3.7
通讯作者：
Brayne, Carol
中科院分区：
文献类型：
--
作者：
Matthews, Fiona E.;Bennett, Holly;Brayne, Carol
背景在高收入国家，人们对长期护理的态度、获得长期护理的机会和长期护理的性质发生了根本性的变化。生活在这种环境中的老年人口的比例和概况因社会、文化和经济特点以及政府政策而异。不同环境中的人的概况的变化对决策者和护理提供者很重要。尽管细节会有所不同，但随着时间的推移如何发生变化对所有人都很重要，包括中低收入国家自己制定政策。在这里，变化是在英格兰检查了二十年。方法和发现使用两个认知功能和老龄化研究（CFAS I：77%响应，CFAS II：56%的回答），在同一地区进行的两项基于人口的老年人研究相隔二十年，使用计算机辅助分类的自动老年病检查对痴呆症的研究诊断，健康和福祉进行了检查，专注于长期护理。在CFAS I（47.6%，95% CI：42.3-53.1）和CFAS II（62.7%，95% CI：54.8-70.0）之间，生活在长期护理中的每个人中，患有三种或三种以上健康状况的人的比例增加，并且在两项研究中，与痴呆症患者相比，无痴呆症患者的比例始终较高。功能障碍的日常生活活动增加辅助生活设施从48%（95%CI：44%-52%）到67%（95%CI：62%-71%）。痴呆症患病率和报告的多种健康状况有所增加。在社区接受护理会给无薪护理人员和正规服务带来压力;这些结果对支持在家的人的政策以及长期护理中的服务提供产生影响，包括护理质量，健康管理，成本以及熟练，关怀和知情的劳动力的发展。
BackgroundThere have been fundamental shifts in the attitude towards, access to and nature of long term care in high income countries. The proportion and profile of the older population living in such settings varies according to social, cultural, and economic characteristics as well as governmental policies. Changes in the profiles of people in different settings are important for policy makers and care providers. Although details will differ, how change occurs across time is important to all, including lower and middle income countries developing policies themselves. Here change is examined across two decades in England.Methods and FindingsUsing the two Cognitive Function and Ageing Studies (CFAS I: 77% response, CFAS II: 56% response), two population based studies of older people carried out in the same areas conducted two decades apart, the study diagnosis of dementia using the Automated Geriatric Examination for Computer Assisted Taxonomy, health and wellbeing were examined, focusing on long term care. The proportion of individuals with three or more health conditions increased for everyone living in long term care between CFAS I (47.6%, 95% CI: 42.3-53.1) and CFAS II (62.7%, 95% CI: 54.8-70.0) and was consistently higher in those without dementia compared to those with dementia in both studies. Functional impairment measured by activities of daily living increased in assisted living facilities from 48% (95% CI: 44%-52%) to 67% (95% CI: 62%-71%).ConclusionsHealth profiles of residents in long term care have changed dramatically over time. Dementia prevalence and reporting multiple health conditions have increased. Receiving care in the community puts pressure on unpaid carers and formal services; these results have implications for policies about supporting people at home as well as for service provision within long term care including quality of care, health management, cost, and the development of a skilled, caring, and informed workforce.