Title: Homecare for the elderly: What holds the future?
Authors: De Lepeleire, Jan
Boelanders, Tom #
Issue Date: Sep-2012
Host Document: European Geriatric Medicine vol:3 issue:Suppl I pages:S63-S63
Conference: European Geriatric Medicine Society location:Brussels date:27-28 september 2012
Abstract: Background: Ageing is already noticeable in home care and will increase in the next few years.
Care needs of the elderly are currently appraised by the general practitioner. Until now, there was
no good standardized method in use to detect care needs. The KATZ- scale is used to determine
the autonomy of each patient in home care and is often decisive for nursing home admission.
Objective: The primary study aim was to determine the current care needs (=CAP: clinical
assessment protocol) in modern home care and to assess to which extent MDS-RAI can make a
contribution to this.
Secondly, we discuss the identification of care needs. It is questionable that a general practitioner is fully
aware of the care needs of his patient. In this study, we explore if MDS-RAI-HC is superior to GP in
assessing care needs.
Methods: Patients were selected based on 4 inclusioncriteria: home-dwelling, born before 1/1/1931,
FRAIL-score > 19 and commitment to one GP. Twenty-four patients were interviewed, using MDS-RAI-HC.
Three GP's were invited to intuitively determine care needs about the included patients. Secondly, correlation
coefficients were calculated for every care need, using SPSS 20.0, to compare MDS-RAI and the GP.
MDS-RAI : MDS-RAI Home Care detects a mean of 6,6 CAP's pp (per person), pertaining to a mean of 3,6
CAP's pp by the GP. The CAP's most frequently detected by MDS-RAI are: cognitive loss (95,8%), urinary
incontinence (95,8%), mood disorders 70,8%), physical activity promotion (58,3%), informal support (54,2%)
and cardiorespiratory conditions (54,2%). The CAP's most frequently activated by GP's: home environment
(50%), appropiate medication use (37,5%), institutional risk (33,3%), informal support (33,3%) and falls
(33,3%). 'Informal support' is highly ranked by both GP and MDS-RAI.
GP : Each GP focuses on one specified area: 'cognition and mental health' (GP 1), 'social life' (GP 2),
and 'clinical issues' and 'functional performance' (GP 3). The CAP 'communication' was the only
statistic significant correlation between MDS-RAI and GP (corr. coeff. 0,552 en p< 0,05)
When MDS-RAI is compared to each GP alone, there are four statistic significant results: GP1 (home
environment (p<0,05) and communication (p<0,01)), GP 2 ((social relationship (p<0,05)) and GP3 (physical
activity promotion (p<0,01)).
Conclusion: MDS-RAI-HC has a quantatively and qualitatively added value in detecting care needs in a
population of frail home-dwelling eighty-year-olds, compared
Publication status: published
KU Leuven publication type: IC
Appears in Collections:Academic Center for General Practice
# (joint) last author

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