Journal of the American Geriatrics Society vol:Ahead of print
OBJECTIVES: To examine the effects of home care interventions
for frail older people in delaying permanent institutionalization
during 6 months of follow-up.
DESIGN: Longitudinal quasi-experimental research study,
part of a larger study called Protocol 3.
SETTING: Community care in Belgium.
PARTICIPANTS: Frail older adults who received interventions
(n = 4,607) and a comparison group of older
adults who did not (n = 3,633). Organizations delivering
the interventions included participants provided they were
aged 65 and older, frail, and at risk of institutionalization.
A comparison group was established consisting of frail
older adults not receiving any interventions.
INTERVENTION: Home care interventions were identified
as single component (occupational therapy (OT), psychological
support, night care, day care) or
multicomponent. The latter included case management
(CM) in combination with OT and psychological support or
physiotherapy, with rehabilitation services, or with OT
MEASUREMENTS: The interRAI Home Care (HC) was
completed at baseline and every 6 months. Data from a
national database were used to establish a comparison
group. Relative risks of institutionalization and death were
calculated using Poisson regression for each type of intervention.
RESULTS: A subgroup analysis revealed that 1,999 older
people had mild impairment, and 2,608 had moderate to
severe impairment. Interventions providing only OT and
interventions providing CM with rehabilitation services
were effective in both subpopulations.
CONCLUSION: This research broadens the understanding
of the effects of different types of community care
interventions on the delay of institutionalization of frail
older people. This information can help policy-makers to
plan interventions to avoid early institutionalization. J Am
Geriatr Soc 2016.