Catharina Lindencrona

Ability for self-care among home dwelling elderly people in a health district in Sweden

The aim of this study was to describe the ability for self-care among home dwelling elderly in the community in a health district in western Sweden. Two self-report instruments plus a number of self-care related questions were distributed by mail to an age stratified random sample and finally completed by a total of 125 subjects. Bivariate and multivariate statistical methods were used in the analyses. The results showed that self-care ability and self-care agency decreased for respondents 75+ years of age. Self-care ability was predicted by three productive means for self-care and four risk factors.

Validity of Two Self-care Instruments for the Elderly

The aim of this study was to address concurrent and construct validity of two instruments, the Self-care Ability Scale for the Elderly (SASE) and the self-report form of the Appraisal of Self-care Agency Scale (ASA-A), by testing them with home-dwelling, elderly Swedish patients. The two self-report instruments, including some additional new questions, were mailed to an age-stratified random sample of 420 elderly subjects and were finally completed by 125 of them. Bivariate and multivariate statistical methods were used in the analyses. An analysis of the non-respondents revealed no significant differences between them and the respondents. Standardized regression coefficients for reported abilities/activities on the scores were 0.71 for SASE (p < 0.0001) and for ASA-A 0.51 (p < 0.0001). SASE and ASA-A were found to measure related but not identical concepts (r = 0.69). Sensitivity and specificity ratings for managing without any help from official and unofficial caregivers were 68% and 72% respectively for SASE, and 50% and 64% for ASA-A. Individuals of 80+ years of age had lower scores than younger respondents on the SASE (p < 0.001) and ASA-A (p < 0.05) scales. Respondents living independently had higher scores on both scales than those living in institutions (p < 0.001). Lower scores on both scales were found for respondents who were not in good health compared with those who were in good health (p < 0.001). A five-factor solution for SASE explained 70.2% of the variances, and an eight-factor solution explained 67.9% of the variances for ASA-A. The results of this study confirm that the SASE and ASA-A assessments substantially measured what they were intended to measure in the studied group of lucid, elderly subjects.

Äldre och Nutrition

Adequate nutrition is crucial for frail and ill elderly. In Sweden, poor nutritional status among elderly in hospitals and in community care has been reported in mass media and study reports. A retrospective study of hospital records and community acts is here presented. Notes on nutrition of 94 patients (80 years>) during their last stay in acute somatic medical care were analysed. Also, community acts for those who had received home-care after discharge. Prospectively in addition, focusing the need for nutrition, one elderly person was observed and interviewed after discharge from hospital to community care in own home as a case study. Three questions were asked: 1) What was documented on nutritional needs during the acute medical care episode? 2) In case of home-care after discharge, what was documented on nutritional needs in community acts? 3) What actions for meeting demands for adequate nutrition is planned by community home-care services for an elderly client discharged from hospital to own home? In this sample notes on nutrition were made in 87 percent of the acute medical care patient records. In the community services acts, notes on nutrition were rare. In the case study, needs of high-energy food intake and psychological support during meals were not adequately planned for and met in home care. The conclusion is, that in order to undertake caring responsibilities for elderly, knowledge of nutritional needs, psychological and social support as well as documentation skills is necessary within all levels of care and important indicators of quality of care. At the community level, in plans for home care and in individual care of elderly clients, explicit and planned assessment must be made for nutritional needs and meal situation. Also, for the continuity of care between hospital and community care and evaluation.

Äldre och Nutrition Dokumentationen vid en medicinsk klinik och i kommunal hemvård samt en fallbeskrivning i samband med omsorg och vård i eget hem

Adequate nutrition is crucial for frail and ill elderly. In Sweden, poor nutritional status among elderly in hospitals and in community care has been reported in mass media and study reports. A retrospective study of hospital records and community acts is here presented. Notes on nutrition of 94 patients (80 years>) during their last stay in acute somatic medical care were analysed. Also, community acts for those who had received home-care after discharge. Prospectively in addition, focusing the need for nutrition, one elderly person was observed and interviewed after discharge from hospital to community care in own home as a case study. Three questions were asked: 1) What was documented on nutritional needs during the acute medical care episode? 2) In case of home-care after discharge, what was documented on nutritional needs in community acts? 3) What actions for meeting demands for adequate nutrition is planned by community home-care services for an elderly client discharged from hospital to own home? In this sample notes on nutrition were made in 87 percent of the acute medical care patient records. In the community services acts, notes on nutrition were rare. In the case study, needs of high-energy food intake and psychological support during meals were not adequately planned for and met in home care. The conclusion is, that in order to undertake caring responsibilities for elderly, knowledge of nutritional needs, psychological and social support as well as documentation skills is necessary within all levels of care and important indicators of quality of care. At the community level, in plans for home care and in individual care of elderly clients, explicit and planned assessment must be made for nutritional needs and meal situation. Also, for the continuity of care between hospital and community care and evaluation.