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Transitions between levels of dependency among older people receiving social care - a retrospective longitudinal cohort study in a Swedish municipality

Zingmark, Magnus LU orcid and Norström, Fredrik LU (2021) In BMC Geriatrics 21. p.1-8
Abstract

BACKGROUND: Knowledge is scarce on how needs for home help and special housing evolve among older people who begin to receive support from municipal social care. The purpose of this study was to describe baseline distributions and transitions over time between levels of dependency among older persons after being granted social care in a Swedish municipality.

METHODS: Based on a longitudinal cohort study in a Swedish municipality, data was collected retrospectively from municipal records. All persons 65 years or older who received their first decision on social care during 2010 (n = 415) were categorized as being in mild, moderate, severe, or total dependency, and were observed until the end of 2013. Baseline distributions and... (More)

BACKGROUND: Knowledge is scarce on how needs for home help and special housing evolve among older people who begin to receive support from municipal social care. The purpose of this study was to describe baseline distributions and transitions over time between levels of dependency among older persons after being granted social care in a Swedish municipality.

METHODS: Based on a longitudinal cohort study in a Swedish municipality, data was collected retrospectively from municipal records. All persons 65 years or older who received their first decision on social care during 2010 (n = 415) were categorized as being in mild, moderate, severe, or total dependency, and were observed until the end of 2013. Baseline distributions and transitions over time were described descriptively and analysed with survival analysis, with the Kaplan-Meier estimator, over the entire follow-up period. To test potential differences in relation to gender, we used the Cox-Proportional hazards model.

RESULTS: Baseline distributions between mild, moderate, severe, and total dependency were 53, 16, 24, and 7.7%. During the first year, between 40 and 63% remained at their initial level of dependency. Among those with mild and moderate levels of dependency at baseline, a large proportion declined towards increasing levels of dependency over time; around 40% had increased their dependency level 1 year from baseline and at the end of the follow-up, 75% had increased their dependency level or died.

CONCLUSIONS: Older people in Sweden being allocated home help are at high risk for decline towards higher levels of dependency, especially those at mild or moderate dependency levels at baseline. Taken together, it is important that municipalities make use of existing knowledge so that they implement cost-effective preventative interventions for older people at an early stage before a decline toward increasing levels of dependency.

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Please use this url to cite or link to this publication:
author
and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aged, Aged, 80 and over, Cities, Cohort Studies, Humans, Longitudinal Studies, Retrospective Studies, Social Support, Sweden/epidemiology
in
BMC Geriatrics
volume
21
article number
342
pages
1 - 8
publisher
BioMed Central (BMC)
external identifiers
  • pmid:34078277
  • scopus:85107175748
ISSN
1471-2318
DOI
10.1186/s12877-021-02283-x
language
English
LU publication?
no
id
08f47c2e-71ad-4cf7-9935-ad6e9571c0a0
date added to LUP
2021-08-31 15:51:57
date last changed
2024-06-15 15:27:19
@article{08f47c2e-71ad-4cf7-9935-ad6e9571c0a0,
  abstract     = {{<p>BACKGROUND: Knowledge is scarce on how needs for home help and special housing evolve among older people who begin to receive support from municipal social care. The purpose of this study was to describe baseline distributions and transitions over time between levels of dependency among older persons after being granted social care in a Swedish municipality.</p><p>METHODS: Based on a longitudinal cohort study in a Swedish municipality, data was collected retrospectively from municipal records. All persons 65 years or older who received their first decision on social care during 2010 (n = 415) were categorized as being in mild, moderate, severe, or total dependency, and were observed until the end of 2013. Baseline distributions and transitions over time were described descriptively and analysed with survival analysis, with the Kaplan-Meier estimator, over the entire follow-up period. To test potential differences in relation to gender, we used the Cox-Proportional hazards model.</p><p>RESULTS: Baseline distributions between mild, moderate, severe, and total dependency were 53, 16, 24, and 7.7%. During the first year, between 40 and 63% remained at their initial level of dependency. Among those with mild and moderate levels of dependency at baseline, a large proportion declined towards increasing levels of dependency over time; around 40% had increased their dependency level 1 year from baseline and at the end of the follow-up, 75% had increased their dependency level or died.</p><p>CONCLUSIONS: Older people in Sweden being allocated home help are at high risk for decline towards higher levels of dependency, especially those at mild or moderate dependency levels at baseline. Taken together, it is important that municipalities make use of existing knowledge so that they implement cost-effective preventative interventions for older people at an early stage before a decline toward increasing levels of dependency.</p>}},
  author       = {{Zingmark, Magnus and Norström, Fredrik}},
  issn         = {{1471-2318}},
  keywords     = {{Aged; Aged, 80 and over; Cities; Cohort Studies; Humans; Longitudinal Studies; Retrospective Studies; Social Support; Sweden/epidemiology}},
  language     = {{eng}},
  pages        = {{1--8}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Geriatrics}},
  title        = {{Transitions between levels of dependency among older people receiving social care - a retrospective longitudinal cohort study in a Swedish municipality}},
  url          = {{http://dx.doi.org/10.1186/s12877-021-02283-x}},
  doi          = {{10.1186/s12877-021-02283-x}},
  volume       = {{21}},
  year         = {{2021}},
}