Frailty, Dementia Nervous System Diseases Dementia
Conditions
Interventions
Trained community nurses visit patients at home, assess the care needs with the Resident Assessment Instrument - Home Care (RAI-HC), a multidimensional geriatric assessment. Computerisation enables di
Sponsors
Vrije University Medical Centre (VUMC) (Netherlands)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Frail elderly as defined by: 1.1. Aged 75+ years persons living at home who score in the worst quartile of at least two of six COOP-charts are considered frail 1.2. Persons at high risk on the 7-minute screen and below the threshold of the Mini-Mental State Examination (MMSE) (less than 24) 2. Caregivers of demented persons (under 1.2.)
Exclusion criteria
Exclusion criteria: Does not comply with the above inclusion criteria
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Health related quality of life as measured with the Short Form 36 (SF-36), and Quality Adjusted Life Years by health utilities based on Euroqol (EQ-5D), measured at baseline, 6 and 18 months. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. (Days until) institutionalization: hospital stay, placement in nursing home or home for the elderly are surveyed and crosschecked at institutes, measured at baseline, 6 and 18 months 2. Hospital admissions, measured at 18 months 3. (Days until) mortality as checked with the Primary Care Physicians (PCPs), measured at 18 months 4. Direct costs as measured by patient questionnaires with three-monthly recall periods. These self-report data are supplemented by data from the centralized regional pharmacy database (medication use), regional hospital check, and nursing home checks. In case patients are not able to fill out the forms themselves a close relative will be approached, measured at baseline, 6 and 18 months | — |
Countries
Netherlands
Outcome results
None listed