Frail Elderly
Conditions
Keywords
Case Management, Frail Elderly, Health Services Administration, Delivery of Health Care, Accidental Falls, Health Status, Health Care Economics
Brief summary
The aim of is to test the effects of a model for care (case management) to older people with high healthcare consumption and functional dependency on healthcare consumption, quality of life, functional ability and experiences of care.
Interventions
OTHERCase management
Nurses and a physiotherapist (PT) worked as case managers (CM). The intervention lasted 12 months and comprised 4 dimensions. The first was traditional CM tasks: assessment, planning, monitoring, care coordination and evaluation. Home visits were made at least once a month. The second and third was general and specific information related to the participants' situation. The fourth part included aspects of continuity and safety. The PT also paid home visits and made an assessment regarding physical function and balance. The intervention consisted of multidimensional prevention of falls and/or consequences of falls, and supporting and motivating the participant to increased physical activity. When those in the control group had participated for 12 months they were offered the intervention.
Sponsors
Lund University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* aged 65 or over * need help with at least two activities of daily living * been admitted to hospital on at least two occasions, or * have had at least four contacts with outpatient or primary care during the previous twelve months, * be able to communicate verbally * have no cognitive impairment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of falls | baseline and then after 3,6,9,12,24 months |
| Health care consumption | two years (one year before vs after baseline) |
| Health care costs | two years (one year before vs after baseline) |
| Feelings of loneliness | baseline and then after 3,6,9,12,24 months |
| Depressive symptoms | baseline and then after 3,6,9,12,24 months |
| Health Related Quality of Life | baseline and then after 3,6,9,12,24 months |
Secondary
| Measure | Time frame |
|---|---|
| Activities and social participation | baseline and then after 3,6,9,12,24 months |
| Functional capacity | baseline and then after 3,6,9,12,24 months |
| Balance | baseline and then after 3,6,9,12,24 months |
| Risk of falling | baseline and then after 3,6,9,12,24 months |
| Fear of Falling | baseline and then after 3,6,9,12,24 months |
| Timed up and go (TUG) | baseline and then after 3,6,9,12,24 months |
| Life Satisfaction | baseline and then after 6,12,24 months |
| Health complaints | baseline and then after 3,6,9,12,24 months |
| Knowledge about prescribed drugs | baseline and then after 3,6,9,12,24 months |
| Attitudes towards prescribed drugs | baseline and then after 3,6,9,12,24 months |
| Drug use | baseline and then after 3,6,9,12,24 months |
Other
| Measure | Time frame | Description |
|---|---|---|
| Experiences of care | approximately one year | qualitative interviews with participants, next of kins and case managers |
Countries
Sweden
Outcome results
None listed