Needs Assessment Research: Aging

Home adaptation: helping older people age in place.

Fielo SB, Warren SA.
State University of New York’s Health Science Center at Brooklyn, USA. Geriatr Nurs 2001 Sep-Oct;22(5):239-46; quiz 246-7

As people age, decrements in sensory, motor, and cognitive function often jeopardize their ability to manage activities of daily living safely and comfortably in their own homes. The purposes of this article are to discuss common problems faced by many elders who want to remain at home, present information about possible solutions that increase their safety and comfort, and provide resources for additional information on assistive products.

Perceptions of problems and needs for service among middle-aged and elderly outpatients with schizophrenia and related psychotic disorders.

Auslander LA, Jeste DV.
Department of Psychiatry, University of California, San Diego, USA. Community Ment Health J 2002 Oct;38(5):391-402

We examined the perceived problems and needs for services among 72 middle-aged and elderly outpatients with schizophrenia and related psychotic disorders. The survey questionnaire included 50 Likert scaled items involving everyday functioning skills, health, clinical symptoms, and social skills. Subjects assigned the highest priority to physical health and memory. Other areas of high priority were: social functioning, education about their own mental illness, and improvements in sleep and mood. Reducing frequency of psychiatric hospitalization, and drug or alcohol rehabilitation received low priority. Focused interventions targeting health-related and social issues are needed in older patients with schizophrenia.

The orodental status of a group of elderly in-patients: a preliminary assessment.

McNally L, Gosney MA, Doherty U, Field EA.
Department of Clinical Dental Sciences, University of Liverpool, UK. Gerodontology 1999 Dec;16(2):81-4

Objective: To provide a preliminary assessment of the orodental status and dental treatment requirements of a group of elderly in-patients.
p. Design: Cross-sectional.
p. Setting: Acute Care of the Elderly and Stroke Rehabilitation units at teaching hospitals in Merseyside.
SUBJECT: 150 patients aged 58 to 94 years, in which a history could be validated at interview.
p. Interventions: Questionnaire administered by dentist and clinical examination.
p. Main Outcome Measures: Registration with a dentist, prosthetic status and difficulties with dentures, denture hygiene and identification marking, dental treatment needs and evidence of mucosal pathology.
p. Results: Only 27% of patients claimed registration with a dentist. Three quarters of the patients were edentulous and 66 patients wore full dentures; 18 had no prostheses. Difficulties were experienced by one quarter of patients with upper dentures, compared with a half of lower denture wearers. Of the dentures available for inspection, 61% had removable soft debris, 66% were left out at night and 75% were cleaned by the patient, whilst on the ward. No dentures had evidence of identification marking. Of the 39 partially dentate patients, 75% required interventive dental treatment. Denture stomatitis was diagnosed in 29% of patients and 19 had evidence of benign mucosal pathology.
p. Conclusion: The orodental status of this group of elderly in-patients was poor, with a high proportion being edentulous. Few were registered with a dentist and denture hygiene was inadequate. Lack of identification marking is a matter of concern. Closer liaison between hospital staff responsible for elderly in-patients is required, to improve the orodental health and quality of life of this medically compromised group of patients.

The prevalence of diagnoses, impairments, disabilities and handicaps in a population of elderly people living in a defined geographical area: the Gospel Oak project.

Harwood RH, Prince MJ, Mann AH, Ebrahim S.
University Department of Primary Care and Population Sciences, Royal Free Hospital, London, UK. Age Ageing 1998 Nov;27(6):707-14

Objective: to measure the prevalence of impairments, disabilities and handicaps in a geographically-defined elderly population.

Design: cross-sectional analysis of an interview survey.

Setting: a single North London electoral ward (district). p. Participants: 654 residents (74%) over the age of 65 years were interviewed from a register of 889. A random sample of 225 had additional data collected which are reported in this analysis.
p. Main Outcome Measures: point prevalence and distribution of the total number of reported diagnoses, impairments and disabilities, and distributions of the Office of Population Censuses and Surveys (OPCS) disability scale and the London Handicap Scale scores.
p. Results: participants had a median of three reported diagnoses and two impairments. Forty-three percent were in the least disabled OPCS disability category (i.e. below the disability threshold) and 41% were able to undertake all of 12 basic activities of daily living without difficulty. Overall handicap scores were heavily skewed towards no health-related disadvantage, with a median score of 83 out of 100, and 37% having a score of 90 or more. All indicators showed deteriorating health with increasing age, but age-adjusted gender differences were small.
p. Conclusion: an elderly population’s health problems were classified using a comprehensive framework, revealing high prevalences of diagnoses, impairments, disabilities and handicaps. The schema is appropriate for health care needs assessment and is a suitable basis for describing the population’s health.