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PubMedDate not supplied

Homebound older adults' experiences with the Internet and e-mail.

The purpose of this study was to explore homebound older adults' experiences with the Internet and e-mail employing the Dutch phenomenological approach. A sample of 5 homebound older adults was included. All participants were interviewed twice. Data were analyzed employing the technique recommended by Dutch phenomenologists. The analysis resulted in a total of 10 shared themes and a thick description of the homebound older adults' experiences with the Internet and e-mail. The findings indicated that all participants were faced with various challenges in learning the Internet and e-mail. Those difficulties, however, were overcome by continuous practice and support from various sources. Ultimately they found that the Internet and e-mail were excellent sources of support and enjoyment, resulting in an improved quality of life.

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PubMed2000

Homebound status.

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Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Treatment of homebound mentally ill elderly patients: the multidisciplinary psychiatric mobile team.

Authors evaluated the general feasibility of using a multidisciplinary psychiatric mobile team model for homebound elderly patients. Information was collected with a semistructured interview on 235 homebound elderly patient referrals over a 2.5-year period. Ninety-three subjects were accepted into the program; 12.9% of those accepted required psychiatric hospitalization during the follow-up. Maintaining individuals in the community was achieved with intense case management and significant increases in home-care hours. The multidisciplinary team approach appeared to lessen psychiatric disability in homebound mentally ill elderly patients.

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PubMedDate not supplied

Diabetes screening for housebound patients.

Annual screening for patients with diabetes plays an important role in preventing complications. An audit carried out at a GP practice showed that housebound patients with diabetes were not receiving adequate treatment and support as they could not attend the clinic at the surgery. District nurses at the practice were trained in the management of diabetes and screened patients, who were then visited by a GP. The initiative highlighted a range of previously undetected problems with the patients' conditions, which were then addressed. The service is now available to newly diagnosed housebound patients with diabetes, as well as providing annual reviews for current patients.

Community Health Nursing↗
PubMedDate not supplied

In-home respite intervention reduces plasma epinephrine in stressed Alzheimer caregivers.

OBJECTIVE: Some excess morbidity and mortality in Alzheimer caregivers (CGs) may be related to chronic activation of the sympatho-adrenal-medullary (SAM) system. Authors tested the efficacy of an in-home respite intervention to reduce peripheral markers of SAM activation and psychological distress in spousal caregivers of patients with Alzheimer disease. METHODS: Caregivers were classified as Vulnerable (n = 27) or Non-Vulnerable (n = 28). Vulnerable CGs were those with a severe mismatch between caregiving demand and help received in the preceding 6 months. CGs had plasma catecholamine levels sampled at rest and in response to a stressor (speech task) before and 1 month after a 2-week in-home respite intervention. Self-reported symptoms of anxiety and depression were also obtained. RESULTS: ANOVA revealed a group x treatment interaction: At the 1-month follow-up, plasma epinephrine declined significantly in the vulnerable caregivers who received respite, but rose in those who were wait-listed. No effect was found for norepinephrine, heart rate, blood pressure, or psychological symptoms. CONCLUSION: Findings suggest that an in-home respite program may reduce SAM activation independent of psychological symptoms. To the extent that sympathetic activation mediates pathophysiological events, these results suggest an approach that may reduce morbidity and mortality in certain caregivers.

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