Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Homebound Persons”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed1990

[Dental health among homebound mental (psychiatric) patients].

The purpose of the present study was to describe the dental health behavior, oral health and dental treatment needs in a group of chronic, homebound mental patients. 84 patients were interviewed with regard to oral hygiene and utilization of dental services, by means of a standardized questionnaire. Furthermore, 56 patients were examined clinically. About 20% did not brush their teeth regularly. A similar group had not payed regular dental visits for the last 3 years although they were not edentulous. The dental examinations showed an average DMFS of 84.6. One out of four persons were edentulous and 45% of the dentate participants had periodontal pockets deeper than 5 mm. Restorative need was found for 71%, 12% were in need of fillings of more than 15 surfaces, whereas 45% were in need of scaling or advanced periodontal treatment. Finally, 15% exhibited need of their first removable denture. An index for the overall dental treatment need showed that 63% were in great need for dental treatment. The findings indicate significant dental needs in non-institutionalized persons with mental disease. A hospital based dental team combined with mobile primary dental health care are proposed as a possible solution to the dental health problems of deinstitutionalized psychiatry.

DMF Index↗
PubMed1984

Development of scales to measure satisfaction and preferences regarding long-term and terminal care.

This report describes efforts to develop and test scales for measuring attitudes toward the medical care of chronically and terminally ill patients and their families. The following satisfaction scales were developed: General Satisfaction, Availability of Care, Continuity of Care, Physician Availability, Physician Competence, Personal Qualities of Physician, Communication with Physician, Involvement of Patient and Family in Treatment Decisions, Freedom from Pain, and Pain Control. Preference scales were developed to measure preference for home care and preference for physician decisions. These scales were tested in two independent study samples: Home Care Study subjects--patients and their caretakers enrolled in a trial to evaluate a new method of home care for chronically and terminally ill homebound patients; and Terminal Care Study subjects--surviving relatives of a random sample of cancer patients who died. The internal consistency, discriminant validity, and convergent validity of each scale were assessed by means of item-total correlations, Cronbach 's alpha, and comparison with other questionnaire items. The results supported the use of several scales in their original form. Recommendations are made for appropriate modifications in the remaining scales.

Attitude↗
PubMed1980

A factor analysis of life satisfaction, adjustment and morale measures with elderly adults.

Seven frequently used measures of life satisfaction, adjustment and morale were subjected to the techniques of construct validation. Data for the analysis was obtained from 259 people over the age of sixty who represented three clusters: nursing home residents, homebound older people and "community" aged. The data were analyzed through Alpha factor analysis methods. Items from six of the seven measures were found on the two factors that best represented the conceptual area of life satisfaction.

Aged↗
PubMed1996

Marketing nutrition services for the elderly.

The Older Americans Act of 1965 was implemented to provide assistance in the development of new or improved programs to help older persons through grants for the States. Community planning, and services for training, were established within the Department of Health, Education, and Welfare under an agency designated as the Administration on Aging (Older Americans Act of 1965, p. 1). There has been an evolution of Community Nutrition services for the elderly. The original purpose was the establishment of community based congregate dining sites where seniors would come together for food and fellowship. The homebound seniors were recognized and home-delivered meal service was developed. This home delivered meal service has steadily increased as the participant population has changed with less family support and is becoming older and frailer while congregate participation has decreased. The challenge to marketers is to continue to bring together the need for nutritional assistance in the elderly population and nutritional programs to satisfy that need. The authors have conducted a nutrition service program study that can benefit the industry that serves this segment of the population. This study observes trends and behaviors and can assist the development of new products and services for the aging.

Aged↗
PubMed1993

Advances in portable and mobile equipment systems.

Specific efforts need to be directed towards eliminating and/or minimising the significant barriers that threaten the oral health of nursing home and homebound individuals. Exciting new portable dental system options are now available which will help to overcome difficulties associated with meeting the dental needs of this cohort.

Aged↗
PubMedDate not supplied

A nontraditional cancer support group. The Internet.

The benefits of cancer support groups (CSGs) have been well documented. Recently, several nontraditional CSGs have been used, including Internet CSGs (ICSGs). The purpose of this study was to describe categories or themes of information shared on an Internet cancer support group (ICSG), determine how many people used the list, and how frequently they posted on it. Content analysis of 300 messages posted on an ICSG were analyzed and eight categories of responses were identified: (1) information giving/seeking; (2) personal opinions; (3) encouragement/support; (4) personal experience; (5) thanks; (6) humor; (7) prayer; and (8) miscellaneous. Forty million American homes will have Internet access in the near future, making electronic cancer support groups available to vast numbers of people. The ICSG is a means of offering support to cancer patients, their families, and caretakers in a nontraditional format. Nurses should be versed in the use of Internet resources and the advantages (eg, 24-hour availability, accessibility to the homebound) and disadvantages (eg, cost of Internet access, lack of a professional facilitator) for ICSGs.

Colorectal Neoplasms↗
PubMed1996

Use of central nervous system medications among elderly home health clients.

Older persons consume a disproportionate share of all medications dispensed in the United States. In particular, medications acting upon the central nervous system (CNS) have been overprescribed for elderly persons, both in and out of the institutional setting. Although researchers have studied drug use by elders who live in the community, little is known about the use of CNS medications by ill older persons who live at home. This descriptive study examined the use of CNS medications in a group of elderly persons (N = 141) admitted to a visiting nurse association for skilled care. Subjects resided in the community of a large midwestern city. Approximately half of the subjects used some type of CNS drug. Sedative/hypnotic and narcotic and opioid analgesics, two categories of medications with the potential for serious side effects, were most frequently prescribed. Nurses in community and institutional settings are in an ideal position to screen and monitor the use of CNS medications by homebound ill elders.

Aged↗
PubMed1976

Detection of the disabled in a rural area.

A rural Jewish and Arab population of about 24,000 was selected for a rehabilitation study on the disabled. The detection consisted of the collection of existing data from local sources and a door-to-door screening based on an interview schedule. About 22,000 (93%) individuals responded to the interview. In subjects under the age of 65, the degree of agreement between the findings of the door-to-door screening and the information obtained from official local sources was 45.4% among disabled Jewish villagers, and 24% for disabled Arab villagers. On the other hand, in the same age group, the door-to-door interview failed to reveal between 12 to 18% of the subjects reported as disabled by the various local authorities. The reason for this low percentage of agreement is discussed. The disablement rate in the 0- to 13-year age group was 9% for Arab and 12.5% for Jewish children. In the working age group (14 to 64 years) the disablement rate was 5.3% for Arabs and 7.9% for Jews. More than 30% of both Arabs and Jews in this age group had impairments and chronic conditions that did not interfere with their functioning in normal life. In the pensionable age group (65+ years), 8.3% of Arab villagers and 2.3% of Jewish villagers were totally dependent. Special efforts were made to detect the functional limitations of housewives and of the homebound. The interview schedule had a marked educational effect on the professionals and on the villagers. This facilitated the establishment of a rural rehabilitation service in an Arab village, the first service of its kind in Israel.

Adolescent↗
PubMed1977

Dental care for the homebound--assessment and hygiene.

A general categorization of homebound patients is presented to aid the dentist in assessing their treatment needs and requirements. The importance of oral hygiene is shown, and modifications of oral hygiene appliances are presented. The role of the general dentist in the care of these patients is stressed.

Dental Care↗
PubMed1992

Homebound Learning Opportunities: reaching out to older shut-ins and their caregivers.

Homebound Learning Opportunities (HLO) represents an innovative health promotion and educational outreach service for homebound older adults and their caregivers. It provides over 125 topics for individualized learning programs delivered to participants in their own places of residence, an audiovisual lending library, educational television programming, and a peer counseling service. Shut-ins are recruited as instructors and as participants in service projects that benefit the greater community. Preliminary assessments reveal high levels of participation and satisfaction with the program.

Aged↗
PubMedDate not supplied

The rehabilitation nurse in the home care setting: treating chronic wounds as a disability.

Rehabilitation nurses have moved into the home care setting; along with other home care nurses, they treat clients with chronic wounds. A rehabilitation nurse, however, views the homebound client needing wound care as having a disability that requires lifestyle modification. Rehabilitation nurses also treat clients with other disabilities who are at risk for developing wounds, so they are in an ideal position to instruct clients in wound prevention. Rehabilitation nurses in home care have the skills and expertise to assess clients needing wound care for deficits that might otherwise be overlooked.

Aged↗
PubMed1992

Oral care for the homebound and institutionalized.

Most patients who are homebound or in LTC facilities have multiple health problems that require the cooperation of many different types of providers. Dentists have a specific role in this process because they can improve the quality of life for the elderly by keeping them free of oral infection, restoring their dentition so they can enjoy eating, and restoring facial esthetics. It should be apparent that dental care for these patients is a complicated process. There are many considerations in prescribing the type of treatment needed by each patient. These include the patient's life span, medical history, drug history, mental status, mobility status, neuromuscular coordination, dental status, previous dental experience, dental expectations, and economic status. This information must be gathered by the dentist from the patient, the family, the nursing staff, and the patient's physician. Furthermore, the dentist also must assess the facilities and equipment available to carry out oral health care. Only after such considerations can a dental treatment plan evolve that is appropriate for the individual concerned. Dental care for one patient may be no treatment whatsoever, whereas a different patient in the same institution may require the most technologically sophisticated care that dentistry has to offer. Finally, the following circumstances should suggest that a homebound or institutionalized patient needs an urgent oral/dental evaluation: General Signs and Symptoms; Orofacial pain, Visible oral infection, Difficulty chewing food, Halitosis/dry burning mouth, Visible oral soft tissue lesions (white, red, or ulcerated). Tooth-related signs and symptoms; Visible dental decay, Loose or mobile teeth, Bleeding or sore gums. Denture-related Signs and Symptoms; Loose, ill-fitting, or worn dentures, Missing denture teeth, Home repairs attempted.

Aged↗
PubMedDate not supplied

Implementation of the Zuluaga-Raysmith (Z-R) model for assessment of perceived basic human needs in home health clients and caregivers.

The Zuluaga-Raysmith (Z-R) model is a conceptual framework that incorporates accepted concepts of universal basic human needs developed by Maslow, yet removes the hierarchical nature of these. The Z-R model recognizes the existence of a health-illness continuum and accepts that an entity (individual, family, aggregate, or community) may move freely in the direction of greater health and self-actualization or towards illness and premature death. The Z-R model identifies 10 basic needs and recognizes that a perceived deficit in any one of these needs can adversely affect the level of wellness of the entity being considered. This exploratory and descriptive study used 11 nurses as interviewers. Subjects consisted of a convenience sample of homebound clients of a home health agency in a metropolitan city, and selected caregivers (n = 27). A modified functional wellness inventory (developed in 1993 by Louvenia Carter) was used with several open-ended questions, which together related to the 10 needs of the Z-R model. Reliability coefficient of the instrument was 0.84. Descriptive statistics were used to analyze the data, using means, percentages, and frequencies. Open-ended questions were grouped according to content and ranked in order of frequency. The five most pressing needs of this small sample were income; physical health; opportunity to make a contribution; mobility; and mental, emotional, social, and spiritual health (MESSH). Nurses unanimously reported that use of the instrument and the Z-R model helped them to focus on the total person, identify strengths in their clients, identify perceived needs deficits, and therefore, with the client, facilitate the preparation of a timely and cost-effective interdisciplinary plan of care to help the entity to move to a higher level of wellness despite the presence of chronic disease, disability, or impending death. These findings suggested that further research is warranted to explore the use of the Z-R model. A replication study is in progress.

Aged↗
PubMed1988

Rehabilitation management of homebound elderly with locomotor disability.

Functional disabilities, the final common pathway of all medical and surgical conditions, are frequently preventable and treatable. Etiologic diagnosis of functional problems is important so that one does not miss the opportunity to improve and increase independence. Rehabilitation of the elderly can be a special problem. Their habits are longstanding and difficult to change. It is important to establish realistic and attainable goals with the patient. Not every habit needs to be altered. What is more important is that the patient safely achieve maximum independence. An environmental assessment is "key" to a full understanding the limitations of function, and how well management strategies can be integrated.

Activities of Daily Living↗
PubMed1992

Prearrest predictors of survival following in-hospital cardiopulmonary resuscitation: a meta-analysis.

BACKGROUND: The success rate of cardiopulmonary resuscitation (CPR) varies with the patient population studied. Prearrest variables have been used to identify groups of patients with a particularly low rate of survival following CPR. The purpose of this study was to use the technique of meta-analysis to identify prearrest variables associated with a decreased rate of survival to the time of discharge following CPR of hospitalized patients. METHODS: The MEDLINE database was searched using the following key words: resuscitation, survival, and 1980-1991. The bibliographies of studies identified in the computerized search as well as those of appropriate studies in the author's personal files were reviewed. The following inclusion criteria were used: study published since 1980 (data collected after 1975), in-hospital resuscitation, retrospective or prospective design, consecutive adult patients from both the general wards and intensive care units, an end-point of survival to hospital discharge, and data reported for at least one variable measured before cardiac arrest. Of the 22 studies initially identified, 14 met the above criteria. Data were taken directly from the published reports. In two cases where no specific survival data were reported but the studies met all other criteria for inclusion, the authors were contacted and agreed to supply the necessary information. Two-way variables were combined across studies using the Mantel-Haenszel statistic. RESULTS: The following prearrest variables were associated with a decreased rate of survival to discharge following CPR (P less than .005): age over 70 years, serum creatinine greater than 130 mumol/L, serum creatinine greater than 220 mumol/L, homebound lifestyle, presence of cancer or metastatic cancer, and a primary diagnosis of sepsis or pneumonia. A primary diagnosis of myocardial infarction was associated with an increased rate of survival to discharge following CPR (P = .005). Based on these results, modifications to the Pre-Arrest Morbidity Index initially devised by George and colleagues have been proposed. CONCLUSIONS: The identification of prearrest variables that are associated with decreased survival following CPR will assist clinicians when they counsel their patients regarding do-not-resuscitate (DNR) orders. In addition, the further refinement of a predictive tool such as the modified Pre-Arrest Morbidity Index can help clinicians to identify patients for whom CPR is futile. Such an instrument must be validated on an independent data set before it can be considered for clinical application.

Age Factors↗
PubMed1990

Mental health home visits to nonhomebound elderly.

A caseload of 86 patients in a geriatric home visiting service was examined to identify the characteristics that determine why certain geriatric patients receive home visits. Only about a third of the patients were physically homebound. The rest left home for at least some medical care and sustenance, and half of those patients went out for everything but mental health care. Among the 29 nonhomebound patients, few were self-referred, and generally the patient's clinician was more concerned than the patient about the continuation of treatment, findings that suggest that the concern of others was a determining factor in provision of home-based care. The most common problems among the nonhomebound elderly in the caseload were paranoia, depression, and physical frailty.

Activities of Daily Living↗
PubMed1988

Collaboration needed to bolster home care.

To survive financially and better meet the needs of the elderly, hospitals must take the lead and collaborate with community leaders to enhance home healthcare, which can help the elderly maintain their independence and prevent institutionalization. Informal home healthcare is provided mostly by women, primarily wives, daughters, and daughters-in-law. These care givers often take the elderly person into their own homes, which can increase tension and conflicts, crowd the home, and propagate adverse perceptions by the spouse or children. Many care givers quit their jobs, thereby forfeiting income and relinquishing the mental stimulation of co-workers. Care givers who remain employed sacrifice their free time, family time, and other social opportunities. Other factors that influence the degree of stress and burden on the care giver include the type, extent, and duration of care needs; the location of home care; use of formal services; and the care giver's age, health status, and relationship to the elderly patient. Without help from formal home care agencies and local support groups, informal care giving at home may diminish rapidly due to physical and emotional exhaustion, sometimes resulting in abuse of the elderly patient. Government intervention is necessary if informal home care is to continue as a viable source of long-term care. In addition, local community medical societies must develop a team approach involving physicians, social workers, and nurses to adequately supplement home care givers or help single homebound elderly. Hospital administrators must work with community leaders to implement formal networks of home care services, such as respite care, adult day care, meals on wheels, and nursing care.

Aged↗
PubMed2005

Determinants of self-management strategies to reduce out-of-pocket prescription medication expense in homebound older people.

OBJECTIVES: To determine the extent to which homebound older people adopt strategies to reduce out-of-pocket prescription medication cost and the factors associated with level of cost-related medication management. DESIGN: Cross-sectional study. SETTING: Home-delivered meals programs in four North Carolina counties. PARTICIPANTS: Random sample of 222 home-delivered meal recipients aged 60 and older. MEASUREMENTS: The use of six different management strategies to reduce medication expenses was reported at the in-home assessment. Associations between level of cost-related medication management and sample characteristics, drug coverage, behaviors to cope with out-of-pocket medication expense, and payment difficulty were examined. RESULTS: Forty-five (20.3%) participants used one or more behaviors that restricted medication use; another 47 (21.2%) used one or more strategies to reduce out-of-pocket medication cost. Using medication restriction to reduce medication expense was more likely in older people who had difficulty paying for medications (odds ratio (OR)=8.2, 95% confidence interval (CI)=1.4-50.3), or used a strategy to cope with out-of-pocket expenses (choose food or medications (OR=5.1, 95% CI=1.7-15.7) or borrowed money or had another person pay for medications (OR=5.5, 95% CI=2.6-11.6)). Income, drug coverage, and medication use (prescribed and over-the-counter) increased the likelihood of having increased difficulty paying for medications. CONCLUSION: Clinicians should attempt to identify patients who are at risk for medication restriction and develop strategies for minimizing any unintended consequences of cost-related medication management behaviors. Provider-patient communication should include discussion of medication cost and appropriate medication management strategies.

Aged↗