Risk assessment during preventive home visits among older people

Abstract

Astrid Fjell,1,2 Berit Seiger Cronfalk,1,3 Nina Carstens,4 Arvid Rongve,5,6 Lars M Rosseland Kvinge,7 Åke Seiger,8 Knut Skaug,9 Anne-Marie Boström1,2,10 1Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; 2Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway; 3Department of Nursing Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden; 4Hospital Pharmacies Enterprise, Western Norway, Bergen, Norway; 5Department of Research and Innovation, Helse Fonna, Haugesund Hospital, Haugesund, Norway; 6Institute of Clinical Medicine, University of Bergen, Bergen, Norway; 7FOUSAM, Western Norway University of Applied Sciences, Haugesund, Norway; 8Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden; 9Department of Medicine, Helse Fonna, Haugesund Hospital, Haugesund, Norway; 10Theme Aging, Karolinska University Hospital, Huddinge, Sweden Background: Preventive home visits (PHV) may contribute to identify risks and needs in older people, and thereby delay the onset of functional decline and illness, otherwise often followed by home care or admission to hospital or nursing homes. There is a need to increase knowledge about which factors are associated with different risk areas among older people, so that the PHV questionnaire focuses on relevant tests and questions to make the PHV more specific and have a clear focus and purpose.Objective: The objective of this study was to examine associations between five kinds of risks: risk of falls, malnutrition, polypharmacy, cognitive impairment, and risk of developing illness and factors related to lifestyle, health, and medical diagnoses among older people living at home.Methods: A cross-sectional study design was applied. PHV were conducted by nurses among 77-year-old people in an urban municipality and among ≥75-year-old people in a rural municipality. A questionnaire including tests and a risk assessment score for developing illness was used. Descriptive and inferential statistics including regression models were analyzed.Results: The total sample included 166 persons. Poor perceived health was associated with increased risk of developing illness and risk of fall, malnutrition, and polypharmacy. Lifestyle and health factors such as lack of social support, sleep problems, and feeling depressed were associated with risk of developing illness. Risk of falls, malnutrition, polypharmacy, and cognitive impairment were also associated with increased risk of developing illness. None of the independent factors related to lifestyle, health, or medical diagnosis were associated with risk of cognitive impairment.Conclusion: Poor perceived health was associated with health-related risks in older persons living at home. Preventive health programs need to focus on social and lifestyle factors and self-reported health assessment to identify older people at risk of developing illnesses. Keywords: preventive home visits, older adults, risk assessment, developing illness, perceived health, social factors, logistic regression analysis, lifestyle 

Keywords

• preventive home visits
• older adults
• risk assessment
• developing illness
• perceived health
• social factors