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Medical Etiology And Medical Consequences Of Functional Dependence In Elderly at Home Care
Ljiljana Zikic
Purpose. The elderly with dependence in basic self/care tasks ? the activities of daily living (ADL) incur high health care costs. Many authors agree that independence with difficulties occurs between independence and dependence and has prognostic significance for functional status decline, health care utilization, nursing home placement and survival. This middle state should identify and through interventions implemented earlier, it should prevent that ?dependence? replace ?difficulty?. The aim of the research was to assess functional status and level of immobility in elderly patients admitted in home care unit in Belgrade, and to get some generalization regarding to medical etiology and medical consequences of functional dependency.
Methodology. Comprehensive questionnaire including multidimensional assessment of health has been administrated to patients at their admission at home care unit in IGHTC. The research was composed on 1696 respondents age 60+ out of total elderly patients admitted at home care from 1996-2003 (N=5008). Functional status was assessed through standard 9 items regarding to ability to perform ADL and edited by Index of Functional Status ? IFS. Research population was divided into two groups: 1.Independent with difficulties (IFS=>-22.56) N=1094 and 2.Dependent in ADL (IFS=-22.56) N=602. Research groups were compared by medical etiology and medical consequences through means of statistical analyses.
Results. Data about medical complication pointed out that there has been significant difference between dependent and independent patients concerning incidence of pressure sores (25.6%-5.4%), permanent catheterization (30.99%-8.16%), urinary incontinence (56.4%-21.1%), and deformities (19.8%-12.5%). Dependent elderly significantly more (69.3%) reported physically difficulties through presence of variety of symptoms than independent (56.8%). Statistically significant higher prevalence of neoplasms (C00-D48)(32.8%); injuries, poisoning and certain other consequences of external causes (S00-T98)(26.3%); symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) (26.3%) was found among dependent elderly patients.
Conclusion. Knowledge about common medical consequences in dependent and immobile elderly patients would help to improve care management and to maintain quality of life in disability patients. Results should help to prevent functional decline of independent patients through appropriate interventions.
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