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Community Services for the Elderly

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5161. A profile of functionally impaired elderly persons living in the community (PubMed)

A profile of functionally impaired elderly persons living in the community The Health Care Financing Administration, in cooperation with other agencies of the Department of Health and Human Services, conducted surveys in 1982 and 1984 designed to develop a better understanding of the number and circumstances of functionally impaired elderly persons living in the community. This report is based on data from the 1982 Long-Term Care Survey. There were approximately 5 million functionally impaired (...) elderly persons living in the community in 1982. The data show that functionally impaired persons in the community are older, are more often female, have lower incomes, and have a larger proportion of black people than the general elderly population. The data also provide baseline information on what functional impairments are prevalent among them, what means they use to cope with the limitations, and from whom they receive help. The baselines data gathered in 1982 will be supplemented by longitudinal

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1986 Health Care Financing Review

5162. Parkinson's disease as community health problem: study in Norwegian nursing homes. The Norwegian Study Group of Parkinson's Disease in the Elderly. (PubMed)

Parkinson's disease as community health problem: study in Norwegian nursing homes. The Norwegian Study Group of Parkinson's Disease in the Elderly. To examine the extent of under-diagnosis and overdiagnosis of Parkinson's disease and to determine quality of treatment in a defined population.Clinical evaluation of an elderly population.40 Norwegian nursing homes.3322 residents of nursing homes, of whom 500 were selected by nursing staff for evaluation on the basis of a structured information (...) , the treatment was changed, and 36 patients showed a definite functional improvement after a 12 week observation period.The quality of life of many elderly patients with Parkinson's disease could be improved by increasing medical and neurological services.

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1991 BMJ : British Medical Journal

5163. Community care for the elderly: is it really better? (PubMed)

Community care for the elderly: is it really better? 8439910 1993 04 01 2018 11 13 0820-3946 148 3 1993 Feb 01 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Community care for the elderly: is it really better? 393-6 Gordon M M Baycrest Centre for Geriatric Care, Toronto, Ont. eng Journal Article Canada CMAJ 9711805 0820-3946 AIM IM CMAJ. 1993 Sep 1;149(5):538, 540 8267727 CMAJ. 1993 May 1;148(9):1444-5 8477357 Aged Caregivers Community Health (...) Services economics Health Services for the Aged economics Humans Long-Term Care Ontario 1993 2 1 1993 2 1 0 1 1993 2 1 0 0 ppublish 8439910 PMC1490478 Milbank Q. 1988;66(2):309-88 3141762 J Am Geriatr Soc. 1992 Apr;40(4):421-4 1556374 Gerontologist. 1983 Aug;23(4):364-9 6413303 Gerontologist. 1983 Dec;23(6):619-25 6662376 Am J Public Health. 1985 Feb;75(2):134-41 3966617 Nature. 1985 Jun 6-12;315(6019):463-6 3158823 J Am Geriatr Soc. 1985 Oct;33(10):664-70 4045083 Gerontologist. 1986 Aug;26(4):389-97

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1993 CMAJ: Canadian Medical Association Journal

5164. Community care for the elderly. (PubMed)

Community care for the elderly. 8267727 1993 10 07 2018 11 13 0820-3946 149 5 1993 Sep 01 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Community care for the elderly. 538, 540 Clarfield A M AM eng Comment Letter Canada CMAJ 9711805 0820-3946 AIM IM CMAJ. 1993 Feb 1;148(3):393-6 8439910 Canada Community Health Services Health Services for the Aged Humans 1993 9 1 1993 9 1 0 1 1993 9 1 0 0 ppublish 8267727 PMC1485998 Can Med Assoc J. 1983 Dec

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1993 CMAJ: Canadian Medical Association Journal

5165. Prescription and nonprescription drug use among black and white community-residing elderly. (PubMed)

Prescription and nonprescription drug use among black and white community-residing elderly. To examine and compare concomitants of prescription and nonprescription drug use of Black and White community-dwelling elderly.Information on prescription and nonprescription drug use, demographic and health characteristics, and use of health services was obtained from a probability-based sample of Black (n = 2152) and White (n = 1821) community-resident elderly in the Piedmont area of North Carolina (...) . Descriptive statistics were calculated. Linear regression, in which sample weights and design effects were taken into account, was used for the final models.For prescription drug use, 37% and 32% of the variance was explained for Whites and Blacks, respectively (6% and 5% for nonprescription drugs). Health status and use of medical services were the strongest predictors of prescription drug use for both races (with Medigap insurance also important for Whites and Medicaid important for Blacks). Demographic

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1993 American Journal of Public Health

5166. Community care for the elderly. (PubMed)

Community care for the elderly. 2555493 1989 12 29 2008 11 20 0035-8797 39 320 1989 Mar The Journal of the Royal College of General Practitioners J R Coll Gen Pract Community care for the elderly. 122 Wheatley K A KA eng Letter England J R Coll Gen Pract 7503107 0035-8797 IM Aged Aged, 80 and over Community Health Services Female Health Services for the Aged Humans Male Work 1989 3 1 1989 3 1 0 1 1989 3 1 0 0 ppublish 2555493 PMC1711782

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1989 The Journal of the Royal College of General Practitioners

5167. A community rehabilitation unit for the elderly. (PubMed)

A community rehabilitation unit for the elderly. 3694578 1988 01 26 2008 11 20 0035-8797 37 297 1987 Apr The Journal of the Royal College of General Practitioners J R Coll Gen Pract A community rehabilitation unit for the elderly. 177-8 McCallum N N eng Letter England J R Coll Gen Pract 7503107 0035-8797 IM Aged England Health Services for the Aged Humans Middle Aged Rehabilitation Centers 1987 4 1 1987 4 1 0 1 1987 4 1 0 0 ppublish 3694578 PMC1710726

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1987 The Journal of the Royal College of General Practitioners

5168. Dysthymia among the community-dwelling elderly. (PubMed)

Dysthymia among the community-dwelling elderly. There are few data on the clinical features of dysthymia among the community-dwelling elderly. Forty elderly individuals with dysthymic disorder were identified following screening in the community with GMS-AGECAT. A detailed clinical history was obtained and DSM-IV checklists and standardized scales were used, at a second interview. Comparisons were made with a group of 630 non-depressed elderly from the same community. Dysthymia (...) was predominately of late onset (93%) and associated with a major stressor in 65% of cases. Comorbid axis 1 disorders were present in 15% of dysthymics and an axis 2 disorder in 10%. The dysthymic group had significantly higher degrees of physical impairment than the non-depressed elderly. The symptom profile demonstrated prominent anxiety and functional features. Eighty-three per cent of the elderly with dysthymia had presented to their GP with anxiety/depressive symptoms at some stage during the dysthymic

1999 International Journal of Geriatric Psychiatry Controlled trial quality: uncertain

5169. Effect of preventive home visits by a nurse on the outcomes of frail elderly people in the community: a randomized controlled trial. (PubMed)

Effect of preventive home visits by a nurse on the outcomes of frail elderly people in the community: a randomized controlled trial. Timely recognition and prevention of health problems among elderly people have been shown to improve their health. In this randomized controlled trial the authors examined the impact of preventive home visits by a nurse compared with usual care on the outcomes of frail elderly people living in the community.A screening questionnaire identified eligible (...) questionnaire was mailed to 415 elderly people, of whom 369 (88.9%) responded. Of these, 198 (53.7%) were eligible, and 142 consented to participate and were randomly assigned to either the visiting nurse group (73) or the usual care group (69). The combined rate of deaths and admissions to an institution was 10.0% in the visiting nurse group and 5.8% in the usual care group (p = 0.52). The rate of health services utilization did not differ significantly between the 2 groups. Influenza and pneumonia

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2000 Canadian Medical Association Journal Controlled trial quality: predicted high

5170. Improving the well-being of elderly patients via community pharmacy-based provision of pharmaceutical care: a multicentre study in seven European countries. (PubMed)

Improving the well-being of elderly patients via community pharmacy-based provision of pharmaceutical care: a multicentre study in seven European countries. This study aimed to measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients (> or =65 years of age) by community pharmacists in a multicentre international study performed in 7 European countries.The study was a randomised, controlled, longitudinal, clinical trial with repeated measures (...) of the intervention, such as the increased support provided by community pharmacists, rather than via biomedical mechanisms.This study is the first large-scale, multicentre study to investigate the effects of pharmaceutical care provision by community pharmacists to elderly patients. Future research methodology and implementation will be informed by the experience gained from this challenging trial.

2001 Drugs & Aging Controlled trial quality: uncertain

5171. Benefits of nutritional supplementation in free-living, frail, undernourished elderly people: a prospective randomized community trial. (PubMed)

variables were measured at the start and end of the study at subjects' homes by a dietitian blinded to treatment assignment.83 elderly people (experimental group: n=42; control group: n=41; mean age=80+/-7 years) receiving community home-care services and at high risk for undernutrition.Provision of a nutrient-dense protein-energy liquid supplement and encouragement to improve intake from other foods.Anthropometric indexes, handgrip strength, isometric elbow flexion and leg extension strength, lower (...) Benefits of nutritional supplementation in free-living, frail, undernourished elderly people: a prospective randomized community trial. To evaluate the impact of nutritional supplementation on nutritional status, muscle strength, perceived health, and functional status in a population of community-living, frail, undernourished elderly people.A 16-week intervention study in which subjects were randomized to an experimental or a control group and visited in their home on a monthly basis. Outcome

2002 Journal of the American Dietetic Association Controlled trial quality: uncertain

5172. The use of health and social services in the management of stroke in the community: results from a controlled trial. (PubMed)

The use of health and social services in the management of stroke in the community: results from a controlled trial. The use of hospital and community services during the follow-up of a controlled trial which evaluated the effectiveness of a stroke unit and medical units in the management of acute stroke in the elderly is described. Patients from the stroke unit received more health and social services compared with medical unit patients, particularly in the initial follow-up period. The use (...) of services was not related to the functional outcome of patients at hospital discharge. No overall difference occurred between stroke unit and medical unit patients in hospital bed days used throughout the study.

1981 Age and ageing

5173. DataView: Medicaid Home and Community-Based Care Waiver Programs: Providing Services to People With AIDS (PubMed)

, respite care, home intravenous therapy, attendant care, hospice, and home-delivered meals. The study demonstrates that in addition to the AIDS-specific waiver program, State Medicaid programs use the home and community-based care waiver programs for the elderly and disabled to provide services to people with AIDS because of their disability status. (...) DataView: Medicaid Home and Community-Based Care Waiver Programs: Providing Services to People With AIDS The authors present the results of a survey demonstrating how Medicaid programs use the home and community-based waiver programs to provide services to people with acquired immunodeficiency syndrome (AIDS) and to other targeted groups. The survey identified a number of waiver services that are effective at meeting the care needs of people with AIDS, such as case management, personal care

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1997 Health Care Financing Review

5174. Caring for older people. Community services: health. (PubMed)

Caring for older people. Community services: health. Many frail or disabled elderly people are now being maintained in the community, partially at least as a consequence of the Community Care Act 1993. This paper details the work of the major health professionals who are involved in caring for older people in the community and describes how to access nursing, palliative care, continence, mental health, Hospital at Home, physiotherapy, occupational therapy, equipment, and optical, dental (...) , and dietetic services. In many areas, services are evolving to meet needs and some examples of innovative practice are included.

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1996 BMJ : British Medical Journal

5175. Community, service, and policy strategies to improve health care access in the changing urban environment. (PubMed)

Community, service, and policy strategies to improve health care access in the changing urban environment. Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement (...) in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures

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2000 American Journal of Public Health

5176. Expenditures for long-term care services by community elders (PubMed)

Expenditures for long-term care services by community elders Costs of care are presented for elderly persons in five community-based settings. These settings include elderly persons living in their own homes or in group housing and who do or do not receive case-managed home care. Expenditures for care ranged from a low of about $1,100 per year to a high of $4,025. The level of expenditure was directly related to risk of institutionalization and was higher for those receiving case-managed home (...) care. As a majority of the elderly use a substantial amount of care even without case management, the potential for community care demonstration programs to yield significant cost savings appears quite limited.

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1989 Health Care Financing Review

5177. General practitioners' use of community psychiatric nursing services: a preliminary survey. (PubMed)

General practitioners' use of community psychiatric nursing services: a preliminary survey. A questionnaire on general practitioners' use of community psychiatric nursing services was sent to a random sample of 100 general practitioners in two contrasting areas, Croydon and Cambridgeshire. General adult services were widely available though used less often by Cambridgeshire general practitioners than Croyden doctors. Apart from services for the elderly, specialist services were uncommon. Over (...) a third of doctors reported that their adult services were based in a psychiatric hospital. Less than a quarter of general practitioners had access to primary care based nurses. The pattern of responses demonstrates the wide variety of ways in which general practitioners relate to community psychiatric nurses, even where the psychiatric nursing services are long-established. There remains a need for more consistent and coherent policies about the ways in which community psychiatric nurses are employed

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1989 The Journal of the Royal College of General Practitioners

5178. Medicaid Enrollment among Elderly Medicare Beneficiaries: Individual Determinants, Effects of State Policy, and Impact on Service Use (PubMed)

Medicaid Enrollment among Elderly Medicare Beneficiaries: Individual Determinants, Effects of State Policy, and Impact on Service Use To better understand factors associated with Medicaid enrollment among low-income, community-dwelling elderly persons and to examine the effect of Medicaid enrollment on the use of health care services by elderly persons, taking into account selection in program participation.1996 Medicare Current Beneficiary Survey (MCBS) Access to Care and Cost and Use (...) files.Individual-level predictions of the probability of dual enrollment are obtained from equations that estimate jointly the residential status of Medicare beneficiaries (community versus institution) and the probability of Medicaid enrollment among community-dwelling eligible beneficiaries. Predicted values are then substituted into the service use equations, which are estimated via two-part models.Less than half of all community-dwelling elderly persons with incomes at or below 100 percent of the Federal

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2002 Health Services Research

5179. Visual problems in the elderly population and implications for services. (PubMed)

Visual problems in the elderly population and implications for services. To determine the prevalence of visual disability and common eye disease among elderly people in inner London.Cross sectional random sample survey.Inner London health centre.Random sample of people aged 65 and over taken from practice's computerised age-sex register.Presenting binocular Snellen 6 m distance acuity and best monocular 3 m Sonksen-Silver acuity to classify prevalence of blindness by World Health Organisation (...) and Finland suggested higher rates in this sample, mainly due to the prevalence of disabling cataract.There seems to be a considerable amount of undetected ocular disease in elderly people in the community.

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1992 BMJ : British Medical Journal

5180. Home-delivered meals programs for the elderly: distribution of services in New York State. (PubMed)

Home-delivered meals programs for the elderly: distribution of services in New York State. This study examined the ability of six countywide home-delivered meals programs in upstate New York to meet the challenge of serving the elderly in geographically isolated and impoverished regions. The six counties were divided geographically into county subdivisions. For each subdivision, program client levels were analyzed in relation to two subdivision-level census statistics: poverty rates (...) and population densities for community-residing individuals aged 65 years and older. Client levels were positively correlated with population densities but not with poverty rates. These findings suggest that service delivery was concentrated in densely populated regions. In contrast, impoverished and sparsely populated regions received minimal services.

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1993 American Journal of Public Health

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