Longitudinal effects on self-determination in the RCT “Continuum of care for frail elderly people”

Abstract

Purpose

An intervention “Continuum of care for frail elderly people” was designed to create an integrated care from the hospital emergency department (ED) to home. The purpose of this paper is to evaluate longitudinal effects in terms of self-determination in daily life for community-living frail older persons.

Design/methodology/approach

A non-blinded, controlled trial with participants randomised to the intervention group or a control group with follow-ups at three, six and 12 months. The intervention involved collaboration between a nurse with geriatric competence at the ED, the hospital wards and a multi-professional team in the community with a case manager as the hub. The intervention’s person-centred approach involved the older persons in all decisions. Inclusion criteria: 80 years and older or 65-79 years with at least one chronic disease and dependent in at least one daily activity. Analyses were made on the basis of the intention-to-treat principle and outcome measure experienced self-determination in daily life measured by Impact on Participation and Autonomy for Older persons (IPA-O). The analysis was made using Svenssons’ statistical method.

Findings

There were significant differences in favour of the intervention at three months in self-determination concerning activities at home and at three and six months concerning social relationships.

Originality/value

Self-determination seems to deteriorate over time in both groups, and the intervention “Continuum of care for frail elderly people” seemed to slow the rate of decline in two dimensions; activities in and around the house at three-month follow-up, and at three and six months concerning social relationship. Thus, the intervention has the means to support them in exercising self-determination and aging in place, a valuable benefit both for the individual and for society.

Citation

Ekelund, C. and Eklund, K. (2015), "Longitudinal effects on self-determination in the RCT “Continuum of care for frail elderly people”", Quality in Ageing and Older Adults, Vol. 16 No. 3, pp. 165-176. https://doi.org/10.1108/QAOA-12-2014-0045