Predictors of long-term residential placement of the elderly in Hong Kong

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Predictors of long-term residential placement of the elderly in Hong Kong


Author: Lai, Mei-ho Petty
Title: Predictors of long-term residential placement of the elderly in Hong Kong
Year: 1999
Subject: Older people -- Institutional care -- China -- Hong Kong
Older people -- Long-term care -- China -- Hong Kong
Older people -- Services for -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: viii, 84 leaves : ill. ; 30 cm
Language: English
Abstract: This study aims to investigate the major predictors for the level of long-term residential care needs of elderly in Hong Kong. As noted from previous studies, key predictors of the need for residential care include sociodemographic characteristics like age, gender, marital status, utilization of support service, utilization of financial assistance, functional disability measurements of ADL and IADL performance, and cognitive impairment. A total of 100 elderly persons with mean age of 80.5, were recruited from the multidisciplinary placement assessment clinic in Tuen Mun Hospital. No sociodemographic variables were significantly associated with the level of residential placement. A discriminant analysis was conducted to predict the level of residential care needs of elderly persons from age and three measurements of functional disability. It was found that measurements of ADL independence (using the Barthel Index) and cognitive impairment (using the CMMSE) are most useful in predicting the placement recommendation of the elderly. The classification model was able to correctly predict the residential placement of 81% of the subjects. At the time of follow-up at six months, the updated status on the level of care of 83 cases was successfully traced. There is an excellent agreement between the CGAT placement recommendation and the level of care required by the elderly persons as revealed by a kappa value of .963. The results of the study support the combination of physical and mental disabilities, as measured by BI and CMMSE scores, in determining the level of residential care of elderly. The results reiterated the importance of the use of standardized instruments in assessing residential care needs, and provide support for the importance of a multi-disciplinary clinical assessment for residential placement. The Community Geriatric Assessment Team could be an effective gate-keeper for efficient allocation of the scarce residential places. The results of the study could also be an important reference for the reorganization of admission criteria for different types of residential services.

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