[The physical and mental health of home care recipients: A quantitative secondary data analysis]. / Die physische und psychische Gesundheit von Menschen mit häuslichem Pflegebedarf.

The physical and mental health of home care recipients: A quantitative secondary data analysis Abstract: Background: Although more and more people are being supported by home care services, there is a lack of information regarding the health limitations and needs of this group. Aim: The objective of this study was to examine the health status of people with home care needs in Switzerland. Method: A secondary data analysis based on the HomeCareData database, which contains routine data on people with home care requirements in Switzerland, was conducted. All cases with a fully completed Resident Assessment Instrument (RAI-HC) were included. Data on various items of the RAI-HC and other standardized scale scores with reference to physical or mental health were analyzed using descriptive statistics. Results: In total, 74,674 data records were evaluated. Physical limitations most frequently manifested in the form of fatigue (40.6%), pain (29.7%) or within the scope of impaired hearing (21.9%). Around a third of individuals sampled had experienced a fall in the last 90 days. With regard to mental health, the most frequent signs were fear of falling (33.5%), loneliness (13.9%), depression (12.8%) and anxiety (4%). Approximately one third showed signs of impaired cognition and polypharmacy was detected in almost 68% of those evaluated. Conclusion: Considering the comparatively high prevalence of mental health problems among people with home care requirements, there is a need to develop appropriate skills of employees in home care services and for adequate care planning.

[Influencing factors for nursing home admission in case of pre-existing need of care - a systematic review]. / Einflussfaktoren für einen Heimeintritt bei bestehender Pflegebedürftigkeit ­ eine systematische Übersichtsarbeit.

INTRODUCTION: Knowledge about predictors of nursing home placement is highly relevant. If they are known, targeted interventions such as counselling can help prevent or delay relocation to a nursing home. Above all, preventive and structural measures can target influenceable predictors. The aim of the review was to map predictors of nursing home admission and thus the permanent stay in inpatient long-term care for the target group of people with a pre-existing need for care. METHODS: A systematic literature search in the databases The Cochrane Library, PubMed, CINAHL, GeroLit and CareLit® was conducted in September 2017. Longitudinal studies with quantitative analyses were included. The methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS: 45 cohort studies were included. 21 studies examined study populations with need for care, in 24 studies the care status was unclear. A variety of predictors of nursing home admission with at least one-and-a-half times higher risk for both study populations could be identified, including higher age, dementia, underweight, higher age of caregiver, psychiatric symptoms, smoking status, ethnicity, challenging behaviour in people with dementia, higher number of hospitalizations and lower level of life satisfaction. DISCUSSION: All the predictors identified are relevant to people in need of care. No predictors for the study population with need of care could be identified that are particularly important in contrast to persons with an unclear care status. However, the quality of studies among people with care and support needs is limited compared to studies targeting people with unclear care status. CONCLUSIONS: Many factors seem to predict the admission to a nursing facility. For the first time, these factors are listed in this systematic review for the target group of people in need of care. Interventions or preventive measures based on known influenceable predictors can help prevent or delay nursing home admission.

[Upcoming challenges in providing care for thalidomide impaired individuals]. / Behindertenspezifische Herausforderungen bei der pflegerischen Versorgung von contergangeschädigten Menschen ­ eine Bedarfsanalyse.

Upcoming challenges in providing care for thalidomide impaired individuals Abstract. Background: Between 1957 and 1962 an approximate 5000 children were born in Germany with severe birth defects as their mothers took the substance Thalidomide during pregnancy as a sedative and effective relief from morning sickness. Objective: The aim of this study was to describe the care and assistance needed by the individuals impaired by Thalidomide and indicate upcoming challenges. A further aim was to determine the association between the impairment type and the care needed. Methods: Cross sectional study, 202 individuals impaired by Thalidomide were examined by two orthopedists as well as surveyed via questionnaire. They were also evaluated mentally by either a psychiatrist or psychotherapist. The need for care was determined by the acquired legal status for long-term care. Results: The sample divides roughly into two groups: the ones with impairments in their extremities and those who are not affected in their extremities. Many of the ones affected in their extremities are already dependent on assistance and need to be nursed. Those who are depending on assistance and care are mostly informally cared for. Conclusions: The prevalence for long-term care is already higher than in the age-adjusted general population in Germany, while formal care is underutilized. Therefore a challenge will be to make a shift from informal care to professional care providers as the informally caring (sometimes actually the parents of the impaired) are aging along with the ones they care for.

[ Comparison of BESA and RAI: evaluating the outcomes of two assessment instruments for long-term residential care needs]. / Pflegebedarfserfassungsinstrumente BESA und RAI: Vergleich der Outcomes in Minuten.

In Switzerland, the level of nursing care required for residents in nursing homes is either assessed by the BESA Catalogue 2010 or by the Minimum Data Set (MDS) of the Resident Assessment Instrument (RAI). Within both instruments the nursing care need is represented in minutes. According to these minutes, the resident is allocated to a tariff level. The aim of the study was to compare the outcomes of the two assessment instruments BESA Catalogue 2010 and MDS. For this purpose data were collected in two nursing homes. At each facility 60 nursing home residents were assessed with the BESA Catalogue 2010 and the MDS. The assessments were independently performed by nurses of the facility (internal assessment) and by system experts (external assessment). Descriptive data analysis and a comparison of the outcome in minutes and with regard to tariff level were carried out. In average, internal assessments were higher than external assessments. In both nursing homes, half or 54 % of residents were allocated into a higher tariff level by means of internal assessment. Comparing the outcomes in total and within tariff level, significant differences were found. Different classifications may occur, especially for residents with high nursing care needs. As a result, higher or lower costs of nursing care may arise.