Background: China is experiencing a rapid growth of elder people which demands suitable health care models for the disabled community seniors to meet the government’s “aging at home” policy. Objective: To establish the geriatric care model for “home based” health care for the disabled or frail seniors in urban communities. Methods: 1207 urban community seniors were screened and the volunteered disabled or frail seniors were enrolled. The geriatric team and community health care works were organized to provide geriatric health care services for the intervention group. Results: 103 seniors who were frail or disabled were selected for intervention, with 105 similar seniors as control. The mean age of the intervention group was 78.8 ± 8.3, as well as 79.4 ± 8.2 of the control group. After 1 year intervention, the improvement of ADL score has no difference between two groups, but the health status of the intervention group were more stable or improved than control (73.7% vs 57.1%, p=0.023). We also found that, in the intervention group, it is likely that the seniors with poor family or social support may have more ER visits and hospitalizations, which may also affect the medical intervention. Conclusion: For the disabled seniors in urban community of Beijing, the in-door health care services might be more doable. Only health care services without the supports of assist living may reduce the effectiveness of home medical services. It is important for the government to combine assist living with medical services for the seniors.
Little is known about the current representative depression situation among Chinese older inpatients. The aim of this study is to examine prevalence of depression and associated risk factors among Chinese older inpatients by a large-scale cross-sectional national survey. This study is based on baseline survey data from a large-scale cohort study in a representative sample of Chinese older inpatients. The procedure of this study involves physical examination and face-to-face questionnaire interviews. Depression was assessed based on the Geriatric Depression Scale 15. Mixed-effect Poisson regression model was used to examine the relationship between depression and covariates by controlling the cluster effect of hospital wards. Of all 9727 respondents, the mean age of all respondents was 72.4±5.7 years, from 65 to 97. The average GDS score was 2 (1, 4). The prevalence rate of depression was 16.7% (95%CI: 15.8–17.4%) among older inpatients. The prevalence rates were 14.6% for males and 19.5% for females respectively. After controlling the cluster effect of hospital wards, age, gender, ADL score, educational level, BMI, frail, marriage, falls, alcohol drinking, cognitive function, living conditions, vision, hearing, sleep and defecation function were associated with depression. Emaciation (OR=1.176, 95%CI: 1.107–1.249), frail (OR=1.562, 95%CI: 1.489–1.639), divorced or widowed (OR=1.083 95%CI: 1.017–1.153), living in the bungalow (OR=1.075, 95%CI: 1.023–1.130), falls (OR=1.078, 95%CI: 1.030–1.128), cognitive function (OR=1.142, 95%CI: 1.091–1.195), vision dysfunction (OR=1.125, 95%CI: 1.076–1.177), hearing dysfunction (OR=1.061, 95%CI: 1.011–1.113), sleep dysfunction (OR=1.237, 95%CI: 1.194–1.282), defecation dysfunction (OR=1.160, 95%CI: 1.103–1.221) could increase prevalence risk of depression. There was a high prevalence of depression among Chinese older inpatients. Demographic characteristics, physical and mental conditions indicators have strong effect on prevalence and strength of depression. Therefore, it is essential to assess depression and perform comprehensive measures to improve physical and mental conditions in order to manage depressive symptoms in older inpatients.
Healthcare for community-dwelling seniors in China is still disease-centered, with geriatric issues being largely neglected. Supported by the Irma and Paul Milstein Program for Senior Health of the Milstein Medical Asian American Partnership (MMAAP) Foundation, the Department of Geriatrics at Peking Union Medical College (PUMC) Hospital, together with Pinetree Care Group and Johns Hopkins University, has developed an innovative home care model that integrates geriatrics, community/home services, and computer-based digital technology. In this continuous home care model, the PUMC Hospital interdisciplinary team provides various geriatrics training for community/home service staff members, conducts real time clinical assessment and monitoring via computer-based digital technology called “Little Fish at Home”, and develops personalized intervention plans for frail seniors at their home. The PUMC Hospital geriatric team plays a leading and integral role in ensuring quality and promoting geriatrics care in for frail older adults living in the community.
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