21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak Aspects of Home and Health over Nine years among Very Old People in Latvia and Sweden.

21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak

Aspects of Home and Health over Nine years among Very Old People in Latvia and Sweden

CHARLOTTE LÖFQVIST2 PHD, REG OT, MARIA HAAK2 PHD, REG. OT

CO-AUTHORS: SIGNE TOMSONE1, VIBEKE HORSTMANN2, SUSANNE IWARSSON2

1 Riga Stradins University, Department of Rehabilitation2 Lund University, Department of Health Sciences,

Centre for Aging and Supportive Environments


Aim

To present preliminary results from a longitudinal study on

home and health among single-living very old people in

Latvia and Sweden, 2002-2011


Changes Latvia Sweden

2002 2011 2002 2011

Population, mil. 2.3 2.2 8.9 9.5

Over working age, % 21.6 20.2 17.2 18.5

Life expectancy for males / females

65/77 69/78 78/82 80/84

Unemployment, % 8.5 14.3 6.5 8.5

Health care expenses, % of GDP

6.3 6.2 9.2 9.4

Average pension per month,USD

100 333 1 200 2 100


Material and methods

Data from the Latvian and Swedish parts of the ENABLE-AGE Survey Study:

• Baseline (2002/2003)

• Follow-up (2011)

• Single living

• Urban regions in Latvia

(Riga and Jūrmala) and

Sweden (Lund, Helsingborg,

Halmstad)


Study participants Latvia

N=303, 75-84 yrs

N=59, 86-90 yrs

Baseline

2002/03

Follow-up

2011

Sweden

N=397, 80-89 yrs

N=67, 91-99 yrs


Reasons for drop-out

• Deceased

• Health reasons

• Not possible to reach (more common in Lv than Sw)

• No interest in participating


InstrumentsHousing Health

Objective

- Part of The Housing Enabler (Iwarsson, S.& Slaug,B., 2001) - nb of environmental barriers,184 items

- (188 – communication)

- Part of The Housing Enabler (Iwarsson,

S.& Slaug,B., 2001) - functional limitations, 15 items

- ADL Staircase (Hulter Åsberg & Sonn, 1989; Sonn & Hulter Åsberg, 1991), difficulty in performing 9 activities

Perceived

- Housing satisfaction (Sixsmith & Sixsmith, 2000), single question

- Housing related control beliefs -external (Oswald, Wahl, Martin, & Mollenkopf, 2003), 16 items

- Meaning of home (Oswald,

Mollenkopf, & Wahl, 1999), 23 items

- Geriatric depression scale (Yesavage & Brink, 1983), 15 items

- Perceived functional independence (Oswald et al., 2001), single question

- Perceived health (Sullvan & Karlsson,

1994), single question- Perceived physical mobility (Sullvan &

Karlsson, 1994), single question - Life satisfaction, single question


Results: Participants description At baseline Participants Lv

N=59Participants Sw

N=67Age, years, Md (q1,q3) 78 (77-81) 83 (81-86)

Sex, males, n (%) 6 (10) 14 (21)

Lv/Sw identity, n (%) 42 (71) 67 (100)

Marital status, widowed, n (%) 35 (59) 48 (72)

Type of housing, multifamily, n (%)

51 (86) 59 (88)

Number of rooms, Md 1 3


Results: Objective housingLatvia, N=54 Sweden, N=58

Changes 2002-2011 in each country

Direction of changes P-value Direction of changes P-value

Environmental barriers

Indoor (0-100) Higher nb ** Higher nb ***

Outdoor (0-33) n.s. n.s.

Entry (0-49) Higher nb *** Higher nb ***

p<.05*, p<.01**, p<.001***


Results: Perceived housingLatvia, N=54 Sweden, N=58

Changes 2002-2011 in each country

Direction of changes

P-value Direction of changes P-value

Housing satisfaction (1- 5) Unchanged (n=14)

Increased (n=13)

Decreased (n=24)

n.s.

Unchanged (n=43)

Increased (n=9)

Decreased (n=5)

n.s.

Housing related control beliefs, external control (1-5)

Slightly higher external control believe

n.s.

Higher external control believe

***

Meaning of home (0-10)

- physical bonding More important * Less important *

- behavioral bonding Slightly less important

n.s. Less important **

- cognitive emotional bonding More important *** Slightly less important n.s.

p<.05*, p<.01**, p<.001***


Results: Objective healthLatvia, N=59 Sweden, N=67

Changes at individual and group level 2002-2011 in each country

Direction of changes P- value Direction of changes P- value

Nb. of functional limitations, 15 items

Increased * Increased ***

P-ADL, nb. of items performed without difficulty, 5 activities

Unchanged (n=9)

Increased (Better) (n=6)

Decreased (Worse) (n=44)

*** Unchanged (n=30)



n.s.

I-ADL, nb. of items performed without difficulty, 4 activities

Unchanged (n=7)



*** Unchanged (n=20)



***

Statistical tests for differences: Wilcoxon signed rank test with p<.05*, p<.01**, p<.001***


Results:Perceived health

Latvia, N=59 Sweden, N=67

Changes at individual and group level 2002-2011 in each country

Direction of changes P- value Direction of changes P- value

Depression score 0.04 (-3,1.57) n.s. 1(0;2.03) ***

Perceived health, 1- 5 Unchanged (41)

Better health (13)

Worse health (4)

* Unchanged (17)

Better health (15)

Worse health (35)

*

Perceived functional independence, 1- 10

Unchanged (16)

Less dependent (7)

More dependent (33)

*** Unchanged (24)

Less dependent (4)

More dependent (35)

***

Perceived physical mobility, 1- 5

Unchanged (6)

Better mobility (5)

Worse mobility (45)

** Unchanged (8)

Better mobility (28)

Worse mobility (31)

n.s.

p<.05*, p<.01**, p<.001***


Latvia, N=59 Sweden, N=67

Changes at group level 2002-2011 in each country

Baseline Follow-up P-value

Baseline Follow-up P-value

Depression score 5 4 n.s. 2 3 ***

Health, 1- 5 * 4 4 * 2 3 *

Functional independence, 1- 10**

** Higher score indicate higher independence

8 6 *** 10 8 ***

Physical mobility, 1- 5*

* Higher score indicate worse health/mobility

4 4 (4; 4.25) ** 2 (2; 3) 3 (2; 3) n.s.

p<.05*, p<.01**, p<.001***


Results: Life satisfactionLatvia, N=59 Sweden, N= 67

Changes at individual and group level 2002-2011 in each country (n)

P-value

P- value

Life satisfaction (0-10)

Unchanged (12)Better satisfaction (30)Worse satisfaction (12)

** Unchanged (18)Better satisfaction (24)Worse satisfaction (22)

n.s.


Concluding remarks

• One of the first studies of detailed information among very old people taking housing as well as health aspects into account.

• Objective and perceived aspects of home changes over time even in advanced age.

• Need to be further investigated in order to develop suitable and appropriate services and living conditions for very old people in different European contexts.


Thank you for your attention!

For more information please contact: [email protected] or [email protected]

Please visit us on the web: http://www.med.lu.se/case

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Discussion

• How does these results on housing and health correspond with our experiences of very old peoples everyday life in Latvia?

• Perceived aspects of housing – why does it differ between countries – according to satisfaction, control believe, meaning of home etc?

21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak Aspects of Home and Health over Nine years among Very Old People in Latvia and Sweden.

Documents

home oswald

department of health

maria haakreasons

maria haak8results

maria haakmaterial

health care expenses

higher nb

maria haak7 results