Background:The prevalence, health care expenditures, and hospitalization experiences are important considerations among elderly populations with multiple chronic conditions.Methods: A cross-sectional analysis was conducted on a nationally random sample of 1 217 103 Medicare feefor-service beneficiaries aged 65 older living in the United States enrolled both Part B during 1999.Multiple logistic regression used to analyze influence age, sex, number types conditions risk incurring inpatient...

Family and unpaid caregivers commonly help older adults who are at high risk for poorly coordinated care.

Abstract Objectives Social isolation among older adults is an important but under-recognized risk for poor health outcomes. Methods are needed to identify subgroups of at social isolation. We constructed a typology using data from the National Health and Aging Trends Study (NHATS) estimated prevalence correlates community-dwelling adults. The was formed four domains: living arrangement, core discussion network size, religious attendance, participation. Results In 2011, 24% self-responding,...

Purpose:Family caregivers comprise the backbone of long-term-care provision in United States, yet little is known about how composition and experience family caregiving has changed over time. Design Methods:Data are drawn from 1989 1999 National Long-Term Care Survey Informal Caregiver to develop nationally representative profiles disabled older adults their primary informal at two points Results:The proportion chronically community-dwelling who were receiving assistance or friends declined...

Purpose: This study attempts to determine the associations between postdischarge environmental (PDE) and socioeconomic (SES) factors early readmission hospitals. Design Methods: was a cohort using 2001 Medicare Current Beneficiary Survey claims for period from 2002. The participants were community-dwelling beneficiaries admitted hospitals, discharged home, surviving at least 1 year after discharge (n = 1,351). measurements (within 60 days), PDE factors, SES factors. consisted of having usual...

The number of US adults ages sixty-five and older who are living with dementia is substantial expected to grow, raising concerns about the demands that will be placed on family members other unpaid caregivers. We used data from 2011 National Health Aging Trends Study its companion study, Caregiving, investigate role in caregiving. found among caregivers noninstitutionalized adults, one-third caregivers, 41 percent hours help they provide, people dementia, account for 10 adults. Among receive...

Treatment of chronic diseases such as obstructive pulmonary disease (COPD) is complicated by the presence comorbidities. The objective this analysis was to estimate prevalence comorbidity in COPD using nationally-representative data. This study draws from a multi-year analytic sample 14,828 subjects aged 45+, including 995 with COPD, National Health and Nutrition Examination Survey (NHANES), 1999–2008. defined self-reported physician diagnosis bronchitis or emphysema; patients who reported...

To assess trends in family caregiving between 1999 and 2015. We construct nationally representative profiles of community-dwelling older adults receiving help with self-care or indoor mobility their "primary" unpaid caregiver using the 2004 National Long Term Care Survey, 2011 2015 Health Aging Trends Study, linked surveys. are examined. Older were incrementally younger, more racially diverse, better educated Primary caregivers overwhelmingly continued to be spouses adult children....

The Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program, funded by the Center Medicare and Medicaid Innovation, aims to reduce impact of disability among low-income older adults addressing individual capacities home environment. described this innovation profile, uses an interprofessional team (an occupational therapist, a registered nurse, handyman) help participants achieve goals they set. For example, it provides assistive devices makes repairs modifications...

To examine factors associated with caregiver burden from a multifactorial perspective by examining and care recipient characteristics full range of caregiving tasks.Nationally representative surveys community-dwelling older adults their family caregivers residing in the United States.2011 National Health Aging Trends Study Caregiving.Community-dwelling caregivers.Caregiver burden, comprising emotional, physical, financial difficulties caregiving.An estimated 14.9 million assisted 7.6...

Use of harmful and/or unnecessary medications in older adults is prevalent. This can lead to avoidable harms such as adverse drug reactions, falls, hospitalization, and mortality. Primary care physicians report that patient resistance discontinuing medication use a significant barrier deprescribing.To describe the attitudes toward deprescribing determine whether individual characteristics are associated with these attitudes.For this population-based survey study US Medicare beneficiaries 65...

Objectives: To assess the economic impact of excess medical and informal care health utility loss associated with visual impairment blindness in adults aged 40 years older United States.Methods: Medical Expenditure Panel Survey data from 1996 to 2002 were pooled estimate relationship total expenditures, components days received, utility.Estimates accounting for complex sampling design based on regressions including confounders such as comorbidities demographics.The aggregate was estimated by...

<h3>Background</h3> The effect of interdisciplinary primary care teams on the use health services by patients with multiple chronic conditions is uncertain. This study aimed to measure guided multimorbid older patients' services. <h3>Methods</h3> Eligible from 3 systems in Baltimore, Maryland–Washington, DC, area were cluster-randomized receive or usual for 20 months between November 1, 2006, and June 30, 2008. Eight a nurse working partnership physicians provided: comprehensive assessment,...

<h3>Background</h3> Sicker patients are less satisfied with the quality of health care they receive than their healthier counterparts. <h3>Methods</h3> A sample 12 018 community-dwelling Medicare beneficiaries 65 years or older from 2004 Current Beneficiary Survey was studied. Multivariate regression used to describe whether beneficiaries' self-reported satisfaction usual-care physician related presence functions assumed by visit companions. <h3>Results</h3> Overall, 38.6% reported being...

Purpose: The purpose of this study was to test the feasibility a new model health care designed improve quality life and efficiency resource use for older adults with multimorbidity. Design Methods: Guided Care enhances primary by infusing operative principles seven chronic innovations: disease management, self-management, case lifestyle modification, transitional care, caregiver education support, geriatric evaluation management. To practice Care, registered nurse completes an educational...

Background. The quality of health care for older Americans with multiple chronic conditions is suboptimal. We designed “Guided Care” (GC) to enhance by integrating a registered nurse, intensively trained in care, into primary practices work physicians providing comprehensive 50–60 multimorbid patients.

To estimate the number of caregivers providing assistance to community-dwelling older persons with and without dementia or substantial disability; describe characteristics care recipients in these groups; characterize health-related tasks that provide; associations between numbers caregiver burden.Nationally representative surveys adults United States.2011 National Health Aging Trends Study Caregiving.Community-dwelling their family caregivers, who were selected on basis having assisted...

Background: Family and friends are thought to be the predominant providers of end-of-life care, although nationally representative data on this topic have been lacking.Methods: This study draws from 1999 National Long-Term Care Survey its Informal Caregivers characterize primary informal caregivers' experiences providing care chronically disabled communitydwelling older adults.Study participants were 1149 caregivers, stratified by recipients' survival or death during following 12...

We examined the acceptability and effects of delivering doctors' visit notes electronically (via OpenNotes) to patients care partners with authorized access patients' electronic medical records. Adult at Geisinger Health System were surveyed baseline after 12 months exposure OpenNotes. Reporting on partner OpenNotes, stated that they had better agreement about patient treatment plans more productive discussions their care. At follow-up, confident in ability manage health, felt prepared for...

Background: Applying disease-specific guidelines to people with multimorbidity may result in complex regimens that impose treatment burden. Objectives: To describe and validate a measure of healthcare task difficulty (HCTD) sample older adults multimorbidity. Research Design: Cross-sectional longitudinal secondary data analysis. Subjects: Multimorbid aged 65 years or from primary care clinics. Measures: We generated scale (0–16) self-reported 8 HCTD conducted factor analysis assess its...

To date, knowledge of the experiences older adults' caregivers at end life has come from studies that were limited to specific diseases and so-called primary relied on recollections people in convenience samples. Using nationally representative, prospective data for 2011, we found 900,000 community-dwelling Medicare beneficiaries ages sixty-five who died within following twelve months received support 2.3 million caregivers. Nearly nine ten these unpaid. Compared other caregivers,...