Objective: Long-lived human population, centenarians particularly, have not been in focus of gerontological imagination and praxis. However, with the main demographic projection that emphasizes increasing life expectancy, the main issue is becoming how to improve quality of life in “oldest old”; taking into consideration that the oldest old have the highest prevalence of morbidity and disability. This fact should not imply the progression of frailty or withdrawal from life.
Design: The study is basically descriptive. It represents an attempt to identify and describe through the case study specific health and social needs of the oldest old outpatients that have an effect on maintaining life satisfaction, psychosocial and healthy well-being. Through the self perception and objective evaluation of patients’ needs it was possible to recognize what kind of care services should be provided in improving home health care in the oldest old.
Materials and Methods: The data presented in this work has been obtained by instruments of qualitative methodology. Data represented in case reports have been collected by informal interview associated with observation. Observation, as an instrument of qualitative methodology, helped us to get detailed perception of quality of physical environment, personal hygiene, and potential elder abuse. Analyses of medical and social documentation (medical record for each patient) have been taken into consideration to get information about health status (functional and mental status). The case study included 95+ old patients that have been under the home treatment and care in the Institute in April 2002. Interviewing was used as a guide. It included questions concentrated around several issues: basic socio-demographic data; data of social status; living arrangement including quality of living environment; style of living due to the life course; social activity today; life satisfaction; evaluation of provided professional services (social and health care services) and need for additional services; evaluation of informal support; evaluation of informal caregivers’ needs; attitude toward institutionalization
Results: Out of the total number treated elderly patients in the Institute Of Gerontology, Home Treatment And Care in April there were 30 persons age 95+; female 27, male 3. One main fact was pointed out in the case study: besides well organized and provided home health services, psychosocial support of social network, family and kinship first of all, appears as a significant determinate of life satisfaction. The interviewed patients living alone and without psychosocial support were more likely to feel less satisfied with their present life. Persons who are not satisfied with their relationships had lower levels of well-being as reflected in their higher levels of depressive symptomatology. Either patients or informal caregivers all reject institutionalization.
Conclusion: Coordination between home health care services and social support services apears as one of the priority in maintaining quality of life in the oldest outpatients.
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