A continuum of care for frail elderly people
The intervention “A continuum of care for frail elderly people” takes place in the municipality of Mölndal, Sweden, including municipal health and social care, the hospital of Mölndal, and primary care. The study has a descriptive analytical and experimental design. The intervention is performed as a randomised controlled trial. The participants were randomised to two study arms, one intervention group and one control group.
Intervention group: The intervention includes an early geriatric assessment, early family support, a case manager in the community with a multi-professional team and the involvement of the elderly people and their relatives in the planning process.
Control group: The control group received conventional care and follow up.
The study group included 161 elderly people who sought care at the emergency department at Mölndal Hospital during the period October 2008 to June 2010 and who were discharged to their own homes in the municipality of Mölndal. Inclusion criteria were age 80 and older or 65 to 79 with at least one chronic disease and dependent in at least one activity of daily living.
A baseline interview and assessment were done within a week of discharge. In some cases it was not possible to do the baseline interview so soon, mostly because the frail elderly person not having enough strength. Follow up data were collected at 3, 6 and 12 months, and after 2 years following the baseline measurement.
Purpose:
The overall aim of the study was to implement the intervention and thereby create a continuum of care for frail elderly people, from the emergency ward to their own homes, resulting in a better quality of care and higher cost-effectiveness. Another aim was to study the implementation process of the intervention programme.
The dataset includes the participants in the intervention group and the control group, a total of 161 participants. The baseline intervention was carried out between October 2008 and June 2010, and follow ups at 3, 6 and 12 months.
Contact for data - Katarina Wilhelmson
Opens in a new tabkatarina.wilhelmson@socmed.gu.se
Citation and access
Citation and access
Data access level:
Creator/Principal investigator(s):
- Katarina Wilhelmson - University of Gothenburg - Institute of Neuroscience and Physiology
- Synneve Dahlin-Ivanoff - University of Gothenburg - Institute of Neuroscience and Physiology
Research principal:
Data contains personal data:
No
Citation:
Method and outcome
Method and outcome
Population:
The population is based on elderly people who sought care at the emergency department at Mölndal Hospital during the period October 2008 to June 2010 and who were discharged to their own homes in the municipality of Mölndal.
Study design:
- Experimental study
Sampling procedure:
Description of sampling:
The participants were recruited at the emergency wards at Mölndal Hospital. Inclusion criteria were age 80 and older or 65 to 79 with at least one chronic disease and dependent in at least one activity of daily living. Exclusion criteria were acute severe illness with immediate need of assessment and treatment by a physician (within ten minutes), dementia (or severe cognitive impairment), and palliative care. The nurse with geriatric competence screened most of the patients during her work shift to see if they fulfilled the inclusion criteria. If so, the nurse informed about the study both verbally and in writing. The information included a description of the study, how it would be conducted and what was expected of people who agreed to participate. There were opportunities to ask questions if anything was unclear. It was stressed, both in the verbal and the written information that participation was voluntarily. Of all those invited to participate, 17 were invited by letter, as they had been discharged before the nurse was able to ask them. People who accepted to participate in the study were randomised to intervention or control by using a system of sealed opaque envelopes. All participants signed a written consent form. The study started with a pilot study to test intervention, inclusion/exclusion criteria and logistics. The pilot study comprised the first ten included participants.
Time period(s) investigated:
Number of individuals/objects:
161
Data format/data structure:
Data collection - Physical measurements and tests
Data collection - Physical measurements and tests
Mode of collection:
Physical measurements and tests
Time period(s) for data collection:
2008-10 - 2011-07
Source of the data:
- Population group
Data collection - Face-to-face interview
Data collection - Face-to-face interview
Mode of collection:
Face-to-face interview
Time period(s) for data collection:
2008-10 - 2011-07
Source of the data:
- Population group
Data collection - Observation
Data collection - Observation
Mode of collection:
Observation
Time period(s) for data collection:
2008-10 - 2011-07
Source of the data:
- Population group
Geographic coverage
Geographic coverage
Geographic description:
Mölndal municipality
Administrative information
Administrative information
Responsible department/unit:
Institute of Neuroscience and Physiology
Ethics Review:
Gothenburg - 413-08
Topic and keywords
Topic and keywords
CESSDA Topic Classification:
Standard för svensk indelning av forskningsämnen 2025:
Keywords:
Publications
Publications
Citation:
Eklund K, Wilhelmson K, Gustafsson H, Landahl S, Dahlin-Ivanoff S. One-year outcome of frailty indicators and activities of daily living following the randomised controlled trial: "Continuum of care for frail older people". BMC Geriatr. 2013 Jul 22;13:76. doi: 10.1186/1471-2318-13-76.
Citation:
Ebrahimi Z, Dahlin-Ivanoff S, Ekund K, Jakobsson A, Wilhelmson K. Self-rated health and health strengthens factors in community living frail elders. Accepted for publication in Journal of Advanced Nursing.
Citation:
Ekelund, C, Dahlin-Ivanoff, S, Eklund, K. Self-determination and older people--a concept analysis. Scand J Occup Ther. 2014 Mar;21(2):116-24. doi: 10.3109/11038128.2013.853832.
Citation:
Berglund H, Wilhelmson K, Blomberg S, Dunér A, Kjellgren K, Hasson H. Older people's views of quality of care: a randomised controlled study of continuum of care. J Clin Nurs. 2013 Oct;22(19-20):2934-44. doi: 10.1111/jocn.12276.
Citation:
Berglund H, Hasson H, Kjellgren K, Wilhelmson K. Effects of a continuum of care intervention on frail older persons' life satisfaction: a randomized controlled study. J Clin Nurs. 2014 Oct 8. doi: 10.1111/jocn.12699.
Citation:
Dunér A, Blomberg S, Hasson H. Implementing a continuum of care model for older people-results from a Swedish case study. Int J Integr Care. 2011 Oct;11:e136. Epub 2011 Nov 18.
Citation:
Berglund H, Blomberg S, Dunér A, Kjellgren K (accepted) Organizing integrated care for older persons: strategies in Sweden during the past decade. Journal of Health Organization and Management.
Citation:
Wilhelmson K, Duner A, Eklund K, Gosman-Hedström G, Blomberg S, Hasson H, Gustafsson H, Landahl S, Dahlin-Ivanoff S. Design of a randomized controlled study of a multi-professional and multidimensional intervention targeting frail elderly people. BMC Geriatr. 2011 May 14;11:24. doi: 10.1186/1471-2318-11-24.
Citation:
Ebrahimi Z, Wilhelmson K, Moore CD, Jakobsson A. Frail elders' experiences with and perceptions of health. Qual Health Res. 2012 Nov;22(11):1513-23. doi: 10.1177/1049732312457246.
Citation:
Wilhelmson K, Fritzell E, Eklund K, Dahlin-Ivanoff S. Life satisfaction and frailty among older adults. Health Psychology Research 2013 1 (3): 167-172. doi: 10.4081/hpr.2013.e32
Citation:
Fornazar R, Spak F, Dahlin-Ivanoff S, Wilhelmson K. Alcohol consumption among the oldest old and how it changes during two years. ISRN Geriatrics 2013. Article ID 671218, 10 pages. doi:10.1155/2013/671218.
Citation:
Wilhelmson K, Dunér A, Eklund K, Gosman-Hedström, G, Gustafsson H, Dahlin-Ivanoff S. Bättre vård och omsorg för multisjuka äldre kräver samverkan och ansvariga vårdgivare. Läkartidningen 2009; 48: 3273-4.
Citation:
Ottenvall Hammar I, Dahlin-Ivanoff S, Wilhelmson K, Eklund K. Shifting between self-governing and being governed: a qualitative study of older persons' self-determination. BMC Geriatrics 2014,14:126 doi:10.1186/1471-2318-14-126.
Citation:
Dunér A. Care planning and decision making in teams in Swedish elderly care - a study of interprofessional collaboration and professional boundaries. J Interprof Care. 2013 May;27(3):246-53. doi: 10.3109/13561820.2012.757730.
Citation:
Wilhelmson K, Eklund K, Gustafsson H, Larsson A-C, Landahl S, Dahlin-Ivanoff S. Skörhet bra begrepp för att hitta äldre stort behov av vård och omsorg. Läkartidningen 2012; 109 (16): 826-827.
Citation:
Berglund H, Dunér A, Blomberg S, Kjellgren K. Care planning at home: a way to increase the influence of older people? Int J Integr Care. 2012 Aug 10;12:e134.
Citation:
Bångsbo A, Dunér A, Lidén E. Patient participation in the discharge planning conference. Int J Integr Care. 2014 Nov 6;14:e030.
Citation:
Ottenvall-Hammar I, Ekelund C, Wilhelmson K, Eklund K. Impact on Participation and Autonomy for older persons and its Validity and Reliability. In press Health Psychology Research. Doi 10.4081/hpr.2014.1825
Citation:
Ebrahimi Z, Wilhelmson K, Eklund K, Moore CD, Jakobsson A Health despite frailty: exploring influences on frail older adults' experiences of health. Geriatr Nurs. 2013 Jul-Aug;34(4):289-94. doi: 10.1016/j.gerinurse.2013.04.008.
