ABSTRACT
The role of social support in the health of older persons is well documented. This support is particularly important for isolated nursing home residents. The purpose of this study was to test the feasibility of using low-cost videophones to enhance communication between nursing home residents and their families. Ten pairs of residents and family members received videophones and engaged in regular televisits for six months. All participants completed brief survey instruments prior to and after the study period to determine the effects of the televisits on the frequency and quality of contacts. A post-study survey assessed ease and satisfaction with using videophones. Findings include identification of technical and design problems, possible solutions, factors affecting actual use of equipment, and conditions under which benefits of use may be optimal. Categories for estimating potential actual users are suggested. Importantly, the study demonstrates that videophones can be used successfully by a wide range of frail nursing home residents and can enhance social interactions, regardless of distance. Affordable videophone technology offers the potential for reduced isolation among institutionalized elders and others with distance and mobility barriers.
Subject(s)
Computer Communication Networks , Family Relations , Homes for the Aged , Institutionalization , Nursing Homes , Telecommunications , Visitors to Patients/psychology , Adult , Aged , Aged, 80 and over , Cognition/physiology , Female , Humans , Interpersonal Relations , Male , Middle AgedABSTRACT
OBJECTIVE: The study explored knowledge of mental health benefits and preferences for providers among the general public. METHODS: Analysis was based on a telephone survey of 1,358 adults randomly sampled throughout Michigan in 1997-1998. RESULTS: A large proportion of the respondents were uninformed about their mental health benefits. One-quarter of the sample were unsure if their health plan even included mental health services. Forty-three percent of the sample believed that mental health benefits were equal to benefits provided for general medical services. In answer to a survey question that summarized payment restrictions for psychiatric services and counseling under Medicare, nearly a quarter of older respondents indicated that they would not seek care even when needed. In the overall sample, the majority of respondents said they would initially seek care from their primary care physician for a mental health problem, although responses varied by age. Persons over age 65 were significantly more likely to seek assistance from their primary care doctor than were younger persons. CONCLUSIONS: The general public lacks information about important mental health benefits, and this lack of information may represent a barrier in their seeking care when needed. Given the overriding preference for primary care providers to treat mental health problems, particularly among older adults, mental health issues should be given more attention at all levels of primary care education.
Subject(s)
Health Services Accessibility/economics , Insurance Coverage , Insurance, Psychiatric , Medicare/economics , Mental Health Services/economics , Professional-Patient Relations , Adult , Age Factors , Aged , Aged, 80 and over , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Michigan , Middle Aged , Population Surveillance , Sampling Studies , Sex Factors , Surveys and Questionnaires , United StatesABSTRACT
Primary care physicians are often the professionals to whom older patients turn for advice about medical coverage in Medicare managed care health plans. To assist in this dialogue, these authors outline current characteristics and financial arrangements for psychiatric and mental health services in Medicare managed care. Advantages and disadvantages of Medicare managed care for enrollees with mental disorders are outlined. Mental health "carve-out" and "carve-in" models are defined, and questions are raised about the number of psychiatrists and other mental health care providers needed to provide appropriate care for a plan's enrollees.
Subject(s)
Managed Care Programs/organization & administration , Medicare Part B/organization & administration , Mental Health Services/organization & administration , Aged , Alzheimer Disease/therapy , Contract Services , Decision Making , Health Services Accessibility , Humans , Managed Care Programs/standards , Mental Health Services/standards , Models, Organizational , Patient Education as Topic , Quality of Health Care , United StatesABSTRACT
This study investigated health and sociodemographic variables associated with co-residency patterns among older patients and their adult children following discharge from an acute care hospital. Data for the analysis were obtained from 172 adult children caring for functionally impaired parents. Logistic regression was employed to determine the probability that an older parent establishes co-residency with the adult child following hospitalization instead of remaining in a separate household. Results indicate that the overall level of caregiver involvement in activities of daily living (ADL) and instrumental activities of daily living (IADL) were strong predictors of parent and adult children forming a joint household. Increased household income of caregivers was inversely related to co-residency. Decisions about co-residency following hospitalization appear to hinge both on parental need and the resources of the adult child, suggesting that the decision to move together is largely one of need and not preference.