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Elderly profit from group meetings and home visits

By Ronnie Cohen

NEW YORK (Reuters Health) - Group meetings and preventive home visits helped octogenarians maintain their health, independence and a positive outlook, according to a first-of-its-kind study in Sweden.

Gerontologist Gwen Yeo told Reuters Health she was "amazed" that researchers at the Sahlgrenska Academy at the University of Gothenburg successfully documented what she has long suspected - health-promotion programs can postpone disease progression in older adults and keep them in relatively good shape.

Yeo, director emeritus of the Stanford School of Medicine Geriatric Education Center, was not involved in the new study published in the Archives of Gerontology and Geriatrics.

It found that the health of people 80 years and older who attended group meetings or were visited at home by healthcare workers was only half as likely to deteriorate over two years as the health of older adults without the meetings or the visits.

The U.S. Centers for Disease Control and Prevention expects the population of Americans 65 years and older to double over the next 25 years. The elderly also represent a rapidly growing share of Sweden's population.

Public health nurse Lina Behm, the study's lead author and a Sahlgrenska Academy doctoral student, told Reuters Health she hopes to convince the Swedish government to offer people entering old age health-promotion programs similar to the ones used in her study.

"We want to offer these interventions to older persons, 80 plus, so the quality of their remaining years can be as good as possible," she said.

Sweden funds groups to prepare and educate new parents, and Behm said she would like to use the current study to convince the government to adopt a similar program to educate the elderly to prepare themselves for aging.

"It's not so complicated to do either of these interventions, and there are really positive results," she said.

The two-year study included 459 residents of the industrial port city of Gothenburg, Sweden's second largest city, who were at least 80 years old, living on their own and not overtly cognitively impaired.

The researchers randomly assigned participants to receive a home visit, to participate in a senior-meeting group or to be in a control group.

One-third of participants received a visit of up to two hours from a healthcare worker who offered advice about activities, meeting places, physical training, walking groups, housing adaptations and fall-prevention methods. The healthcare worker also gave the seniors contacts to help with a range of potential problems.

Meeting group participants attended four weekly two-hour sessions with five other seniors. The meetings focused on the consequences of aging and offered tools and strategies to cope with challenges.

"The participants' experiences formed the basis of the meetings," the authors write. "In contrast to traditional education, the professionals' role was to be enablers, while the participants were the experts."

Two to three weeks after the conclusion of the group meetings, a healthcare worker visited group members individually in their homes.

The control group had the same access as everyone else to Sweden's services for the elderly, including meals on wheels, help cleaning and shopping, personal-care assistance, transportation and home healthcare. But they got no special attention or visits and did not attend meetings.

The researchers used a method of rating the severity of chronic illness to look at the study participants in one-year and two-year follow-up periods. They found members of the control group were significantly more likely than the other two groups to experience disease progression.

Moreover, those who had home visits or attended group meetings reported being significantly more satisfied with their physical health after one and two years, researchers found.

Participants who attended the senior group meetings were also significantly less likely to rate their health as having deteriorated after a year.

Previous research has found that elderly people who see themselves as healthy are less likely to become depressed and more likely to live longer, Behm said.

She said group members told her that "they had learned from one another, and it affected their self esteem."

"They are getting role models and someone to share and social contacts," she said. "If they see other persons aging gracefully, I think it's motivating to be active."

Stanford gerontologist Yeo said preventive home visits are becoming more commonplace in the United States in an effort to keep people out of emergency rooms and because hospitals can be penalized for readmissions.

She has seen group meetings for specific diseases, like diabetes, but does not expect to see general health-promotion groups for seniors in the United States.

"To me, there's a real value in the group-based meetings," she said. "People have a chance to learn from each other, and sometimes elders, and I consider myself one, discount younger people's knowledge. We might say to a nurse in her 20s, ‘what do you know; you've never had this arthritis.'

"But I don't see our healthcare system providing this."

Behm said she hopes that Sweden will soon offer octogenarians a choice between home-prevention visits and senior group meetings.

"I am hoping that we could offer both because some people don't like to be in a group, while some people need the social," she said. "I hope that it is possible to choose."

SOURCE: http://bit.ly/1fneLBo Archives of Gerontology and Geriatrics, online January 27, 2104.

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