How Are Homebound Older Adults Identified? Definitions, Approaches, and Challenges-A Scoping Review.

Area of Science:

• Gerontology
• Public Health
• Social Sciences

Background:

• Homebound status is a growing concern for older adults, presenting significant social and health challenges.
• This population is often difficult to reach, necessitating improved methods for definition and identification.
• Understanding homebound status is vital for targeted interventions and support.

Purpose of the Study:

• To systematically review and synthesize existing literature on the definition and identification of homebound older adults.
• To explore factors contributing to homebound status and methods used for identification.
• To identify challenges in current identification practices and propose a need for a formal framework.

Main Methods:

• A comprehensive literature search was conducted across eight databases using a librarian-guided strategy.
• The Arksey and O'Malley framework guided the search and data extraction process.
• Two authors independently screened titles, abstracts, and full texts, including data extraction based on predefined criteria.

Main Results:

• Nineteen studies were included, defining homebound status by factors like confinement duration/frequency, consequences of impairments (physical, social, cognitive), and need for assistance.
• Identification methods include health records, clinics, and community reports (e.g., Meals on Wheels).
• Challenges identified were reliance on convenience sampling and time constraints hindering systematic identification.

Conclusions:

• A clear definition of homebound status incorporates confinement, impairments, and assistance needs.
• Current identification methods are varied but face challenges in systematic application.
• A formal framework is essential to guide the consistent and accurate identification of homebound older adults.