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

Homebound status increasingly emerges as a critical social and health concern among older adults. Recognized as a "hard-to-reach" group, there is a need to better understand how to define and identify homebound older adults. Using the Arksey and O'Malley framework (2005), we searched eight databases with a librarian-guided strategy. Two authors independently screened titles, abstracts, and full texts, and extracted data based on set criteria. We included 19 studies that define homebound status through factors such as the duration and frequency of confinement; consequences of physical, social, or cognitive impairments; and those needing assistance. Researchers identify homebound individuals through health records, outpatient clinics, reports from family, neighbors, or community agencies like Meals on Wheels. Challenges include over-reliance on convenience and snowball sampling, as well as time constraints that limit the ability of researchers and clinicians to systematically identify those missing clinical appointments. A framework is needed to guide a formal identification.