Functional status of the oldest-old in a home setting

The purpose of this cross-sectional study was to examine six domains of functioning: physical, mental, social, spiritual, economic and activities of daily living. The primary inclusion criteria at the time of recruitment were that participants be over the age of 85, be cognitively intact, and be living in a home setting. Instruments used for the study included the Older Americans Resource Survey (OARS), Mini-Mental Status Examination (MMSE), Geriatric Depression Scale (GDS), Spiritual Well Being Scale (SWBS). Fifty subjects, mean age 89 years, lived alone (65%) or with their spouse (22%) in their homes. Person's correlation analysis found significant relationships among physical, mental, social, economic and activities of daily living. Good to excellent functioning was found in the mental (82%) and social (82%) domains. Highest functional impairments were identified with ability to carry out activities of daily living (72%) and in the domains of physical functioning (55%). Common chronic illnesses reported were arthritis (56%), hypertension (46%) and cardiac problems (30%). The average daily use of prescribed drugs was three times and over-the-counter use was once per day. Eleven per cent of subjects were mildly (7%) or moderately (4%) depressed. Subjects reported that they needed visiting nurses (29%), home health aids (20%) and help with shopping (24%) and transportation (24%). The data suggest that multidimensional assessment is necessary to identify nursing interventions that will regain, maintain or enhance functioning among oldest-old people.