Table 1
Specific search terms and search strategies.
| KEY SEARCH TERMS | ALTERNATIVE SEARCH TERMS | |
|---|---|---|
| Integrated care | OR | “combination of medical care and pension*”.ti, ab., “medical-nursing combination*”.ti, ab., “medical and older adults care combination*”.ti, ab., “PACE*”.ti, ab., “NHS*”.ti, ab., “long-term care”.ti, ab., “long-term nursing”.ti, ab., “integrated long-term care”.ti, ab., “Health Service”.ti, ab., “home-and community-based services (HCBS)*”.ti, ab., “community-based adult services(CBAS)*” |
| AND needs | OR | “demands”.ti, ab., “choice”.ti, ab., “preference”.ti, ab. |
| AND older adults | OR | “older adult*”.ti, ab., “older people”.ti, ab, elderly.ti, ab., “ageing population*”.ti, ab., senior.ti, ab. |
| AND influencing factors | OR | “affect”.ti, ab., “influence”.ti, ab. |
Figure 1
Literature inclusion process and results.
Table 2
A summary of various categories of integrated care needs among older adults.
| CATEGORY | SUBCATEGORY AND STUDIES | DESCRIPTION |
|---|---|---|
| Basic life needs | Accommodation [25, 48, 54, 58, 59, 63, 70, 78, 81] | Inappropriately or inadequately housed, e.g., adaptation required, home repair, vacuuming; gardening; maintenance; lawn mowing; add decorations in the living space |
| Preparing meals [5, 25, 43, 44, 45, 48, 49, 54, 55, 56, 59, 62, 63, 64, 68, 70, 78, 79, 84] | Prepare breakfast and cooking meals and provide home-delivered and congregate meals; ensure the good nutritional status of older adults | |
| Housekeeping services [5, 25, 41, 42, 44, 48, 49, 50, 52, 54, 56, 58, 59, 60, 62, 68, 70, 74, 75, 78, 79, 81, 82, 83, 84] | Assistance with chores/homemaking, cleaning, tidying up, completing the laundry and errands | |
| Self-care [2, 5, 25, 42, 43, 47, 48, 49, 50, 53, 55, 56, 58, 59, 60, 61, 63, 64, 66, 67, 68, 69, 71, 74, 75, 76, 78, 79, 81, 82, 84] | Management of hygiene, including eating, bathing, shampooing, shaving, nail trimming, dressing, grooming, using the toilet | |
| Sensory needs [48, 57, 59, 63, 64, 80] | Eyesight/hearing/communication/watching TV | |
| Daytime activities [57, 59, 63, 80] | Helping older adults participate in regular appropriate daytime activities | |
| Self-mobility [48, 56, 59, 63, 64, 68] | Transfers, walking inside, walking outside, using the stairs, putting on prostheses or orthoses, moving around in a wheelchair | |
| Adult day care [40, 41, 42, 43, 50, 54, 78] | A health care service provided for adults who require partial or supplemental care and companionship during the day when family members are working or otherwise unable to stay at home with an older adult relative. Among the services that may be offered at an adult day care centre are nursing services (e.g., medication administration and health monitoring); nutritional and health education, health counselling; physical, speech, and occupational therapy; and socialization. | |
| Respite care [41, 42, 43, 50, 54] | Respite care provides short-term relief for primary caregivers. It can be arranged for an afternoon or for several days or weeks. Care can be provided at home, in a healthcare facility, or at an adult day care centre. | |
| Safety [40, 56, 72, 81] | Emergency response systems and client protection (day and evening) to ensure that everything is OK and that no accidents occurred | |
| Sleep aids [49, 81] | Guidance to help older adults improve their sleep in a variety of ways | |
| Memory [48, 63] | Helping older adults remember recent events and where they placed items | |
| Caring for others [48, 59, 63] | Replace older adults or help them care for the people they have responsibility for | |
| Medical and nursing needs | Medical transportation [52, 55] | In emergencies, older adults can use professional medical transportation services and receive prioritized medical treatment, or they can be transferred from the community to a higher-level hospital for treatment |
| Home health care [2, 5, 40, 41, 42, 43, 44, 46, 50, 55, 60, 62, 68, 70, 72, 73, 74, 76, 78, 79, 82] | A commonly used bridge strategy for transitioning from hospital to home-based care is expected to contribute to readmission avoidance efforts. Older people can receive home visits from doctors, nurses and physiotherapists or occupational therapists from regional health care facilities. | |
| Medication [45, 48, 49, 52, 55, 56, 59, 63, 64, 72, 81] | Medication reminders and supervision | |
| Building health archives [46, 49] | After conducting a health check-up, record older patients’ physical symptoms and past health (disease, treatment, medication) and establish and maintain health archives. | |
| Preventive care [60, 65, 84] | Help the older adults avoid illness through prevention. | |
| Regular physical examination [5, 46, 49, 55, 60, 61, 66, 70, 75, 78, 79, 81, 82, 84] | Regular (once or twice a year) physical examination of older adults through medical means and methods | |
| Disease diagnosis and treatment [2, 5, 48, 50, 55, 58, 60, 63, 65, 66, 67, 69, 71, 73, 76, 81, 84, 85] | A doctor conducts professional diagnosis and treatment of older adults. | |
| Emergency care [85] | Provide emergency response for unexpected serious health events and unexpected security incidents, such as offering assistance to older patients who experience sudden cardiovascular and cerebrovascular events | |
| Home sickbed care [47, 55, 61] | According to the treatment needs of older patients and the lifestyle of bedridden persons, the home is used as the nursing site, and medical treatment or rehabilitation is provided in the family environment for certain diseases so that patients can receive medical treatment and nursing in a familiar environment. | |
| Traditional Chinese medicine services [55, 73] | A series of services such as prescribing and brewing Chinese medicine for older adults and providing Chinese medicine treatment | |
| Palliative care [49, 76, 78, 79] | To assist dying patients and their families while reducing the physical pain of the patient, attention is given to the patient’s inner feelings so that he or she can complete the journey of life with dignity | |
| Skilled nursing [49, 55, 59, 66, 67, 71, 75, 77, 78, 83, 85] | Provided by skilled nurses, this service includes measurement of four vital signs (body temperature, pulse, respiration, blood pressure), injections, dressing changes, and related services. | |
| Adaptive equipment [40, 50, 52, 54] | All non-insured durable medical equipment, including hearing and visual aids, incontinence supplies, diabetic supplies, and home occupational therapy equipment exclusive of equipment in the home safety category. | |
| Medical information [40, 48, 55, 59, 63, 80] | Verbal or written information on one’s condition, medication or treatment | |
| Chronic disease management [55] | For older adults with chronic diseases, services such as chronic disease screening, follow-up, and guidance on chronic disease self-management are provided | |
| Accompany to doctor’s visits [55, 62, 79] | Community staff accompany unaccompanied older patients to doctor visits. | |
| Skin care [78] | Activities and interventions designed to maintain the integrity of the integument, including care for pressure ulcers and massage. | |
| Rehabilitation needs | Rehabilitation and health care [50, 55, 62, 66, 68, 71, 74, 78, 79, 81, 82, 84] | A comprehensive service integrating sports therapy, occupational therapy, speech therapy, physical therapy, acupuncture, cupping, and massage |
| Rehabilitation guidance [47, 55, 77, 78] | Guidance for older adults and their caregivers on rehabilitation and health care | |
| Ancillary needs | Transportation [25, 40, 42, 44, 45, 52, 54, 70] | Public transportation services, such as taxi vouchers, curb-to-curb transportation (i.e., Dial-a-Ride), and volunteer transport, or help applying for a disability placard |
| Shopping [25, 56, 61, 62, 79] | Shopping for groceries and personal items | |
| Older adults care hotline [45, 46, 61, 76, 78] | Provide support, information, advice, or referrals for older adult callers through a telephone hotline | |
| Managing money [25, 52, 59, 63, 70] | Budget management, banking, paying bills | |
| Counselling [40, 43, 55] | Answer questions for older adults | |
| On-site service [43, 55, 70] | When older clients require a service at home, community workers are on call to meet their needs | |
| Psycho-spiritual support needs | Spiritual solace [51, 52, 58, 63, 65, 66, 68, 69, 74, 77, 78, 84] | Provide relief for mental disorders and alleviating mental stress for older adults to meet their daily mental health needs (providers are volunteers) |
| Psychological counselling [2, 47, 49, 51, 55, 57, 59, 60, 62, 63, 67, 78, 79, 80, 81] | Provide mental health and adjustment services to older patients and consulting with them (providers are professional counsellors) | |
| Company [48, 52, 59, 60, 61, 62, 63, 72, 77, 79, 80, 84] | Provide emotional support and communication and relieving emotional loneliness by chatting with older adults face-to-face | |
| Home-like atmosphere [51, 81] | Help older people feel like they are living at home using various methods | |
| Family visits [81, 84] | Adult children regularly visit the older adults in nursing homes or at home | |
| Social participation needs | Social support [56, 58, 68] | Maintain friendship/socialization, help older adults feel cared for and supported by going on walks or talking, having regular telephone interviews, and performing related activities |
| Intimate relationships [57, 59, 63, 80] | There is one person or several people on whom the older adults depends, whom they trust, and whom they are willing to tell the truth | |
| Cultural and entertainment service (CES) [2, 5, 44, 49, 59, 60, 62, 63, 66, 71, 74, 75, 76, 77, 78, 79, 81] | Chess and mahjong, drama, singing and dancing, calligraphy and painting, daily reading, etc. | |
| Sporting fitness [46, 62, 68, 76, 78] | Provide older adults individuals with places and opportunities to exercise | |
| Volunteer activity [49, 77] | Organize older citizens to serve in society as much as they can voluntarily and without asking for a reward | |
| Senior University/Centre [49, 62, 70, 77, 78] | Through rationalized course arrangement, provide older adults with places to conduct learning activities in the community | |
| Support group [41, 43] | Mutual aid groups or mutual aid support groups composed of older adults who have the same difficulties | |
| Employment [70, 77] | Introduce older workers to suitable jobs and help them realize their self-worth | |
| Remarriage [62] | Help divorced, widowed, or unmarried older people connect with new partners and remarry | |
| Staff make extra effort [51] | Mainly refers to older people’s desire that the staff in the nursing facility will redouble their efforts | |
| Health education needs | Health guidance [5, 43, 55, 60, 61, 66, 67, 77, 78, 82] | Provide education on lifestyle, nutrition and disease management |
| Health lectures [5, 46, 49, 55, 62, 77, 78, 82, 84] | Conduct lectures on health or other useful knowledge for the older population | |
| Health training [49, 55, 68] | Provide health knowledge training opportunities for older adults, such as first aid knowledge or life skills training | |
| Welfare and aid needs | Social welfare [62, 63, 75, 77, 81] | Medicaid enrolment, endowment insurance, various welfare allowances, and government subsidies |
| Legal aid [40, 44, 61, 62, 70, 75, 77] | Provide legal services on civil matters to older adults, e.g., assistance with wills and end-of-life documents |
Table 3
Summary of factors influencing the integrated care needs of older adults.
| CATEGORY | ACTUAL INFLUENCING FACTORS | |
|---|---|---|
| Demographic factors | Age [40, 41, 44, 48, 50, 51, 55, 60, 61, 62, 63, 70, 72, 76, 78, 81, 83, 84, 85], Gender [2, 25, 40, 42, 44, 46, 51, 63, 64, 71, 72], Educational attainment [2, 40, 41, 46, 48, 54, 60, 61, 63, 65, 67, 69, 77, 84, 85], Pre-retirement occupation [2, 46, 60, 61, 67, 69, 84], Marital status [2, 42, 60, 62, 63, 69, 71, 75, 85], Household registration type [76], Ethnicity [45], Residence location [60], English proficiency [42], Religious beliefs [49] | |
| Personal factors | Living condition | Quality of life [68], Diet quality [45], Housing quality [45], Current nursing arrangements [2], Length of stay in long-term care institutions [51] |
| Personal attitudes | Health literacy [49], Purpose in Life [44], Eldercare expectations [2, 46, 76, 78], Eldercare satisfaction level [66], Knowledge of integrated care [2, 62, 67, 75] | |
| Health | IADL [40, 44, 45], ADL [40, 41, 44, 48, 57, 80, 82], ADL caregiving hours [42], Mobility difficulty [25], Level of disability [54, 64], Cognitive impairment [42, 56, 57, 64, 68], Health status [2, 5, 40, 41, 45, 46, 53, 62, 63, 65, 66, 67, 70, 72, 76, 77, 81, 84, 85], Self-care ability [2, 46, 47, 81, 83], Number of illnesses [47, 48, 55, 62, 65, 70, 75, 81], Disease burden [66, 73], Frailty score [48], Number of medical diagnoses [71, 75], Hospital admissions [48], Care dependency [59] | |
| Economic | Willingness to pay for integrated care [2, 5], Monthly income [2, 55, 62, 65, 67, 75, 78, 82], Financial status [41, 46, 60, 61, 63, 76, 77, 84, 85], Insurance status [2, 41, 42, 53, 66, 69, 70, 85] | |
| Social intercourse | Daily leisure and entertainment [79], Number of friends seen per week [79] | |
| Psychological factors | Depression [45, 57, 59], Mental state [59, 77, 81, 84] | |
| Family factors | Adult children | Degree of support [5, 66, 73], Number [2, 5, 60, 61, 63, 65, 67, 71, 85], Distance of Residence [61], Gender [61], Family visits [58, 61, 65, 72], Relationship [61], Degree of filial piety [61] |
| Primary caregiver | Self-efficacy [42], Health [43], Burden [68], Category [60] | |
| Support and help | Living arrangements [46, 50, 62, 63, 64, 66, 70, 75, 77], Relationships between family members [85], Old-age expenses payer [58], Availability of same informal care in the future [43], Long wait time for help or support [43], Levels of informal assistance [54] | |
| Community factors | Service quality [44], Infrastructural facilities [65], Neighbourhood relations [65, 70], Organizational structure [65], Convenience of access to clinics [67] | |
| Social factors | Institutions and services | Number of types of long-term care services [5], Number of physicians per 1,000 county residents [41], Medical and nursing skill level [69], Use of medical management by a physician [50], Types of integrated care institutions [47, 58], Number of skilled nursing facilities [41], Location of integrated care institutions [58], Characteristics of integrated care institutions [47, 52] |
| Social Welfare | Social support [40], Level of health care empowerment [64], Social welfare assistance [71], Levels of assistance received [53] | |
| Region/Economy | Urban GDP [78], County-level enabling [41, 69] | |