Abstract

Background. Preventive care is vital in maintaining health and supporting independence among older persons. In Sweden a national quality register (Senior Alert) was developed in elder care to support healthcare workers working with prevention to reduce malnutrition, falls, pressure ulcers, and poor oral health. However, we predicted that challenges in providing care at home result in preventive work being least used when and where it would be most effective: early in disease processes. The current study examines the preventive care actions planned and performed for older persons with identified risks, to compare quality and equity of care in different care settings.

Methods. Persons from the Swedish Screening Across Lifespan Twin Study registered in the Senior Alert were included in the study (N=2,914). Descriptive and analytical statistical analyses regarding risk assessment and planned and performed preventive actions were conducted among those persons registered at hospital, home health care, nursing home, dementia care homes, or short-term nursing home.

Results. Almost 80 percent of the sample had identified risk in at least one of the four risk areas, with falls and malnutrition being most common. Risks differed between care settings, and having any risk was most common among older persons in short-term nursing homes. The largest difference between planned and performed actions was for older persons with home health care, and especially true for the oldest persons (>80 years old).

Conclusions. Preventive care is vital as it is often easier to prevent than treat, and pressure ulcers, malnutrition, poor oral health, and falls are common among older persons. However, preventive actions were less likely to be performed in the home health care, especially for the oldest adults. Reasons for this might be related to challenges of performing care in a person’s home, lack of knowledge, and organizational challenges but further investigation in needed.