Homebound elderly patients are considered as one of the high-risk populations because of their medical inaccuracies and adverse health outcomes (Stanley, 2010). The health conditions commonly associated with homebound elderly patients include mental disorders, oral disease, food insecurity, and falls. To address these health concerns, interventions and outcome measures were implemented (Feeding America, 2015; Qiu, et al., 2010; Griffin, et al., 2012).
The monitoring and evaluation of these health interventions is important especially when it comes to the determination of the effectivity and efficiency of the intervention along with the program delivery. These evaluations do not only provide feedback of the efficiency and effectiveness of the program because it also helps in the determination of the appropriateness of the intervention for the target population and the identification of possible problems with regards to its implementation and support. There are three types of evaluation such as process evaluation, impact assessment, and outcome evaluation (World Health Organization, n.d.).
Outcome evaluation also known as effectiveness evaluation focuses on the determination of the various effects of the intervention in the target population. The evaluation is done by assessing the progress of the outcomes or outcome objectives of the intervention (Centers for Disease Control and Prevention, n.d.).
For the evaluation of the interventions implemented among the high-risk group of homebound elderly individuals, outcome evaluation was considered. The outcomes measured to evaluate the intervention focused on addressing the oral health status of elderly patients include oral health literacy of health care providers, elderly, and even the caregivers. The oral health literacy can be measured using the Rapid Estimate of Adult Literacy in Dentistry (REALD) and the Test of Functional Health Literacy in Dentistry (ToFHLiD). These tools allow determination of the probability and levels of risk of elderly individuals. Other than oral health literacy, the prevalence of homebound individuals with poor oral health before and after the intervention, the prevalence of elderly individuals covered by the dental benefits of health institutions can also be measured (Dickson-Swift, 2014).
On the other hand, the outcomes measured for the evaluation of the mental health interventions include the mental health status of elderly patients, prevalence of elderly individuals with poor mental health before and after the intervention, incidence of the symptoms associated with the disease, and the probability and risk of the homebound elderly individuals of developing a mental illness. The mental health status of the patient can be obtained using questionnaires such as Patient Health Questionnaire-9 and Brief Symptom Inventory-18 (Thornicroft & Slade, 2014).
Another intervention to be evaluated is the intervention focused on the improvement of health status of elderly individuals experiencing food insecurity. To be able to effectively and efficiently assess the intervention strategies, different outcomes should be measured. The outcomes include nutrient and food intake of the elderly which can be gathered using dietary recalls and food diaries of elderly patients that can be accomplished by caregivers or relatives, anthropometric measurements such as weight, height, and body mass index, blood tests, and different nutritional risk assessments (Campbell, et al., 2015).
For the assessment of interventions focused on falls among homebound elderly patients, the outcomes to be measured include physical status of the elderly which can be measured using Falls Efficacy Scale, 30-secod chair stand test, Timed Up and Go, and even GEM Environmental Assessment. These tools can greatly help in determining whether an individual still has the capacity to move alone without the help of any medical instrument or staff (Gardner & Snow, 2014).
References
Campbell, A.D., Godfryd, A., Buys, D.R., and Locher, J.L. (2015). Does Participation in Home-delivered Meals Programs Improve Outcomes for Older Adults?: Results of a Systematic Review. Journal of Nutrition in Gerontology and Geriatrics 34 (2): 124-167.
Centers for Disease Control and Prevention. (n.d.). Types of Evaluation. CDC. Retrieved from http://www.cdc.gov/std/Program/pupestd/Types%20of%20Evaluation.pdf [Accessed on 22 Mar 2016].
Dickson-Swift, V., Kenny, A., Farmer, J., Gussy, M., and Larkins, S. (2014). Measuring oral health literacy: a scoping review of existing tools. BioMed Central Oral Health 14: 148.
Feeding America. (2015). Spotlight on Senior Health: Adverse Health Outcomes of Food Insecure Older Americans. United States: Feeding America.
Gardner, D. and Snow, L. (2014). Occupational Therapy Interventions for Homebound Older Adults. Student Perspectives in Occupational Therapy. Retrieved from http://spin-ot.com/all-articles/2014/4/28/an-occupational-therapy-intervention-for-homebound-older-adults [Accessed on 22 Mar 2016].
Griffin, S.O., Jones, J.A., Brunson, D., Griffin, P.M., and Bailey, W.D. (2012). Burden of Oral Disease among Older Adults and Implications from Public Health Priorities. American Journal of Public Health 102(3): 411-418.
Qiu, W.Q., Dean, M., Liu, T., George, L., Gann, M., Cohen, J., and Bruce, M.L. (2013). Physical and Mental Health of the Homebound Elderly: An Overlooked Population. Journal of American Geriatric Society 58(12): 2423-2428.
Stanley, J.M. (2010). Advanced Practice Nursing: Emphasizing Common Roles. Philadelphia, PA: F.A. Davis Company.
World Health Organization. (n.d.). Module 4: How to evaluate the programme. Switzerland: World Health Organization.
