Understanding the Changing Health Care Needs of Individuals Aging With Spinal Cord Injury

• Published in: Topics in spinal cord injury rehabilitation Vol. 25; no. 1; pp. 62 - 73
• Main Authors: Kern, Stephen B, Hunter, Louis N, Sims, Ashley C, Berzins, Davis, Riekena, Helena, Andrews, Marisa L, Alderfer, Jillian K, Nelson, Kelly, Kushner, Reva
• Format: Journal Article
• Language: English
• Published: United States Allen Press Inc 01-01-2019; Thomas Land Publishers, Inc
• Subjects: Activities of Daily Living; Age; Age Factors; Aged; Aged, 80 and over; Aging; Caregivers; Data analysis; Data collection; Delivery of Health Care; Disabled Persons - rehabilitation; Environmental Health; Female; Health education; Health Literacy; Health services; Health Status; Humans; Interviews; Male; Middle Aged; Needs Assessment; Older people; Paraplegia - rehabilitation; Participation; Physical therapy; Problem solving; Quadriplegia - rehabilitation; Qualitative Research; Quality of Life; Rehabilitation; Social Support; Spinal cord injuries; Spinal Cord Injuries - rehabilitation; health status; traumatic spinal cord injury; health literacy; outcomes; older adults; aging; environmental supports and barriers; health care; interviews
• DOI: 10.1310/sci2501-62
• EISSN: 1945-5763
• ISSN: 1082-0744

Individuals over age 65 are projected to account for over 20% of the general population by 2030. This trend is reflected in an increase in the age of individuals sustaining traumatic spinal cord injury (SCI). Based on current evidence, there is concern regarding the needs of older individuals aging with SCI and current health care services. Research is limited regarding factors that contribute to health status and treatment outcomes associated with aging 5 or more years post SCI.
The purpose of this qualitative study was to explore changing health care needs of individuals aging with SCI and their caregivers and to identify the environmental supports and barriers to achieving long-term health and treatment outcomes.
This was a phenomenological study utilizing semi-structured interviews. Inclusion criteria were age greater than 60 years old and 5 years post SCI. Between October 2014 and January 2016, 41 individuals with SCI and eight caregivers participated in the semi-structured interviews. Emergent themes and quotations were noted and analyzed using established methods. Triangulation was used to establish rigor and trustworthiness.
Data analysis of the interviews revealed four themes (health literacy, health services, changes with age, and environment) and 10 subthemes.
Rehabilitation programs should consider the health literacy of older individuals with SCI and their caregivers. Similarly, these programs should be designed to allow them to identify and utilize resources in solving barriers to everyday participation. Further investigation is required to examine the macro-environmental influences (systems and policies) on the changing health care needs of individuals aging with SCI.