Identifying and understanding the health and social care needs of older adults with multiple chronic conditions and their caregivers: a scoping review.

McGilton, Katherine S; Vellani, Shirin; Yeung, Lily; Chishtie, Jawad; Commisso, Elana; Ploeg, Jenny; Andrew, Melissa K; Ayala, Ana Patricia; Gray, Mikaela; Morgan, Debra; Chow, Amanda Froehlich; Parrott, Edna; Stephens, Doug; Hale, Lori; Keatings, Margaret; Walker, Jennifer; Wodchis, Walter P; Dubé, Veronique; McElhaney, Janet; Puts, Martine

BACKGROUND As the population is aging, the number of persons living with multiple chronic conditions (MCC) is expected to increase. This review seeks to answer two research questions from the perspectives of older adults with MCC, their caregivers and their health care providers (HCPs): 1) What are the health and social care needs of community-dwelling older adults with MCC and their caregivers? and 2) How do social and structural determinants of health impact these health and social care needs? METHODS We conducted a scoping review guided by a refinement of the Arksey & O'Malley framework. Articles were included if participants were 55 years or older and have at least two chronic conditions. We searched 7 electronic databases. The data were summarized using thematic analysis. RESULTS Thirty-six studies were included in this review: 28 studies included participants with MCC; 12 studies included HCPs; 5 studies included caregivers. The quality of the studies ranged from moderate to good. Five main areas of needs were identified: need for information; coordination of services and supports; preventive, maintenance and restorative strategies; training for older adults, caregivers and HCPs to help manage the older adults' complex conditions; and the need for person-centred approaches. Structural and social determinants of health such as socioeconomic status, education and access influenced the needs of older adults with MCC. CONCLUSION The review highlights that most of the needs of older adults with MCC focus on lack of access to information and coordination of care. The main structural and social determinants that influenced older adults' needs were their level of education/health literacy and their socioeconomic status.