scholarly journals Predictors of Everyday Care Preference Importance Ratings for Veterans Living in the Nursing Home Setting

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 91-91
Author(s):  
Caroline Madrigal ◽  
Lan Jiang ◽  
Whitney Mills ◽  
Wen-Chih Wu ◽  
Diane Berish ◽  
...  
Keyword(s):  
Nursing Home ◽  
Functional Impairment ◽  
Cognitive Abilities ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Preference Assessment ◽  
Nursing Home Care ◽  
Data Set ◽  
Home Setting ◽  
Importance Ratings

Abstract Preference-based care is required by the Centers for Medicare and Medicaid Services and is linked to improved quality of nursing home care. The federally mandated Minimum Data Set (3.0) Preference Assessment Tool (PAT) is a 16-item standardized measure used to facilitate preference-based care through rating how important residents’ daily and activity preferences are. Little work has explored how Veterans’ unique demographic backgrounds and functional/cognitive abilities may influence how they rate their preferences (compared to general nursing home residents). Therefore, the purpose of this retrospective study was to explore the relationships between Veterans’ demographic/clinical characteristics and number of preference importance ratings. Our sample (n=194,068) consisted of Veterans admitted to community nursing homes after hospitalization at a Veterans Affairs facility for heart failure between 2010-2015. We used ordinal regression to explore predictors of preference importance ratings. Veterans were, on average, 78-years-old (SD=10.42) and mostly male (95%), white (81%), married (46%), cognitively intact (74%) with extensive functional impairment (60%) and minimal depressive symptoms (74%). Veterans rated an average of 12.47 preferences as important (SD=2.86; range=0-16). Veterans living with cognitive impairment, depression, and extensive functional impairment who were not married or separated had a lower number of important preferences (all p<0.0001). Veterans that were female, under the age of 85, and any race but white had a higher number of important preferences (all p<0.0001). Discussion will include implications for planning and delivering preference-based care for Veterans as well as next steps in research and practice to better understand and fulfill Veterans’ everyday care preferences.

scholarly journals ISSUES IN HOME CARE AND CAREGIVING ARE MEDICAL FOSTER HOMES SERVING VETERANS WHO HAVE SIMILAR FUNCTIONAL IMPAIRMENT AS TYPICAL NURSING HOME RESIDENTS?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S822-S823
Author(s):  
Cari Levy ◽  
Kate Magid ◽  
Chelsea Manheim ◽  
Kali S Thomas ◽  
Leah M Haverhals ◽  
...  
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Functional Impairment ◽  
Nursing Home Residents ◽  
Similar Proportion ◽  
Care Needs ◽  
Community Based ◽  
Foster Home ◽  
Term Care ◽  
Data Set

Abstract The Veterans Health Administration’s (VHA’s) Medical Foster Home (MFH) program was developed as a community-based alternative to institutional care. This study compares the clinical and functional characteristics of Veterans in the VHA MFH program to residents in nursing homes to understand whether MFHs substitute for nursing home care or serve a population with different care needs. All data were derived from Minimum Data Set (MDS) 3.0 assessments. Nurses collected MDS assessments from Veterans (n=92) in 4 MFHs between April 2014-December 2015. Data for nursing home residents were from a national nursing home dataset of residents with an annual MDS assessment in 2014 (n=818,287). We found that MFH Veterans were more likely to be male, have higher functional status, and perform more activities of daily living (ADLs) independently relative to nursing home residents (p<0.01 for all comparisons). Yet, a similar proportion of MFH Veterans and nursing home residents required total assistance in 9 of the 11 measured ADLs. Cognitive impairment, neurological comorbidity, and psychiatric comorbidity were similar in both cohorts; however, MFH Veterans were more likely to have traumatic brain injury (p<0.01), higher Patient Health Questionnaire (PHQ)-9 depression scores (p=0.04) and less likely to have anxiety (p=0.05). Our results suggest there are two distinct MFH populations, one with lower-care needs and another with Veterans completely dependent in performing ADLs. Given these findings, MFHs may be an ideal setting for both low-care nursing home residents with less functional impairment as well as residents with higher care needs who desire community-based long-term care.

scholarly journals Patterns of preference importance ratings among African-American and White nursing home residents

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Nytasia Hicks ◽  
Katherine Abbott ◽  
Allison Heid ◽  
Kendall Leser ◽  
Kimberly Van Haitsma
Keyword(s):  
African American ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Test Group ◽  
Preference Assessment ◽  
Group Differences ◽  
Test Results ◽  
Importance Ratings ◽  
Preference Ratings

Abstract Background: The Preferences for Everyday Living Inventory (PELI) was developed to assess the psychosocial preferences of older adults receiving home care (PELI-HC) and then revised for nursing home residents (PELI-NH). While the PELI-HC has been tested to identify patterns in preference ratings by race, the PELI-NH has not. We sought to explore whether the PELI-NH tool captures differences in preference ratings of African-American and White NH residents. Methods: Preference assessment interviews were conducted with NH residents (n = 317). Analysis via a Mann-Whitney U test, results show that 46 of 72 (63.88%) a preference importance items were not statistically different between African-American and White NH residents. Additionally, African-Americans reported greater importance than White older adult NH residents in 26 of 72 (36%) preference importance items. Conclusion/Implications: It appears that the PELI-NH can test group differences in preference importance among African-American and White NH residents; implications for practice will be discussed. Part of a symposium sponsored by the Research in Quality of Care Interest Group.

scholarly journals Do Nursing Home Residents With Dementia Receive Pain Interventions?

2019 ◽  
Vol 34 (3) ◽  
pp. 193-198 ◽  
Author(s):  
Taeko Nakashima ◽  
Yuchi Young ◽  
Wan-Hsiang Hsu
Keyword(s):  
New York ◽  
Nursing Home ◽  
Assessment Tool ◽  
New York State ◽  
Nursing Home Residents ◽  
Secondary Data ◽  
Cross Sectional ◽  
Data Set ◽  
Frequency Distributions ◽  
Pain Intervention

This study compares pain interventions received by nursing home residents with and without dementia. Secondary data analyses of cross-sectional data from 50,673 nursing home residents in New York State were collected by the Minimum Data Set 3.0. Frequency distributions and bivariate analyses with χ2 tests were used to organize and summarize the data. Logistic regression analyses were performed to quantify the relationship between dementia and pain interventions. Our results show that residents with dementia had significantly fewer pain assessments and less reported pain presence than their counterparts. After adjusting for covariates, the results indicate that residents with dementia were significantly less likely to receive pro re nata and nonmedication pain intervention. However, there were no significant differences in scheduled pain medication between the 2 groups. To address the gap, we need more research to design a pain assessment tool that can differentiate severity of pain so that appropriate interventions can be applied.

scholarly journals VALIDATING THE PREFERENCES ASSESSMENT TOOL FOR NURSING HOME RESIDENTS USING ITEM RESPONSE THEORY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S341-S342
Author(s):  
Yinfei Duan ◽  
Weiwen Ng ◽  
Tetyana P Shippee
Keyword(s):  
Item Response Theory ◽  
Item Response ◽  
Assessment Tool ◽  
Leisure Activities ◽  
Nursing Home Residents ◽  
Preference Assessment ◽  
Daily Routine ◽  
Psychosocial Needs ◽  
Response Theory ◽  
Data Set

Abstract The Preference Assessment Tool (PAT), part of the Minimum Data Set (MDS), assesses residents’ preferences to enable preference-based care in nursing homes (NHs). The two PAT sections including daily routine preferences and activity preferences are assumed to measure autonomy and meaningful activities as the underlying constructs associated with residents’ psychosocial needs. Yet, the validity of this assumption has not been tested. This study examines PAT’s construct validity using item response theory. We fitted graded response models to the two PAT sections using 2017 MDS annual assessments of 8,829 long-stay residents in 291 Minnesota NHs. Most items discriminated well between residents who had at a low versus high intensity of these two types of psychosocial needs (i.e. have discrimination parameters > 1). Two daily routine preference items (family’s involvement in care planning, and having snacks), and three activity preference items (having pets, keeping up with news, and reading) had poor discrimination in measuring autonomy and meaningful activities respectively. Overall, the PAT appeared to be more sensitive in measuring the lower middle range of the two constructs. We estimated the correlation between the two constructs as 0.65. In conclusion, the PAT performs fairly well in measuring the two types of psychosocial needs for NH residents. Nevertheless, more items are needed to capture a broader range of psychosocial needs beyond autonomy or basic leisure activities. The findings of this study brought attention to the utility of the PAT in measuring residents’ psychosocial needs and in guiding resident-centered care.

The Relationship Between Minimum Data Set Ratings and Scores on Measures of Communication and Hearing Among Nursing Home Residents With Dementia

2001 ◽  
Vol 10 (4) ◽  
pp. 370-381 ◽  
Author(s):  
Tammy Hopper ◽  
Kathryn A. Bayles ◽  
Frances P. Harris ◽  
Audrey Holland
Keyword(s):  
Nursing Home ◽  
Rating Scale ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Minimum Data Set ◽  
Nursing Facilities ◽  
Data Set ◽  
Minimum Data ◽  
Hearing Function ◽  
The Relationship

The Minimum Data Set (MDS) is a federally mandated assessment tool used to evaluate individuals residing in skilled nursing facilities, a large percentage of whom have dementia. Best described as a rating scale, it comprises items related to 16 domains of functioning, including communication and hearing. Typically, the MDS is completed by a nurse. When a deficit is observed, Resident Assessment Protocols (RAPs) are designed to address the impairment and provide information for appropriate plans of care. The purposes of this study were to: (a) comprehensively assess the communication and hearing function of nursing home residents with dementia, (b) evaluate the relationship between ratings on MDS communication and hearing items and the performance of dementia patients on standardized assessments, and (c) determine the number of residents with MDS-identified deficits who received a referral for further evaluation. Fifty-seven individuals with a medical diagnosis of dementia participated. All exhibited deficits in communication and hearing function; however, the majority of participants were rated as having normal or adequate communication and hearing on the MDS. Of those participants with MDS-identified impairments in communication and hearing, none was referred for further evaluation. Implications for policy and care for nursing home residents with dementia are discussed.

Minimum Data Set for Incontinence-Associated Dermatitis (MDS-IAD) in adults: Design and pilot study in nursing home residents

2018 ◽  
Vol 27 (4) ◽  
pp. 191-198
Author(s):  
Karen Van den Bussche ◽  
Sofie Verhaeghe ◽  
Ann Van Hecke ◽  
Dimitri Beeckman
Keyword(s):  
Nursing Home ◽  
Pilot Study ◽  
Nursing Home Residents ◽  
Minimum Data Set ◽  
Data Set ◽  
Minimum Data

scholarly journals Fall incidents in nursing home residents: development of a predictive clinical rule (FINDER)

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042941
Author(s):  
Vanja Milosevic ◽  
Aimee Linkens ◽  
Bjorn Winkens ◽  
Kim P G M Hurkens ◽  
Dennis Wong ◽  
...  
Keyword(s):  
Nursing Home ◽  
Fall Risk ◽  
Nursing Home Residents ◽  
High Sensitivity ◽  
Secondary Outcome ◽  
Operating Characteristics ◽  
Retrospective Case ◽  
Data Set ◽  
Fall Incident ◽  
Clinical Rule

ObjectivesTo develop (part I) and validate (part II) an electronic fall risk clinical rule (CR) to identify nursing home residents (NH-residents) at risk for a fall incident.DesignObservational, retrospective case–control study.SettingNursing homes.ParticipantsA total of 1668 (824 in part I, 844 in part II) NH-residents from the Netherlands were included. Data of participants from part I were excluded in part II.Primary and secondary outcome measuresDevelopment and validation of a fall risk CR in NH-residents. Logistic regression analysis was conducted to identify the fall risk-variables in part I. With these, three CRs were developed (ie, at the day of the fall incident and 3 days and 5 days prior to the fall incident). The overall prediction quality of the CRs were assessed using the area under the receiver operating characteristics (AUROC), and a cut-off value was determined for the predicted risk ensuring a sensitivity ≥0.85. Finally, one CR was chosen and validated in part II using a new retrospective data set.ResultsEleven fall risk-variables were identified in part I. The AUROCs of the three CRs form part I were similar: the AUROC for models I, II and III were 0.714 (95% CI: 0.679 to 0.748), 0.715 (95% CI: 0.680 to 0.750) and 0.709 (95% CI: 0.674 to 0.744), respectively. Model III (ie, 5 days prior to the fall incident) was chosen for validation in part II. The validated AUROC of the CR, obtained in part II, was 0.603 (95% CI: 0.565 to 0.641) with a sensitivity of 83.41% (95% CI: 79.44% to 86.76%) and a specificity of 27.25% (95% CI 23.11% to 31.81%).ConclusionMedication data and resident characteristics alone are not sufficient enough to develop a successful CR with a high sensitivity and specificity to predict fall risk in NH-residents.Trial registration numberNot available.

scholarly journals Between Social Inclusion and Exclusion: Integration of Daycare Guests in the Nursing Home Setting

2020 ◽  
Author(s):  
Kerstin Hämel ◽  
Gundula Röhnsch
Keyword(s):  
Nursing Home ◽  
Social Inclusion ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Cognitive Capacity ◽  
Home Setting ◽  
Residential Care Facilities ◽  
Care Approach ◽  
Nursing Home Setting ◽  
Close Relatives

Abstract Background and Objectives In integrated daycare, community-dwelling older people in need of care join existing groups in residential care facilities during the day. This study focuses on how nursing home residents experience the integrative care approach, exploring opportunities for social inclusion and mechanisms of exclusion. Research Design and Methods A purposive sample of residents differing in cognitive capacity and level of (non)conflictual interaction with daycare guests was selected. Episodic interviews with residents (N = 10) and close relatives (N = 2) were conducted in 3 pilot facilities in Germany and analyzed using thematic coding. Results The analysis revealed different orientation patterns towards the presence of daycare guests: respondents (a) demonstrated indifference to the daycare guests, (b) saw bonding with guests as a means to connect to the outside world, and (c) perceived incompatibility between in-group and out-group. Criticisms included disruption of daily routines and loss of privacy. Most interviewees came to terms with the care situation using rational and moral arguments. Discussion and Implications The study reveals the importance of residents’ participation when integrating daycare guests. Institutional procedures are required to prevent exclusion of daycare guests and avoid overtaxing residents.

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