Shall I Stay or Shall I Go? The Choice to Remain in the Nursing Home Among Residents With High Potential for Discharge

2018 ◽  
Vol 39 (8) ◽  
pp. 863-870 ◽  
Author(s):  
Kathleen Abrahamson ◽  
Zachary Hass ◽  
Greg Arling
Keyword(s):  
Nursing Home ◽  
Daily Living ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Care Needs ◽  
Health Related ◽  
Community Initiative ◽  
Small Decline ◽  
Using Data ◽  
Perception Of Health

Minnesota’s Return to Community Initiative (RTCI) assists private-pay nursing home (NH) residents to return to the community. Using data from a 1-year admission cohort of RTCI-targeted NH residents, we examined why residents who at admission expressed a desire for discharge, were paying privately, and had relatively low-care needs chose to remain in the NH. Characteristics of those who remained were compared with those who discharged using logistic regression, and barriers to discharge were summarized. Residents who were older, more cognitively impaired (OR = 1.8), unmarried (OR = 1.4), had behavior problems (OR = 1.6), or diagnosed with dementia (OR = 2.0) were more likely to remain than discharge to the community. Between admission and their 90-day assessment, residents remaining in the facility had a small decline in cognitive status, yet their continence improved and they became more independent in activities of daily living (ADLs). Seventy-four percent reported a perception of health-related barriers to discharge.

Ethnic Composition of Couples and Mutual Health Benefit Receipt: Register-based Evidence from Finland

2021 ◽  
Author(s):  
Jan Saarela ◽  
Maria Stanfors ◽  
Mikael Rostila
Keyword(s):  
Disability Pension ◽  
Cultural Practices ◽  
Health Benefit ◽  
Ethnic Composition ◽  
Health Care Needs ◽  
Care Needs ◽  
Income Loss ◽  
Health Related ◽  
Using Data ◽  
First Time

Abstract Background: The literature on health dependencies among partners typically ignores diversity when it comes to partnership characteristics, which have consequences on many facets of life and may be important for the health of both parties. One salient example is the ethnic or racial composition of the couple. We extend prior work on partnerships and health by investigating how married and cohabiting partners mutually influence each other’s receipt of health-related benefits, and focus on how any such correlations vary by the couple’s ethnic composition.Methods: We study partners’ mutual receipt of sickness allowance and disability pension in ethnically endogamous and exogamous couples in Finland. The population consists of native individuals in similar socioeconomic positions but belonging to two different ethnic groups, Finnish and Swedish speakers, which differ regarding health and cultural practices related to family life. Using data from population registers (36,034 couples in 1987-2011), we estimate discrete-time hazard models for first-time benefit receipt related to partner’s benefit receipt among midlife couples.Results: We find evidence of mutual receipt of health benefits in both endogamous and exogamous couples, the correlation being strongest for disability pension. Partner correlation in disability pension receipt is slightly stronger in endogamous Swedish than in endogamous Finnish couples, while women in exogamous couples are slightly less sensitive to men’s receipt than vice versa. These findings show that the ethnic composition of couples is important for mutual health benefit receipt.Conclusions: Our findings could be explained both by collateral health effects and by rational decisions concerning mutual leisure time, income loss, and informal health care needs. The results clearly cast light on the important issue of mutual health in couples, and that associations of this kind may be heterogeneous across couples that differ in ethnic composition.

Psychometric Properties of the Hooper Visual Organization Test

Assessment ◽  
2003 ◽  
Vol 10 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Michael N. Lopez ◽  
Michael D. Lazar ◽  
Sindy Oh
Keyword(s):  
Psychometric Properties ◽  
Clinical Utility ◽  
Item Analysis ◽  
Total Sample ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Using Data ◽  
Visual Organization ◽  
Cognitively Intact ◽  
Interrater Reliability Coefficients

The psychometric properties of the Hooper Visual Organization Test (VOT) have not been well investigated. Here the authors present internal consistency and interrater reliability coefficients, and an item analysis, using data from a sample ( N = 281) of "cognitively impaired" and "cognitively intact" patients, and patients with undetermined cognitive status. Coefficient alpha for the VOT total sample was .882. An item analysis found that 26 of the 30 items were good at discriminating among patients. Also, the interrater reliabilities for three raters (.992), two raters (.988), and one rater (.977) were excellent. Therefore, the judgmental scoring of the VOT does not interfere significantly with its clinical utility. The authors conclude that the VOT is a psychometrically sound test.

Excess Disability During Morning Care in Nursing Home Residents With Dementia

2000 ◽  
Vol 12 (2) ◽  
pp. 267-282 ◽  
Author(s):  
Joan C. Rogers ◽  
Margo B. Holm ◽  
Louis D. Burgio ◽  
Chuanchieh Hsu ◽  
J. Michael Hardin ◽  
...  
Keyword(s):  
Nursing Home ◽  
Activities Of Daily Living ◽  
Usual Care ◽  
Daily Living ◽  
Nursing Home Residents ◽  
Disruptive Behaviors ◽  
Cognitively Impaired ◽  
Functional Rehabilitation

Excess disability was examined in 17 nursing home residents with dementia by comparing their performance of morning care tasks under two activities of daily living (ADL) caregiving approaches—a dependence-supportive one under usual care and an independence-supportive one under functional rehabilitation. The results suggest that excess disability in severely cognitively impaired and functionally disabled residents can be reduced by increasing opportunities for independent activity, and substituting nondirective and directive verbal assists for physical assists. Further, the findings indicate that increased independence in ADL can be achieved without increasing disruptive behaviors and can foster appropriate requests for task-related help during caregiving. Functional rehabilitation, however, requires more time than usual care.

scholarly journals A MIXED-METHODS STUDY OF NURSING HOME RESIDENTS’ EXPERIENCES OF RELATIONSHIPS AND DAY-TO-DAY SOCIAL INTERACTIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S555-S555
Author(s):  
Allyson M Washburn ◽  
Susan Williams
Keyword(s):  
Nursing Home ◽  
Social Cognition ◽  
Social Interactions ◽  
Nursing Home Residents ◽  
Social Experiences ◽  
Cognitive Status ◽  
Mixed Methods Study ◽  
Conventional Content Analysis ◽  
Using Data ◽  
Nursing Home Stay

Abstract Nursing home residents with and without cognitive impairment (N=38) answered open-ended questions about their day-to-day social interactions and ongoing relationships with family and friends. One author (SW) completed a conventional content analysis of the transcripts and the other (AW), a phenomenological-hermeneutic analysis. Findings from these analyses were combined and examined further using data from measures of social cognition and staff ratings of social behavior. Participants’ social experiences appeared to be determined not only by long-established habits and preferences and length of nursing home stay but also by their cognitive status and social cognition competencies. A central theme was the importance of managing ongoing relationships and day-to-day interactions so as to reduce one’s own stress as well as the burden on others. This presentation details how findings from distinct analytic strategies were combined to characterize the researchers’ understanding of participants’ lives in their networks of care from their own perspective.

scholarly journals Predicting Change in Depressive Symptoms in the Nursing Home

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 385-385
Author(s):  
Joann Reinhardt ◽  
Orah Burack ◽  
Verena Cimarolli ◽  
Audrey Weiner
Keyword(s):  
Nursing Home ◽  
Depressive Symptoms ◽  
Holistic Approach ◽  
Well Being ◽  
Cognitive Status ◽  
Demographic Characteristics ◽  
Behavioral Symptoms ◽  
Care Needs ◽  
Comfort Care ◽  
Care Practices

Abstract Depressive symptoms are common among nursing home (NH) residents. Important predictors of depression to tease apart include demographic characteristics, physical status, functional ability, and chronic pain. A challenge to addressing depression is that a majority of NH residents have some level of dementia. Nonpharmacological management of depression in the NH is a recommended first line of treatment including: personalized activities, music therapy, repositioning, and attention to personal care needs (toileting, resting, and hydration). A holistic approach to the well-being of NH residents is the adoption of person directed (PDC) care models. In this study, predictors of decreased depression over time was examined in residents (N=144) living in two communities featuring PDC models, and those living in traditional care communities within the same NH. Care in the two PDC communities focused on provision of comfort care for persons with advancing dementia at-risk of not having their care needs met largely due to their inability to clearly communicate these needs. Care practices focused on knowing each elder deeply, and anticipating their needs. Care practices also included an emphasis on staff empowerment and meaningful life activities for residents. Traditional communities are those where PDC practices had not yet been incorporated. Data on demographic characteristics, cognitive status, physical and functional status, behavioral symptoms, and pain were extracted from the MDS. Results showed that being in the PDC group, less time in the nursing home, having less pain, and fewer behavioral symptoms were significant predictors of decreased depressive symptoms over a six-month period.

PREDICTORS OF GLOBAL COGNITIVE IMPAIRMENT 1 YEAR AFTER SUBARACHNOID HEMORRHAGE

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. 1043-1051 ◽  
Author(s):  
Mellanie V. Springer ◽  
J. Michael Schmidt ◽  
Katja E. Wartenberg ◽  
Jennifer A. Frontera ◽  
Neeraj Badjatia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Delayed Cerebral Ischemia ◽  
Cognitive Status ◽  
Cognitively Impaired

Abstract OBJECTIVE We sought to determine the frequency, risk factors, and impact on functional outcome and quality of life (QOL) of global cognitive impairment 1 year after subarachnoid hemorrhage. METHODS We prospectively evaluated global cognitive status 3 and 12 months after hospitalization with the Telephone Interview for Cognitive Status in 232 subarachnoid hemorrhage survivors. Cognitive impairment was defined as a score of 30 or less (scaled 0 = worst, 51 = best). Logistic regression was performed to calculate adjusted odds ratios (AORs) for impairment at 1 year. Basic activities of daily living were evaluated with the Barthel Index, instrumental activities of daily living were assessed with the Lawton scale, and QOL was evaluated with the Sickness Impact Profile. RESULTS The frequency of cognitive impairment was 27% at 3 months and 21% at 12 months. After the effects of age, education, and race/ethnicity were controlled for, risk factors for cognitive impairment at 12 months included anemia treated with transfusion (AOR, 3.4; P = 0.006), any temperature level higher than 38.6°C (AOR, 2.7; P = 0.016), and delayed cerebral ischemia (AOR, 3.6; P = 0.01). Among cognitively impaired patients at 3 months, improvement at 1 year occurred in 34% and was associated with more than 12 years of education and the absence of fever higher than 38.6°C during hospitalization (P = 0.015). Patients with cognitive impairment at 1 year had worse concurrent QOL and less ability to perform instrumental and basic activities of daily living (all P < 0.001). CONCLUSION Global cognitive impairment affects more than 20% of subarachnoid hemorrhage survivors at 1 year, is predicted by fever, anemia treated with transfusion, and delayed cerebral ischemia, and adversely affects functional recovery and QOL.

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