New Composite Measure for ADL Limitations: Application to Predicting Nursing Home Placement for Michigan MI Choice Clients

2019 ◽  
pp. 107755871988673 ◽  
Author(s):  
Hyokyoung G. Hong ◽  
Hong-Su An ◽  
Erin Sarzynski ◽  
Kathleen Oberst
Keyword(s):  
Factor Analysis ◽  
Nursing Home ◽  
Exploratory Factor Analysis ◽  
Self Care ◽  
Nursing Home Placement ◽  
Nursing Home Admission ◽  
Additive Measure ◽  
Composite Measure ◽  
Waiver Program ◽  
Home Placement

Functional status measured by activities of daily living (ADL) may be used to predict nursing home placement. Scoring of ADL measures is summarized for convenience, yet this is accompanied by losing detail regarding deficits. We sought to determine whether a revised composite measure tailored to Michigan Medicaid beneficiaries would better identify those at risk for nursing home admission. We compared composite ADL measures created by exploratory factor analysis and additive modeling to Medicaid Enrollment, MI Choice Waiver program, and Nursing Facility claims data from 2013 to 2017. There were moderate to high levels of correlation between ADLs (.4-.82). Exploratory factor analysis extracted two factors, corresponding to domains of mobility or self-care tasks. Application of the self-care-based ADL limitations composite measure provided prediction power equivalent to an additive measure incorporating all ADL limitations for nursing home admission. This approach demonstrated improved interpretability with the need for just five measures.

scholarly journals Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis

2016 ◽  
Vol 29 (2) ◽  
pp. 195-208 ◽  
Author(s):  
Sandeep Toot ◽  
Tom Swinson ◽  
Mike Devine ◽  
David Challis ◽  
Martin Orrell
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Meta Analysis ◽  
Community Support ◽  
Nursing Home Placement ◽  
Nursing Home Admission ◽  
People With Dementia ◽  
Increased Risk ◽  
Home Placement

ABSTRACTBackground:Up to half of people with dementia in high income countries live in nursing homes and more than two-thirds of care home residents have dementia. Fewer than half of these residents report good quality of life and most older people are anxious about the prospect of moving into a nursing home. Robust evidence is needed as to the causes of admission to nursing homes, particularly where these risk factors are modifiable.Methods:We conducted a systematic literature search to identify controlled comparison studies in which the primary outcome was admission to nursing home of older adults with dementia. Identified studies were assessed for validity and 26 (17 cohort and 9 case-control) were included. Qualitative and quantitative analyses were conducted, including meta-analysis of 15 studies.Results:Poorer cognition and behavioral and psychological symptoms of dementia (BPSD) were consistently associated with an increased risk of nursing home admission and most of our meta-analyses demonstrated impairments in activities of daily living as a significant risk. The effects of community support services were unclear, with both high and low levels of service use leading to nursing home placement. There was an association between caregiver burden and risk of institutionalization, but findings with regard to caregiver depression varied, as did physical health associations, with some studies showing an increased risk of nursing home placement following hip fracture, reduced mobility, and multiple comorbidities.Conclusion:We recommend focusing on cognitive enhancement strategies, assessment and management of BPSD, and carer education and support to delay nursing home placement.

scholarly journals The influence of caregivers and behavioral and psychological symptoms on nursing home placement of persons with Alzheimer’s disease: A matched case–control study

2016 ◽  
Vol 4 ◽  
pp. 205031211666187 ◽  
Author(s):  
Candace N Porter ◽  
Margaret C Miller ◽  
Marcia Lane ◽  
Carol Cornman ◽  
Khaled Sarsour ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Psychological Symptoms ◽  
Nursing Home Placement ◽  
Nursing Home Admission ◽  
Neuropsychiatric Inventory ◽  
Matched Case ◽  
Home Placement ◽  
Behavioral And Psychological Symptoms

Objectives: Behavioral and psychological symptoms of dementia in individuals with Alzheimer’s disease and caregiver characteristics may influence the decision to provide care at home or in a nursing home, though few studies examine this association near the actual time of nursing home placement. Using a matched case–control design, this study investigates the association between (1) total Neuropsychiatric Inventory score, (2) the Neuropsychiatric Inventory-4 (an agitation/aggression subscale), and (3) individual domains of the Neuropsychiatric Inventory and nursing home placement. Methods: Data from the South Carolina Alzheimer’s disease Registry provides an opportunity to expand the literature by looking at cases at the time of nursing home care eligibility/placement and allowing for propensity-score-matched controls. Cases (n = 352) entered a nursing home within 6 months of study initiation; controls (n = 289) remained in the community. Registry data were combined with caregiver survey data, including the Neuropsychiatric Inventory. Conditional logistic regression was applied. Results: A 10% increase in the Neuropsychiatric Inventory score implied a 30% increase in odds of nursing home admission (odds ratio: 1.30; 95% confidence interval: 1.14–1.50), having married or male caregivers predicted nursing home placement. Cases versus controls were significantly more likely to have behavioral and psychological symptoms of dementia related to agitation/aggression 1 month prior to nursing home admission. Conclusion: Interventions targeting behavioral and psychological symptoms of dementia without available effective interventions in individuals with Alzheimer’s disease and caregiver support services are necessary to prevent or delay nursing home admission.

scholarly journals Self-rated health as a predictor of hospital admission and nursing home placement in elderly public housing tenants.

1986 ◽  
Vol 76 (4) ◽  
pp. 457-459 ◽  
Author(s):  
M Weinberger ◽  
J C Darnell ◽  
W M Tierney ◽  
B L Martz ◽  
S L Hiner ◽  
...  
Keyword(s):  
Nursing Home ◽  
Hospital Admission ◽  
Public Housing ◽  
Nursing Home Placement ◽  
Self Rated Health ◽  
Home Placement

scholarly journals Building the Evidence for Hospital Mobility

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 867-867
Keyword(s):  
Nursing Home ◽  
Health System ◽  
Functional Decline ◽  
Bed Rest ◽  
Illness Severity ◽  
Adverse Outcomes ◽  
Nursing Home Placement ◽  
System Level ◽  
Home Placement

Abstract Low mobility in the hospital, defined as mobility limited to bed rest or bed to chair transfers, is associated with high rates of functional decline, nursing home placement, and death even after adjusting for illness severity and comorbidity. This lecture will describe the gradual of building of evidence for both the adverse outcomes and potential solutions at both an individual and a health system level to address the challenge of low mobility.

The Risk of Nursing Home Placement and Subsequent Death Among Older Adults

1992 ◽  
Vol 47 (4) ◽  
pp. S173-S182 ◽  
Author(s):  
F. D. Wolinsky ◽  
C. M. Callahan ◽  
J. F. Fitzgerald ◽  
R. J. Johnson
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Home Placement ◽  
Home Placement

scholarly journals Do Trajectories of At-Home Dementia Caregiving Account for Burden After Nursing Home Placement? A Growth Curve Analysis

2010 ◽  
Vol 49 (8) ◽  
pp. 734-752 ◽  
Author(s):  
Katherina A. Nikzad-Terhune ◽  
Keith A. Anderson ◽  
Robert Newcomer ◽  
Joseph E. Gaugler
Keyword(s):  
Nursing Home ◽  
Growth Curve ◽  
Curve Analysis ◽  
Nursing Home Placement ◽  
Growth Curve Analysis ◽  
Dementia Caregiving ◽  
Home Placement ◽  
At Home

scholarly journals Transcultural Adaptation and Theoretical Models of Validation of the Spanish Version of the Self-Care of Heart Failure Index Version 6.2 (SCHFI v.6.2)

2021 ◽  
Vol 18 (2) ◽  
pp. 569
Author(s):  
Raúl Juárez-Vela ◽  
Angela Durante ◽  
Rosa Antonio-Oriola ◽  
Vicente Gea-Caballero ◽  
Michał Czapla ◽  
...  
Keyword(s):  
Heart Failure ◽  
Factor Analysis ◽  
Psychometric Properties ◽  
Exploratory Factor Analysis ◽  
Self Care ◽  
Public Health Problem ◽  
The Self ◽  
Spanish Version ◽  
Factorial Validity ◽  
Failure Index

Background: Heart failure (HF) is a major and growing public health problem worldwide. Across the world, heart failure is associated with high mortality, high hospitalization rates, and poor quality of life. Self-care is defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiologic stability, the response to symptoms when they occur, and the ability to follow the treatment regimen and control symptoms. One instrument used to measure self-care is the Self Care of Heart Failure Index. Aim: The purpose of this study was to test the psychometric properties of the Spanish version of the Self Care of Heart Failure Index v.6.2 (SCHFI v.6.2). Methodology: Before testing its psychometric properties, the SCHFI v.6.2 was translated and adapted from its original English version into Spanish. Subsequently, we tested the instrument’s psychometric properties on a sample of 203 participants with HF. Descriptive statistics were used to analyze the sociodemographic and clinical variables, and to describe item responses. We tested the factorial validity of the SCHFI v.6.2 using confirmatory and exploratory factor analysis. Results: Confirmatory factor analysis (CFA) was performed using the our pre-existing models which resulted with poor fit indices. Thus, we performed exploratory factor analysis (EFA) on each of the SCHFI v.6.2 scales. Conclusion: The Spanish version of the SCHFI v.6.2. has good characteristics of factorial validity and can be used in clinical practice and research to measure self-care in patients with HF.

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