scholarly journals The prevalence of delirium in belgian nursing homes: a cross-sectional evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sabbe Kelly ◽  
van Der Mast Roos ◽  
Dilles Tinne ◽  
Van Rompaey Bart
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Clinical Problem ◽  
Binary Logistic Regression Analysis ◽  
Geriatric Syndrome ◽  
Cross Sectional ◽  
Fall Incident ◽  
Screening Scale

Abstract Background Delirium is a common geriatric syndrome, but only few studies have been done in nursing home residents. Therefore, the aim of this study was to investigate (point) prevalence of and risk factors for delirium in nursing homes in Belgium. Methods A multisite, cross-sectional study was conducted in six nursing homes in Belgium. Residents of six nursing homes were screened for delirium. Exclusion criteria were coma,‘end-of-life’ status and residing in a dementia ward. Delirium was assessed using the Delirium Observation Screening Scale. Results 338 of the 448 eligible residents were included in this study. Of the 338 residents who were evaluated, 14.2 % (95 %CI:3.94–4.81) screened positive for delirium with the Delirium Observation Screening Scale. The mean age was 84.7 years and 67.5 % were female. Taking antipsychotics (p = 0.009), having dementia (p = 0.005), pneumonia (p = 0.047) or Parkinson’s disease (p = 0.03) were more present in residents with delirium. The residents were more frequently physically restrained (p = 0.001), participated less in activities (p = 0.04), had had more often a fall incident (p = 0.007), had lower levels of cognition (p < 0.001; MoCA ≥ 26, p = 0.04; MoCA ≥ 25, p = 0.008) and a higher “Activities of Daily Living” score (p = 0.001). In multivariable binary logistic regression analysis, a fall incident (2.76; 95 %CI: 1.24–6.14) and cognitive impairment (OR: 0.69; 95 %CI: 0.63–0.77) were significantly associated with delirium. Conclusions Delirium is an important clinical problem affecting almost 15 % of the nursing home residents at a given moment. Screening of nursing home residents for risk factors and presence of delirium is important to prevent delirium if possible and to treat underlying causes when present.

scholarly journals The relationship of nursing home price and quality of life

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Raes ◽  
Sophie Vandepitte ◽  
Delphine De Smedt ◽  
Herlinde Wynendaele ◽  
Yannai DeJonghe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Research Question ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Ownership Type ◽  
Cross Sectional ◽  
The Relationship

Abstract Background Knowledge about the relationship between the residents’ Quality of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes. Methods The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple linear regression analyses were conducted to examine the research question. Results The multiple linear regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P <  0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes. Conclusion Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents’ QOL.

scholarly journals Nursing home staff’s perspective on end-of-life care of German nursing home residents: a cross-sectional survey

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Anke Strautmann ◽  
Katharina Allers ◽  
Alexander Maximilian Fassmer ◽  
Falk Hoffmann
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
Nursing Staff ◽  
End Of Life Care ◽  
Nursing Home Residents ◽  
Hospital Death ◽  
Life Care ◽  
Cross Sectional

Abstract Background Nursing homes are becoming more important for end-of-life care. Within the industrialised world, Germany is among the countries with the most end-of-life hospitalizations in nursing home residents. To improve end-of-life care, investigation in the status quo is required. The objective was to gain a better understanding of the perspectives of nursing home staff on the current situation of end-of-life care in Germany. Methods A cross-sectional study was conducted as a postal survey among a random sample of 1069 German nursing homes in 2019. The survey was primarily addressed to nursing staff management. Data was analyzed using descriptive statistics. Staff was asked to rate different items regarding common practices and potential deficits of end-of-life care on a 5-point-Likert-scale. Estimations of the proportions of in-hospital deaths, residents with advance directives (AD), cases in which documented ADs were ignored, and most important measures for improvement of end-of-life care were requested. Results 486 (45.5%) questionnaires were returned, mostly by nursing staff managers (64.7%) and nursing home directors (29.9%). 64.4% of the respondents rated end-of-life care rather good, the remainder rated it as rather bad. The prevalence of in-hospital death was estimated by the respondents at 31.5% (SD: 19.9). Approximately a third suggested that residents receive hospital treatments too frequently. Respondents estimated that 45.9% (SD: 21.6) of the residents held ADs and that 28.4% (SD: 26.8) of available ADs are not being considered. Increased staffing, better qualification, closer involvement of general practitioners and better availability of palliative care concepts were the most important measures for improvement. Conclusions Together with higher staffing, better availability and integration of palliative care concepts may well improve end-of-life care. Prerequisite for stronger ties between nursing home and palliative care is high-quality education of those involved in end-of-life care.

Risk Factors for Methicillin-Resistant Staphylococcus Aureus Carriage in Residents of German Nursing Homes

2002 ◽  
Vol 23 (9) ◽  
pp. 511-515 ◽  
Author(s):  
H. von Baum ◽  
C. Schmidt ◽  
D. Svoboda ◽  
O. Bock-Hensley ◽  
Constanze Wendt
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Nursing Home ◽  
Nursing Homes ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Significant Risk ◽  
Nursing Home Residents ◽  
Medium Size ◽  
Prevalence Survey ◽  
Methicillin Resistant

Objectives:To determine the prevalence of and the risk factors for methicillin-resistant Staphylococcus aureus (MRSA) carriage in nursing home residents in the Rhine-Neckar region of southern Germany.Design:Point-prevalence survey.Setting:Forty-seven nursing homes in the region.Participants:All residents of the approached nursing homes who agreed to participate.Methods:After informed consent was obtained, all participants had their nares swabbed, some personal data collected, or both. All swabs were examined for growth of MRSA All S. aureus isolates underwent oxacillin susceptibility testing and polymerase chain reaction for demonstration of the meek gene. All MRSA isolates were typed using pulsed-field gel electrophoresis after digestion with SmaI.Results:Swabs from 3,236 nursing home residents yielded 36 MRSA strains, contributing to a prevalence rate of 1.1%. Significant risk factors for MRSA carriage in the multivariate analysis were the presence of wounds or urinary catheters, limited mobility, admission to a hospital during the preceding 3 months, or stay in a medium-size nursing home. One predominant MRSA strain could be detected in 30 of the 36 MRSA carriers.Conclusions:The prevalence of MRSA in German nursing homes is still low. These residents seemed to acquire their MRSA in the hospital and transfer it to their nursing home. Apart from well-known risk factors for the acquisition of MRSA we identified the size of the nursing home as an independent risk factor. This might be due to an increased use of antimicrobials in nursing homes of a certain size.

scholarly journals Determinants of Urinary Incontinence and Subtypes Among the Elderly in Nursing Homes

2021 ◽  
Vol 9 ◽  
Author(s):  
Hongyan Tai ◽  
Shunying Liu ◽  
Haiqin Wang ◽  
Hongzhuan Tan
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Nursing Home ◽  
Nursing Homes ◽  
Spinal Surgery ◽  
Short Form ◽  
Significant Risk ◽  
Nursing Home Residents ◽  
International Consultation ◽  
History Of

Urinary incontinence (UI) is a common problem among older adults. This study investigated the prevalence of UI in nursing home residents aged ≥75 years in China and examined potential risk factors associated with UI and its subtypes. Data were collected during face-to-face interviews using a general questionnaire, the International Consultation Incontinence Questionnaire Short-Form, and the Barthel Index. A total of 551 participants aged ≥75 years residing in Changsha city were enrolled from June to December 2018. The UI prevalence rate among nursing home residents aged ≥75 years was 24.3%. The most frequent subtype was mixed (M) UI (38.1%), followed by urge (U) UI (35.1%), stress (S) UI (11.9%), and other types (14.9%). In terms of severity, 57.5% had moderate UI, while 35.1% had mild and 7.5% had severe UI. Constipation, immobility, wheelchair use, cardiovascular disease (CVD), and pelvic or spinal surgery were significant risk factors for UI. Participants with a history of surgery had higher risks of SUI (odds ratio [OR] = 4.87, 95% confidence interval [CI]: 1.55–15.30) and UUI (OR = 1.97, 95% CI: 1.05–3.71), those who were immobile or used a wheelchair had higher rates of MUI (OR = 11.07, 95% CI: 4.19–29.28; OR = 3.36, 95% CI: 1.16–9.78) and other UI types (OR = 7.89, 95% CI: 1.99–31.30; OR = 14.90, 95% CI: 4.88–45.50), those with CVD had a higher rate of UUI (OR = 2.25, 95% CI: 1.17–4.34), and those with diabetes had a higher risk of UUI (OR = 2.250, 95% CI: 1.14–4.44). Use of oral antithrombotic agents increased UUI risk (OR = 4.98, 95% CI: 2.10–11.85) whereas sedative hypnotic drug use was associated with a higher risk of MUI (OR = 3.62, 95% CI: 1.25–10.45). Each UI subtype has distinct risk factors, and elderly residents of nursing homes with a history of CVD and pelvic or spinal surgery who experience constipation should be closely monitored. Reducing time spent in bed and engaging in active rehabilitation including walking and muscle strengthening may aid in UI prevention and treatment.

scholarly journals The Prevalence of and Documented Indications for Antipsychotic Prescribing in Irish Nursing Homes

Pharmacy ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 160
Author(s):  
Jayne E. Kelleher ◽  
Peter Weedle ◽  
Maria D. Donovan
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Antipsychotic Medication ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Medication Use ◽  
Nursing Home Residents ◽  
Cross Sectional ◽  
Home Setting ◽  
Antipsychotic Prescribing

Background: Antipsychotic medications are often used ‘off-licence’ to treat neuropsychiatric symptoms and disorders of aging and to manage behavioural and psychological symptoms of dementia despite the warnings of adverse effects. Objective: To establish the prevalence of and documented indication for antipsychotic medication use in the Irish nursing home setting. Setting: This study was conducted in six nursing homes located in Co. Cork, Ireland. Method: A retrospective, cross-sectional study was employed. All patients who met the inclusion criteria (≥65 years, residing in a nursing home on a long-term basis) were eligible for inclusion. There were 120 nursing home residents recruited to the study. Main Outcome Measure: The prevalence of antipsychotic medication use in nursing home residents (with and without dementia). Results: The overall prevalence of antipsychotic prescribing was found to be 48% and patients with dementia were significantly more likely to be prescribed an antipsychotic compared to those without dementia (67% vs. 25%) (χ2 (1, N = 120) = 21.541, p < 0.001). In the cohort of patients with dementia, there was a trend approaching significance (p = 0.052) of decreasing antipsychotic use with increasing age (age 65–74 = 90%; age 75–84 = 71%; age 85 and over = 58%). An indication was documented for 84% of the antipsychotic prescriptions in this cohort. Conclusion: The findings of this study highlight that high rates of antipsychotic medication use remains an issue in Irish nursing homes. Further work should explore factors in influencing prescribing of these medications in such settings.

scholarly journals Nursing home residents’ ADL status, institution-dwelling and association with outdoor activity: a cross-sectional study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10202
Author(s):  
Anne Marie Sandvoll ◽  
Ellen Karine Grov ◽  
Morten Simonsen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Performance Status ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Outdoor Activity ◽  
Cross Sectional ◽  
Outdoor Activities ◽  
Low Performance

Introduction The Norwegian regulations for nursing homes consider access to meaningful activities to be an indicator for the quality of nursing homes. Activities of daily living (ADL) provide important basic self-care skills for nursing home residents. Due to the physical changes caused by ageing and comorbidities, nursing home residents may experience functional decline over time, which may affect their ability to perform meaningful ADL, such as outdoor activity, which is considered a valuable and meaningful activity in Norwegian culture. This study aimed to investigate the association between ADL status, institution-dwelling and outdoor activity among nursing home residents. Methods This cross-sectional study included 784 residents aged >67 years living in 21 nursing homes in 15 Norwegian municipalities between November 2016 and May 2018. The Barthel Index was used to assess the nursing home residents’ ADL status. Other variables collected were age, gender, body weight and height, visits per month, institution, ward, and participation in weekly outdoor activities. Descriptive statistics were used to provide an overview of the residents’ characteristics. A Poisson regression model was used to test the association between the outdoor activity level as the dependent variable and ADL score, institution, and other control variables as independent variables. Results More than half (57%) of the nursing home residents in this sample did not go outdoors. More than 50% of the residents had an ADL score <10, which indicates low performance status. Further, we found that residents’ ADL status, institution, ward, and number of visits had an impact on how often the residents went outdoors. Discussion The nursing home residents in this study rarely went outdoors, which is interesting because Norwegians appreciate this activity. Differences in the number of visits might explain why some residents went outdoors more often than other residents did. Our findings also highlight that the institutions impact the outdoor activity. How the institutions are organized and how important this activity is considered to be in the institutions determine how often the activity is performed. Conclusion The low frequency of the outdoor activities might be explained by a low ADL score. More than 50% of the residents had an ADL score <10, which indicates low performance status. Despite regulations for nursing home quality in Norway, this result suggests that organizational differences matter, which is an important implication for further research, health policy and practice.

scholarly journals Contacts with general practitioners, dentists, and medical specialists among nursing home residents: a cross-sectional study in 44 German nursing homes

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Jonas Czwikla ◽  
Annika Schmidt ◽  
Maike Schulz ◽  
Ansgar Gerhardus ◽  
Guido Schmiemann ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Dental Care ◽  
Nursing Home Residents ◽  
Median Number ◽  
Cross Sectional Study ◽  
Care Utilization ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical Specialists

Abstract Background Nursing home residents have high medical care needs. Their medical care utilization is, however, lower compared to community-dwelling elderly and varies widely among nursing homes. This study quantified the utilization of general practitioners (GPs), dentists, and medical specialists among nursing homes and residents, and investigated whether dentist utilization is associated with individual and nursing home characteristics. Methods Forty-four nursing homes invited 2124 residents to participate in a cross-sectional study. For 10 medical specialties, data on contacts in nursing homes, practices, and by telephone in the last 12 months were assessed at individual and nursing home level. The proportion of nursing homes and residents with any form of contact, and the median number and interquartile range (IQR) of contacts among individuals with contact were determined. Using multilevel logistic regression, associations between the probability of individual dental care utilization and sex, age, LTC grade, years of residence, sponsorship, number of nursing home beds, and transport and medical escort services for consultations at a practice were investigated. Results The proportion of nursing homes with any form of contact with physicians ranged from 100% for GPs, dentists, and urologists to 76.7% for gynecologists and orthopedists. Among the nursing homes, 442 residents participated (20.8% response). The proportion of residents with any contact varied from 97.8% for GPs, 38.5% for neurologists/psychiatrists, and 32.3% for dentists to 3.0% for gynecologists. Only for GPs, neurologists/psychiatrists, dentists, otorhinolaryngologists, urologists, and dermatologists, the proportion was higher for nursing home contacts than for practice and telephone contacts. Among residents with any contact, the median number of contacts was highest for GPs (11.0 [IQR 7.0-16.0]), urologists (4.0 [IQR 2.0-7.0]), and neurologists/psychiatrists (3.0 [IQR 2.0-5.0]). Dentist utilization varied widely among nursing homes (median odds ratio 2.5) and was associated with higher age. Conclusions Almost all residents had regular contact to GPs, but only one third had contact with dentists. Lower proportions with contact were found for medical specialists, except for neurologists/psychiatrists. Reasons for the large variations in dental care utilization among nursing homes should be identified. Trial registration DRKS00012383 [2017/12/06].

scholarly journals The Relationship of Nursing Home Price and Quality of Life

2020 ◽  
Author(s):  
Sarah Raes ◽  
Sophie Vandepitte ◽  
Delphine De Smedt ◽  
Herlinde Wynendaele ◽  
Yannai DeJonghe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Research Question ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Ownership Type ◽  
Cross Sectional ◽  
The Relationship

Abstract Background: Knowledge about the relationship between the residents’ Quality Of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes.Methods: The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple linear regression analyses were conducted to examine the research question.Results: The multiple linear regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P < 0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes.Conclusion: Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents’ QOL.

scholarly journals Potentially Inappropriate Drug Prescribing in French Nursing Home Residents: An Observational Study

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 133
Author(s):  
Soraya Qassemi ◽  
Arnaud Pagès ◽  
Laure Rouch ◽  
Serge Bismuth ◽  
André Stillmunkes ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Drug Prescription ◽  
Nursing Home Residents ◽  
Optimization Methods ◽  
Inappropriate Drug ◽  
Utilization Review ◽  
Cross Sectional ◽  
Implicit Approach ◽  
Explicit Criteria

Purpose: To identify the prevalence of potentially inappropriate drug prescription in a sample of nursing home residents in France, combining explicit criteria and implicit approach and to involve pharmacists in the multi-professional process of therapeutic optimization. Methods: A cross-sectional, observational, multicenter study was conducted during a five-month period in a sample of French nursing homes. Information on drug prescription, diseases, and socio-demographic characteristics of nursing home residents was collected. For each prescription, identification of potentially inappropriate drug prescription was done, based on explicit and implicit criteria. Results: Nursing home residents were administered an average of 8.1 (SD 3.2, range 0–20) drugs per day. Nearly 87% (n = 237) of the residents had polypharmacy with five or more drugs prescribed per day. Among the 274 nursing home residents recruited from five nursing homes, 212 (77.4%) had at least one potentially inappropriate drug prescription. According to the Laroche list, 84 residents (30.7%) had at least one drug with an unfavorable benefit–harm balance. An overdosing was found for 20.1% (n = 55) of the residents. Nearly 30% (n = 82) of the residents had a drug prescribed without valid medical indication. Conclusions: This study shows that potentially inappropriate drug prescriptions are highly prevalent among nursing home residents, nevertheless pharmacists can take part in drug utilization review in collaboration with the nursing home staff.

Advance directives and physicians’ orders in nursing home residents with dementia in Flanders, Belgium: prevalence and associated outcomes

2012 ◽  
Vol 24 (7) ◽  
pp. 1133-1143 ◽  
Author(s):  
An Vandervoort ◽  
Lieve van den Block ◽  
Jenny T. van der Steen ◽  
Robert Vander Stichele ◽  
Johan Bilsen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Quality Care ◽  
Nursing Home Residents ◽  
Care Plan ◽  
Care Planning ◽  
Legal Representative ◽  
Cross Sectional ◽  
Diagnosis Of Dementia

ABSTRACTBackground: Advance care planning (ACP) is an important element of high-quality care in nursing homes, especially for residents having dementia who are often incompetent in decision-making toward the end of life. The aim of this study was describe the prevalence of documented ACP among nursing home residents with dementia in Flanders, Belgium, and associated clinical characteristics and outcomes.Methods: All 594 nursing homes in Flanders were asked to participate in a retrospective cross-sectional postmortem survey in 2006. Participating homes identified all residents who had died over the last two months. A structured questionnaire was mailed to the nurses closely involved in the deceased resident's care regarding the diagnosis of dementia and documented care planning, i.e. advance patient directives, authorization of a legal representative, and general practitioners’ treatment orders (GP orders).Results: In 345 nursing homes (58% response rate), nurses identified 764 deceased residents with dementia of whom 62% had some type of documented care plan, i.e. advance patient directives in 3%, a legal representative in 8%, and GP orders in 59%. Multivariate logistic regression showed that the presence of GP orders was positively associated with receiving specialist palliative care in the nursing home (OR 3.10; CI, 2.07–4.65). Chances of dying in a hospital were lower if there was a GP order (OR 0.38; CI, 0.21–0.70).Conclusions: Whereas GP orders are relatively common among residents with dementia, advance patient directives and a legal representative are relatively uncommon. Nursing home residents receiving palliative care are more likely to have a GP order. GP orders may affect place of death.

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