scholarly journals Group Activity Participation in Relation to Contextual Isolation of United States Nursing Home Residents Living with Alzheimer’s Disease and Related Dementias

2021 ◽  
pp. 1-9
Author(s):  
B.M. Jesdale ◽  
C.A. Bova ◽  
A.K. Mbrah ◽  
K.L. Lapane
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Group Activity ◽  
Activity Participation ◽  
Data Set ◽  
Group Activities ◽  
Multiple Characteristics

Background: Residents of nursing homes frequently report loneliness and isolation, despite being in an environment shared with other residents and staff. Objective: To describe, among long-stay US nursing home residents living with Alzheimer’s disease and/or related dementias (ADRD), group activity participation in relation to contextual isolation: living in a nursing home where fewer than 20% of residents share socially salient characteristic(s). Design: A cross-sectional evaluation of group activity participation in relation to contextual isolation across 20 characteristics based on demographic characteristics, habits and interests, and clinical and care dimensions. Setting: US nursing homes. Participants: We included 335,421 residents with ADRD aged ≥50 years with a Minimum Data Set 3.0 annual assessment in 2016 reporting their preference for group activity participation, and 94,735 with participation observed by staff. Measurements: We identified 827,823 annual (any anniversary) assessments performed on nursing home residents in 2016, selecting one at random for each resident, after prioritizing the assessment with the least missing data (n=795,038). MDS 3.0 item F0500e assesses resident interest in group activities. Results: When considering all potential sources of contextual isolation considered, 30.7% were contextually isolated on the basis of a single characteristic and 13.7% were contextually isolated on the basis of two or more characteristics. Among residents reporting importance of group activity, 81% of those not contextually isolated reported that group activity participation was important, as did 78% of those isolated on one characteristic, and 75% of those isolated on multiple characteristics. Among residents with staff-observed group activity participation, 64% of those not contextually isolated reported were observed participating in group activities, as were 59% of those isolated on one characteristic, and 52% of those isolated on multiple characteristics. Conclusion: Residents with ADRD facing contextual isolation placed less importance on group activity than residents who were not contextually isolated.

scholarly journals Advanced cognitive impairment among older nursing home residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tadeja Gracner ◽  
Patricia W. Stone ◽  
Mansi Agarwal ◽  
Mark Sorbero ◽  
Susan L Mitchell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Mortality Risk ◽  
Advanced Disease ◽  
Nursing Home Residents ◽  
Functional Score ◽  
Data Set

Abstract Background Though work has been done studying nursing home (NH) residents with either advanced Alzheimer’s disease (AD) or Alzheimer’s disease related dementia (ADRD), none have distinguished between them; even though their clinical features affecting survival are different. In this study, we compared mortality risk factors and survival between NH residents with advanced AD and those with advanced ADRD. Methods This is a retrospective observational study, in which we examined a sample of 34,493 U.S. NH residents aged 65 and over in the Minimum Data Set (2011–2013). Incident assessment of advanced disease was defined as the first MDS assessment with severe cognitive impairment (Cognitive Functional Score equals to 4) and diagnoses of AD or ADRD. Demographics, functional limitations, and comorbidities were evaluated as mortality risk factors using Cox models. Survival was characterized with Kaplan-Maier functions. Results Of those with advanced cognitive impairment, 35 % had AD and 65 % ADRD. At the incident assessment of advanced disease, those with AD had better health compared to those with ADRD. Mortality risk factors were similar between groups (shortness of breath, difficulties eating, substantial weight-loss, diabetes mellitus, heart failure, chronic obstructive pulmonary disease, and pneumonia; all p < 0.01). However, stroke and difficulty with transfer (for women) were significant mortality risk factors only for those with advanced AD. Urinary tract infection, and hypertension (for women) only were mortality risk factors for those with advanced ADRD. Median survival was significantly shorter for the advanced ADRD group (194 days) compared to the advanced AD group (300 days). Conclusions There were distinct mortality and survival patterns of NH residents with advanced AD and ADRD. This may help with care planning decisions regarding therapeutic and palliative care.

Alzheimer's Disease and Other Dementia in Nursing Homes: Levels of Management and Cost

2001 ◽  
Vol 13 (3) ◽  
pp. 347-358 ◽  
Author(s):  
Judith A. O'Brien ◽  
J. Jaime Caro
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Resident ◽  
Annual Cost ◽  
Nursing Home Residents ◽  
Care Needs ◽  
Diagnosis Of Dementia ◽  
Care Costs

Objective: To estimate comparative mangement levels and the annual cost of caring for a nursing home resident with and without dementia. Method: Data from the 1995 Massachusetts Medicaid nursing home database were used to examine residents with Alzheimer's disease, other types of dementia, and no dementia to determine care and dependency levels. Massachusetts Medicaid 1997 per-diem rates for each of 10 designated management levels were applied accordingly to residents in each level to estimate annual care costs. Costs from this analysis are reported in 1997 U.S. dollars. Results: Of the 49,724 nursing home residents identified, 26.4% had a documented diagnosis of dementia. On average, a resident with dementia requires 229 more hours of care annually than one without dementia, resulting in a mean additional cost of $3,865 per patient with dementia per year. Conclusions: Dementia increases the care needs and cost of caring for a nursing home resident.

scholarly journals Disparities in Nursing Home Use and Quality Among African American, Hispanic, and White Medicare Residents With Alzheimer’s Disease and Related Dementias

2018 ◽  
Vol 31 (7) ◽  
pp. 1259-1277 ◽  
Author(s):  
Maricruz Rivera-Hernandez ◽  
Amit Kumar ◽  
Gary Epstein-Lubow ◽  
Kali S. Thomas
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
African American ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Population Based ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Health Care Equity

Objective: This article examines differences in nursing home use and quality among Medicare beneficiaries, in both Medicare Advantage and fee-for-service, newly admitted to nursing homes with Alzheimer’s disease and related dementias (ADRD). Method: Retrospective, national, population-based study of Medicare residents newly admitted to nursing homes with ADRD by race and ethnic group. Our analytic sample included 1,302,099 nursing home residents—268,181 with a diagnosis of ADRD—in 13,532 nursing homes from 2014. Results: We found that a larger share of Hispanic Medicare residents that are admitted to nursing homes have ADRD compared with African American and White beneficiaries. Both Hispanics and African Americans with ADRD received care in segregated nursing homes with fewer resources and lower quality of care compared with White residents. Discussion: These results have implications for targeted efforts to achieve health care equity and quality improvement efforts among nursing homes that serve minority patients.

scholarly journals Longitudinal Comparison of Stability and Sensitivity in Quality of Life Scores Among Nursing Home Residents With and Without Diagnoses of Alzheimer’s Disease and Related Dementias

2021 ◽  
Author(s):  
Xuanzi Qin ◽  
Zachary G Baker ◽  
Stephanie Jarosek ◽  
Mark Woodhouse ◽  
Haitao Chu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Functional Status ◽  
Nursing Home Residents ◽  
Data Set ◽  
The Stability ◽  
Linear Probability

Abstract Background and Objectives Prevalence of nursing home residents with Alzheimer’s Disease and Related Dementias (ADRD) has increased along with a growing consensus that person-centered ADRD care in nursing homes should maximize quality of life (QoL). However, concerns about whether residents with ADRD can make appropriate QoL judgements persist. This study assesses the stability and sensitivity of a self-reported, multi-domain well-being QoL measure for nursing home residents with and without ADRD. Research Design and Methods This study linked the 2012-2015 Minnesota Nursing Home Resident QoL and Satisfaction with Care Survey, Minimum Data Set 3.0 (nursing home assessments), and Minnesota Department of Human Services Cost Reports. The QoL survey included cohort-resident pairs who participated for two consecutive years (N=12,949; 8,803 unique residents from 2012-2013, 2013-2014 and 2014-2015 cohorts). Change in QoL between two years was conceptualized as stable when within 1.5 standard deviations of the sample average. We used linear probability models to estimate associations of ADRD/cognitive function scale status with the stability of QoL summary and domain scores (e.g., social engagement) and the absolute change in QoL summary score, controlling for resident and facility characteristics. Results Most (86.82%) residents had stable QoL summary scores. Residents with moderate to severe cognitive impairment, irrespective of ADRD, were less likely to have stable summary scores than cognitively capable residents without ADRD (P&lt;0.001), but associations varied by QoL domains. Among those with stable summary QoL scores, changes in health/functional status were associated with absolute changes in summary QoL score (P&lt;0.001), suggesting sensitivity of the QoL measure. Discussion and Implications QoL scores were similarly stable over time for most residents with and without ADRD diagnoses and were sensitive to changes in health/functional status. This self-reported QoL measure may be appropriate for nursing home residents, regardless of ADRD diagnosis and can efficaciously be recommended to other states.

scholarly journals Overlap of Pain and Depression Among Nursing Home Residents With Advanced Alzheimer’s Disease and Related Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 42-43
Author(s):  
Emmanuelle Belanger ◽  
Richard Jones ◽  
Gary Epstein-Lubow ◽  
Kate Lapane
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Hospice Care ◽  
Care Delivery ◽  
Nursing Home Residents ◽  
National Sample ◽  
Fee For Service ◽  
Minimum Dataset

Abstract Physical and psychological suffering are interrelated and should be assessed together as part of palliative care delivery. We aimed to describe the overlap of pain and depressive symptoms among long-stay nursing home (NH) residents with advanced Alzheimer’s disease and related dementia (ADRD), and to determine the incidence of pain and depressive symptoms. We conducted a retrospective study of a US national sample of fee-for-Service Medicare beneficiaries who became long-stay NH residents in 2014-2015, had two consecutive quarterly Minimum Dataset assessments (90 and 180 days +/- 30 days), and had a diagnosis of ADRD in the Chronic Condition Warehouse and moderate to severe cognitive impairment (N= 92,682). We used descriptive statistics and Poisson regression models to examine the incidence of each symptom controlling for age, sex, and concurrent hospice care. Sub-groups with self-reported and observer-rated symptoms (pain/PHQ-9) were modelled separately, as were those switching between the two. The prevalence of depressive symptoms was low (5.7%), while pain was more common (18.2%). Across various subgroups, 2% to 4% had both pain and depression, but between 20% and 25% were treated with both antidepressants and scheduled analgesia. Depressed residents at baseline had an incidence rate ratio (IRR) of pain of 1.2 at the second assessment, while the residents with pain at baseline had an IRR of depressive symptoms of 1.3 at the second assessment. Our results support the expected relationship between pain and depressive symptoms in a national sample of long-stay NH residents with advanced ADRD, suggesting the need for simultaneous clinical management.

Nursing home residents with Alzheimer’s disease in special care units compared to other residents with Alzheimer’s disease

Dementia ◽  
2005 ◽  
Vol 4 (2) ◽  
pp. 249-267 ◽  
Author(s):  
Robert J. Buchanan ◽  
Maryann Choi ◽  
Suojin Wang ◽  
Hyunsu Ju ◽  
David Graber
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Special Care ◽  
Special Care Units

Families, Alzheimer's Disease, and Nursing Homes

1988 ◽  
Vol 7 (3) ◽  
pp. 331-349 ◽  
Author(s):  
Nathan L. Linsk ◽  
Baila Miller ◽  
Roberta Pflaum ◽  
Anna Ortigara-Vicik
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Nursing Homes ◽  
Care Center ◽  
Family Members ◽  
Nursing Home Care ◽  
Demonstration Program ◽  
Home Setting

The Alzheimer's Disease Family Care Center program was established within an intermediate care teaching nursing home as a demonstration program to investigate ways to involve families in care of their relatives. In total, 45 family members participated in a program including an orientation session; a preliminary family involvement interview; contracts with family members, in which they chose specific tasks to engage in during visits; a five-session course on Alzheimer's disease and how families may be partners in care within the facility; and an ongoing family support group. Evaluation data sources include a baseline and 9-month follow-up questionnaire completed by families, preliminary and follow-up family interviews conducted by project codirectors, records of family visits, and family choices on contracts. Findings from the 23 family members who contracted for tasks during their visits and from the follow-up questionnaire completed by 25 family members showed that most sought social and emotional interactions with relatives, some maintained direct personal care activities, and only a few identified interest in extensive involvement with staff and facility. At follow-up, family members involved in the program reported they continued to feel close to their relatives. Many felt that their relatives were generally stable or improved with regard to cognitive function, but over a third noted difficulties in communicating. Participating family members reported that the program of staff supports helped them to feel more integral to the unit. They expressed a need for more education and support for their involvement in the nursing home setting. Project findings confirm previous studies recommending that programming at nursing homes needs to include specific institutional and staff supports to maintain and enhance family contributions to the long-term nursing home care of their relatives.

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