scholarly journals Nutrition in the Nursing Home: Expectation vs Reality

2021 ◽  
Author(s):  
Anu Garg ◽  
Kate Szymanski ◽  
Ganesh Merugu
Keyword(s):  
Nursing Home ◽  
Standard Deviation ◽  
Nursing Homes ◽  
Nutritional Value ◽  
Food Composition ◽  
Community Dwelling ◽  
Added Sugar ◽  
Daily Average ◽  
Saturated Fats ◽  
Average Patient

Abstract Background: Determine the nutritional value of the food provided to the average patient in the nursing home and compare to the guidelines for the age matched community dwelling individual. Methods: We obtained weekly meal plans. Nutritional value of each meal was calculated from the USDA food composition database with reference to the supply company. The 3 nursing homes ranged in ownership and in star rating and averaged 120 beds per facility. Food companies were comparable. Results: Patients received 1.58 cups of vegetables with a standard deviation (SD) of 0.31 daily. 1.26 cups of fruit (SD of 0.08) and 0.79 cups of dairy (SD 0.26) daily. Average of 5,308mg of sodium (SD 770.4) daily. 474.08 mg of added sugar (SD 137.88) daily. Saturated fats were 10.86% (SD 0.01) of the calories. Conclusions: Intake of fruits, dairy and vegetables was below recommended levels. Calories and sodium were above recommended values. Added sugar and saturated fats were within recommendations. Several changes can be made to improve nutrition in the nursing home to bring the nutrition closer to expectations in the average community dwelling adult values. We recommend further study concerning interventions.

scholarly journals Temporal Variations in the Intensity of Care Provided to Community and Nursing Home Residents Who Died of COVID-19 in Ontario, Canada

2020 ◽  
Author(s):  
Kevin A. Brown ◽  
Nick Daneman ◽  
Sarah A. Buchan ◽  
Adrienne K. Chan ◽  
Nathan M. Stall
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Temporal Trends ◽  
Nursing Home Residents ◽  
Admission Rate ◽  
Temporal Variations ◽  
Population Based ◽  
Community Dwelling ◽  
High Concentration ◽  
June July

Introduction - Worldwide, nursing home residents have experienced disproportionately high COVID-19 mortality due to the intersection of congregate living, multimorbidity, and advanced age. Among 12 OECD countries, Canada has had the highest proportion of COVID-19 deaths in nursing home residents (78%), raising concerns about a skewed pandemic response that averted much transmission and mortality in community-dwelling residents, but did not adequately protect those in nursing homes. To investigate this, we measured temporal variations in hospitalizations among community and nursing home-dwelling decedents with COVID-19 during the first and second waves of the pandemic.Methods - We conducted a population-based cohort study of residents of Ontario, Canada with COVID-19 who died between March 11, 2020 (first COVID-19 death in Ontario) and October 28, 2020. We examined hospitalization prior to death as a function of 4 factors: community (defined as all non-nursing home residents) vs. nursing home residence, age in years (<70, 70-79, 80-89, ≥90), gender, and month of death (1st wave: March-April [peak], May, June-July 2020 [nadir], 2nd wave: August-October 2020).Results - A total of 3,114 people with confirmed COVID-19 died in Ontario from March to October, 2020 (Table 1), of whom 1,354 (43.5%) were hospitalized prior to death (median: 9 days before death, interquartile range: 4-19). Among nursing home decedents (N=2000), 22.4% were admitted to hospital prior to death, but this varied substantially from a low of 15.5% in March-April (peak of wave 1) to a high of 41.2% in June-July (nadir of wave 1). Among community-dwelling decedents (N=1,114), admission to acute care was higher (81.4%) and remained relatively stable throughout the first and second waves. Similar temporal trends for nursing home versus community decedents were apparent in age-stratified analyses (Figure 1). Women who died were less likely to have been hospitalized compared to men in both community (80% women vs 84% men) and nursing home (21% women vs 24% men) settings.Discussion - Only a minority of Ontario nursing home residents who died of COVID-19 were hospitalized prior to death, and that there were substantial temporal variations, with hospitalizations reaching their lowest point when overall COVID-19 incidence peaked in mid-April, 2020. While many nursing home residents had pre-pandemic advance directives precluding hospitalization, the low admission rate observed in March-April 2020 (15.5%) was inconsistent with both higher admission rates in subsequent months (>30%), and comparatively stable rates among community-dwelling adults. Our findings substantiate reports suggesting that hospitalizations for nursing home residents with COVID-19 were low during the peak of the pandemic’s first wave in Canada, which may have contributed to the particularly high concentration of COVID-19 mortality in Ontario’s nursing homes.

scholarly journals INTEREST GROUP SESSION—RESEARCH IN QUALITY OF CARE: LIVING IN AND LEAVING NURSING HOMES: THE FACTORS THAT CONTRIBUTE TO QUALITY OF LIFE, HEALTH, AND SAFETY OUTCOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S359-S359
Author(s):  
Nancy Kusmaul ◽  
Mercedes Bern-Klug
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing homes house some of the most vulnerable older adults. They often have complex medical conditions and/or cognitive impairments that put them at risk for negative outcomes and poor quality of life. These outcomes can be altered through incorporating evidence-based practices aimed to improve care and residents’ life experiences. In this symposium we will explore factors that are shown to influence outcomes and quality of life for people that live in and are discharged from, long term care settings. Amy Roberts and colleagues will explore the influences of nursing home social service staff qualifications on residents’ discharge outcomes. Colleen Galambos and colleagues will present findings on advance directives and their impact on reducing potentially avoidable hospitalizations. Kelsey Simons and colleagues will discuss the potential for unmet needs for mental health services as part of nursing home care transitions, and will discuss a model of quality improvement that addresses this gap in care. Vivian Miller will present findings on the impact transportation access has on the ability of community-dwelling family members to visit and provide social support to their family member residents in long-term care. Finally, Nancy Kusmaul and Gretchen Tucker report the findings of their study comparing perceptions of nursing home residents, direct care staff, management, and families on the care practices that influence resident health and quality of life while they live in a long term care setting.

scholarly journals Black–White Disparities in Moves to Assisted Living and Nursing Homes Among Older Medicare Beneficiaries

2019 ◽  
Vol 75 (9) ◽  
pp. 1972-1982 ◽  
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie A Robert
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Assisted Living ◽  
Multinomial Logistic Regression ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Housing Tenure ◽  
Medicare Beneficiaries ◽  
Nationally Representative

Abstract Objectives Investigate black-white disparities in older adults’ moves to assisted living and nursing homes and draw from the Andersen Healthcare Utilization Model to test explanations for any disparities. Methods Data are from a nationally representative sample of older community-dwelling Medicare beneficiaries from the 2015 (N = 5,212) National Health and Aging Trends Study (NHATS). We use stepwise multinomial logistic regression to examine black-white disparities in moves out of community housing to assisted living or a nursing home over 2 years, before and after adjusting for predisposing (age, gender), enabling (income, housing tenure, Medicaid, living arrangement) and need (activities of daily living [ADL] limitation, physical capacity, self-rated health, and dementia) factors. Results Black older adults are less likely to move to assisted living and are more likely to move to a nursing home compared to white older adults. Black-white disparities in moves to nursing homes are explained by black-white differences in enabling and need factors, whereas black-white disparities in moves to assisted living remain even after adjusting for enabling and need factors. Discussion Unmeasured factors related to systemic racism (e.g., residential racial segregation, racial discrimination) and/or black-white differences in care preferences might further explain black-white disparities in moves to assisted living and warrant further investigation.

scholarly journals Needs-based provision of medical care to nursing home residents: protocol for a mixed-methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025614 ◽  
Author(s):  
Jonas Czwikla ◽  
Maike Schulz ◽  
Franziska Heinze ◽  
Thomas Kalwitzki ◽  
Daniel Gand ◽  
...  
Keyword(s):  
Nursing Home ◽  
Mixed Methods ◽  
Nursing Homes ◽  
Medical Care ◽  
Delphi Study ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Mixed Methods Study ◽  
Care Needs ◽  
Term Care

IntroductionNursing home residents typically have greater needs for medical care than community-dwelling elderly. However, restricted cognitive abilities and limited mobility may impede their access to general practitioners and medical specialists. The provision of medical care in nursing homes may therefore be inappropriate in some areas of medical care. The purpose of this mixed-methods study is to systematically assess, evaluate and explain met and unmet medical care needs in German nursing homes and to develop solutions where medical care is found to be inappropriate.Methods and analysisFirst, statutory health insurance claims data are analysed to identify differences in the utilisation of medical care between nursing home residents and community-dwelling elderly with and without need for long-term care. Second, the health status and medical care of 500 nursing home residents are assessed and evaluated to quantify met and unmet medical care needs. Third, qualitative expert interviews and case conferences and, fourth, quantitative analyses of linked data are used to provide structural, case-specific and generalisable explanations of inappropriate medical care among nursing home residents. Fifth, a modified Delphi study is employed to develop pilot projects aiming to improve medical care in nursing homes.Ethics and disseminationThis study was approved by the Ethics Committee of the University of Bremen on 23 November 2017. Research findings are disseminated through presentations at national and international conferences and publications in peer-reviewed scientific journals.Trial registration numberDRKS00012383.

scholarly journals The Effects of Housing Cost Burden and Housing Tenure on Moves to a Nursing Home Among Low- and Moderate-Income Older Adults

2020 ◽  
Vol 60 (8) ◽  
pp. 1485-1494
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie A Robert
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Affordable Housing ◽  
The United States ◽  
Community Dwelling ◽  
Housing Tenure ◽  
Housing Cost ◽  
Cost Burden ◽  
Housing Cost Burden

Abstract Background and Objectives In the United States, a growing number of older adults struggle to find affordable housing that can adapt to their changing needs. Research suggests that access to affordable housing is a significant barrier to reducing unnecessary nursing home admissions. This is the first empirical study we know of to examine whether housing cost burden (HCB) is associated with moves to nursing homes among older adults. Research Design and Methods Data include low- and moderate-income community-dwelling older adults (N = 3,403) from the nationally representative 2015 National Health and Aging Trends Study. HCB (≥30% of income spent on mortgage/rent) and housing tenure (owner/renter) are combined to create a 4-category housing typology. Multinomial logistic regression models test (a) if renters with HCB are most likely (compared with other housing types) to move to a nursing home over 3 years (2015–2018) and (b) if housing type interacts with health and functioning to predict moves to a nursing home. Results Across all models, renters with HCB had the greatest likelihood of moving to a nursing home. Moreover, self-rated health, physical capacity, and mental health were weaker predictors of nursing home moves for renters with HCB. Discussion and Implications Results suggest that older renters with HCB are most likely to experience unnecessary nursing home placement. The growing population of older renters experiencing HCB may not only signal a housing crisis, but may also challenge national efforts to shift long-term care away from nursing homes and toward community-based alternatives.

scholarly journals Well-being and functional abilities in nursing home and home living seniors in Latvia

2018 ◽  
Vol 51 ◽  
pp. 02002
Author(s):  
Aija Balode ◽  
Anda Stolarova ◽  
Anita Villerusa ◽  
Janis Vetra
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Handgrip Strength ◽  
Nursing Home Residents ◽  
Well Being ◽  
Developed Countries ◽  
Community Dwelling ◽  
Functional Abilities ◽  
Subjective Well Being ◽  
Home Living

The society in developed countries is aging. 1.5% of seniors live in nursing homes in Latvia. Aim: to compare functional abilities and well-being between nursing home and home living Latvian seniors. Methods: 280 home living seniors and 285 from nursing homes, age ≥ 65 years able to respond to questions and stand up were included in the study based on availability. They were asked to describe their well-being from very bad to very good. The functional abilities were assessed by hand grip strength, the ability to stand up without assistance, the dependence on caregivers (1 – independent, 2 – partly dependent, 3 – fully dependent), the use of walking device assistance devices. Results:The home living seniors could stand up without assistance of hands more often than nursing home residents (60.4% vs. 38.2%, p < 0.001). The handgrip strength was higher in the elderly community-dwelling women (0.3 (0.2–0.3) vs. 0.2 (0.15–0.2) Ba), p < 0.001. The nursing home residents were less often independent (62.8% vs. 83.9%, p < 0.001), more often partly dependent (30.2% vs. 14.6%, p < 0.001) and independent (7.0% vs. 1.4%, p = 0,001) while performing activities of daily living. The nursing home residents had higher walking device assistance needs (mean rank 345.7 vs. 219.2, p < 0.001) and described their well-being as “good” more often (28.4% vs. 16.8%, p = 0.001) and less often as “bad” or “very bad” (18.9% vs. 26.8%, p = 0.048). Conclusion. The subjective well-being of elderly nurse home residents is better than of home living seniors despite having less functional abilities.

Uitbraak COVID-19 in de verpleeghuiszorg

2020 ◽  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Informal Caregivers ◽  
Rapid Review ◽  
Daily Routine ◽  
Term Care ◽  
Care Facilities

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

EVALUATION OF ADEQUACY OF DAILY ENERGY CONSUMPTION AND NUTRITIONAL VALUE OF DIETS OF JUNIOR ATHLETES

2020 ◽  
Author(s):  
Элеонора Николаевна Трушина ◽  
Оксана Константиновна Мустафина ◽  
Татьяна Николаевна Солнцева ◽  
Валерий Дмитриевич Кузнецов
Keyword(s):  
Energy Consumption ◽  
Nutritional Value ◽  
Caloric Content ◽  
Added Sugar ◽  
Junior Athletes ◽  
Calorie Content ◽  
Daily Diet ◽  
Daily Energy ◽  
Total Calorie ◽  
Recommended Level

В исследовании участвовали 20 спортсменов-юниоров (мастера спорта и кандидаты в мастера спорта) в возрасте 17-18 лет и 10 добровольцев соответствующего возраста и интенсивности физической нагрузки. В результате исследований установлено, что суммарная калорийность потребленных за сутки продуктов в основном соответствовала энерготратам спортсменов обследованных групп. Соотношение белки/жиры/углеводы в суточном рационе спортсменов свидетельствует о недостаточной квоте углеводов в соответствии с формулой оптимального питания для юных спортсменов. При этом потребление добавленного сахара у спортсменов всех категорий превышало рекомендуемый уровень (10% от калорийности суточного рациона). The study involved 20 junior athletes (masters of sports and candidates for masters of sports) aged 17-18 and 10 volunteers of the corresponding age and intensity of physical activity. As a result of the research, it was found that the total calorie content of products consumed per day basically corresponded to the energy consumption of athletes in the surveyed groups. The ratio of protein / fat / carbohydrates in the daily diet of athletes indicates an insufficient carbohydrate quota in accordance with the optimal nutrition formula for young athletes. At the same time, the consumption of added sugar in athletes of all categories exceeded the recommended level (10% of the caloric content of the daily diet).

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

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