Association of body composition with functional capacity and cognitive function in older adults living in nursing homes

2021 ◽  
Vol 14 ◽  
Author(s):  
Pinelopi Stavrinou ◽  
George Aphamis ◽  
Eleni Andreou ◽  
Marios Pantzaris ◽  
Christoforos Giannaki
Keyword(s):  
Older Adults ◽  
Body Composition ◽  
Nursing Home ◽  
Cognitive Function ◽  
Nursing Homes ◽  
Body Fat ◽  
Functional Capacity ◽  
Handgrip Strength ◽  
Nursing Home Residents ◽  
Sit To Stand

Objective: Older adults living in nursing homes have an increased risk of adverse outcomes. However, the role of body composition in vital health and quality of life parameters such as functional capacity and cognitive function is less studied in this group of older adults compared to community-dwelling counterparts. Objective: The aim of the present study was to examine the association of body composition with functional capacity and cognitive function in nursing home residents. Methods: Fifty-three older adults (82.8±7.3 years) were enrolled in this study and they underwent body composition evaluation, functional capacity and cognitive function measurements. Results: The results showed a high prevalence of obesity accompanied by functional capacity limitations and cognitive impairment in older adults living in nursing homes. Partial correlations, controlling for age, showed that body fat percentage was positively correlated with sit-to-stand-5 (r=0.310, p=0.025) and timed-up-and-go (r=0.331, p=0.017), and negatively correlated with handgrip strength test results (r=-0.431, p<0.001), whereas greater lean body mass was associated with better sit-to-stand-5 (r=-0.410, p=0.003), handgrip strength (r=0.624, p<0.001) and cognitive function performance (r=0.302, p=0.037). Conclusions: These important associations reinforce the need to develop effective healthy lifestyle interventions targeting both lean mass and body fat to combat functional and cognitive decline in nursing home residents.

scholarly journals No Other Safe Care Option: Nursing Home Admission as a Last Resort Strategy

2020 ◽  
Vol 60 (8) ◽  
pp. 1504-1514
Author(s):  
Heather J Campbell-Enns ◽  
Megan Campbell ◽  
Kendra L Rieger ◽  
Genevieve N Thompson ◽  
Malcolm B Doupe
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Community Setting ◽  
Nursing Home Admission ◽  
Care Needs ◽  
Community Based ◽  
Field Notes ◽  
Care Nursing

Abstract Background and Objectives Nursing homes are intended for older adults with the highest care needs. However, approximately 12% of all nursing home residents have similar care needs as older adults who live in the community and the reasons they are admitted to nursing homes is largely unstudied. The purpose of this study was to explore the reasons why lower-care nursing home residents are living in nursing homes. Research Design and Methods A qualitative interpretive description methodology was used to gather and analyze data describing lower-care nursing home resident and family member perspectives regarding factors influencing nursing home admission, including the facilitators and barriers to living in a community setting. Data were collected via semistructured interviews and field notes. Data were coded and sorted, and patterns were identified. This resulted in themes describing this experience. Results The main problem experienced by lower-care residents was living alone in the community. Residents and family members used many strategies to avoid safety crises in the community but experienced multiple care breakdowns in both community and health care settings. Nursing home admission was a strategy used to avoid a crisis when residents did not receive the needed support to remain in the community. Discussion and Implications To successfully remain in the community, older adults require specialized supports targeting mental health and substance use needs, as well as enhanced hospital discharge plans and improved information about community-based care options. Implications involve reforming policies and practices in both hospital and community-based care settings.

scholarly journals Comparison of the Microbiota of Older Adults Living in Nursing Homes and the Community

mSphere ◽  
2017 ◽  
Vol 2 (5) ◽  
Author(s):  
Mary-Claire Roghmann ◽  
Alison D. Lydecker ◽  
Lauren Hittle ◽  
Robert T. DeBoy ◽  
Rebecca G. Nowak ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Relative Abundance ◽  
Bacterial Communities ◽  
Nursing Home Residents ◽  
The Body ◽  
Health Care Environment ◽  
The Past

ABSTRACT The nose, throat, and skin over the subclavian and femoral veins are the body sites which harbor the bacteria which most commonly cause health care-associated infection. We assessed the effect of nursing home residence on the microbiota of these body sites in older adults. We found that the microbiota composition of the different body sites was similar between nursing home and community participants, but we identified differences in relative abundance levels. We found remarkable similarities in the bacterial communities of different body sites in older adults who lived in nursing homes compared to those in the community among people who had not been on antibiotics for the past 3 months. We also found that the femoral skin microbiota had evidence of stool contamination in the nursing home residents, providing a rationale for improved skin hygiene. Taken together, it appears that the health care environment does not alter the microbiota to the extent that antibiotics do. Our objective for this study was to characterize the microbial communities of the anterior nares (nose), posterior pharynx (throat), and skin of the femoral and subclavian areas in older adults from nursing homes and the community. Older adults (≥65 years) without antibiotic use for the past 3 months were recruited from nursing homes (NH; n = 16) and from the community (CB; n = 51). Specimens were taken from nose, throat, and skin sites for culture and bacterial profiling using 16S rRNA gene sequencing. We found that pathogenic Gram-negative rod (GNR) colonization on the femoral skin was higher in NH participants than CB participants; otherwise, there were no differences in GNR colonization at other body sites or in Staphylococcus aureus colonization at any body site. Bacterial community profiling demonstrated that the operational taxonomic unit compositions of the different body sites were similar between NH and CB participants, but the analysis identified differences in relative abundance levels. Streptococcus spp. were more abundant and Prevotella spp. were less abundant in the throats of NH participants than in throats of CB participants. Proteus, Escherichia coli, and Enterococcus were more abundant in NH participants on the femoral skin. We found a pattern of decreased abundance of specific Proteobacteria in NH participants at the anterior nares and at both skin sites. We concluded that bacterial communities were largely similar in diversity and composition within body sites between older adults without recent antibiotic use from NH compared to those from the community. Our findings support the rationale for improved hygiene in NH residents to reduce the transmission risk of antibiotic-resistant bacteria, such as Enterococcus spp. or Enterobacteriaceae. IMPORTANCE The nose, throat, and skin over the subclavian and femoral veins are the body sites which harbor the bacteria which most commonly cause health care-associated infection. We assessed the effect of nursing home residence on the microbiota of these body sites in older adults. We found that the microbiota composition of the different body sites was similar between nursing home and community participants, but we identified differences in relative abundance levels. We found remarkable similarities in the bacterial communities of different body sites in older adults who lived in nursing homes compared to those in the community among people who had not been on antibiotics for the past 3 months. We also found that the femoral skin microbiota had evidence of stool contamination in the nursing home residents, providing a rationale for improved skin hygiene. Taken together, it appears that the health care environment does not alter the microbiota to the extent that antibiotics do.

scholarly journals Nurse-Patient Interaction: A Vital Salutogenic Resource in Nursing Home Care

2021 ◽  
pp. 117-136
Author(s):  
Gørill Haugan
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Nursing Home Residents ◽  
Nursing Home Care ◽  
Patient Interaction ◽  
Health Promoting ◽  
To Come

AbstractWe are now witnessing a major change in the world’s population. Many people globally grow very old: 80, 90, and 100 years. Increased age is followed by an increased incidence of functional and chronic comorbidities and diverse disabilities, which for many leads to the need for long-term care in a nursing home. Quality of life and health promotive initiatives for older persons living in nursing homes will become ever more important in the years to come. Therefore, this chapter focuses on health promotion among older adults living in nursing homes. First, this chapter clarifies the concepts of health, salutogenesis, and pathogenesis, followed by knowledge about health promotion. Then insight and knowledge about the nursing home population is provided; what promotes health and well-being in nursing home residents?Health promotion in the health services should be based on integrated knowledge of salutogenesis and pathogenesis. The salutogenic understanding of health is holistic and considers man as a wholeness including physical, mental, social, and spiritual/existential dimensions. Research indicates that various health-promoting interventions, specifically the nurse–patient interaction, influence on older adults in nursing homes as a wholeness of body–soul–spirit, affecting the whole being. Hence, dimensions such as pain, fatigue, dyspnea, nausea, loneliness, anxiety, and depressive symptoms will be influenced through health-promoting approaches. Therefore, two separate studies on the health-promoting influences of nurse–patient interaction in nursing home residents were conducted. In total, nine hypotheses of directional influence of the nurse–patient interaction were tested, all of which finding support.Along with competence in pain and symptom management, health-promoting nurse–patient interaction based on awareness and attentional skills is essential in nursing home care. Thus, health care workers should be given the opportunity to further develop their knowledge and relational skills, in order to “refine” their way of being present together with residents in nursing homes. Health professionals’ competence involves the “being in the doing”; that is, both the doing and the way of being are essential in health and nursing care.

scholarly journals Nurse-Patient Interaction and Self-Transcendence: Assets for a Meaningful Life in Nursing Home Residents?

2019 ◽  
Author(s):  
Gørill Haugan ◽  
Britt Moene Kuven ◽  
Wenche Mjanger Eide ◽  
Siw Eriksen Tåsen ◽  
Eva Rinnan ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Meaning In Life ◽  
Nursing Home Residents ◽  
Well Being ◽  
Nursing Home Care ◽  
Patient Interaction ◽  
Self Transcendence

Abstract Background. Today, we face a shift to an older population worldwide and its consequences; a noteworthy part of older adults will need 24-hours nursing home care at the end of life. Finding new and alternative approaches to increase wellbeing among nursing home residents is highly warranted. Knowledge about nurse-patient-interaction, self-transcendence and meaning-in-life seems vital in order to guide clinical practice in how to best and efficiently boost wellbeing among older adults in nursing homes. Methods In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH patients representing 27 NHs responded to the nurse-patient interaction, self-transcendence, and the purpose-and-meaning-in-life scales. Inclusion criteria were: (1) municipality authority’s decision of long-term NH care; (2) residential time three months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations (five hypotheses) between the latent constructs were tested by means of structural equation modelling (SEM) using Stata 15.1. Results The SEM-model yielded a good fit (χ2=146.824, p=0.021, df=114, χ2 /df=1.29 RMSEA=0.040, p-close 0.811, CFI=0.97, TLI=0.96, and SRMR=0.063), showing significant relationships between the constructs of nurse-patient interaction, inter- and intra-personal self-transcendence and meaning-in-life. Nurse-patient interaction significantly relates with both inter- and intra-personal self-transcendence and meaning in NH patients. Self-transcendence revealed a fundamental influence on perceived meaning, while nurse-patient interaction demonstrated a significant influence on meaning, mediated by self-transcendence Conclusion According to the rapidly growing number of people over 65 in the world, and the growing segment of people 80-100, the present results are significant in their suggestions that nurse-patient-interaction is a crucial resource in relation to nursing home residents’ wellbeing. Knowledge of how nurse-patient-interaction, self-transcendence and meaning relate to each other among older adults in NHs is important for researchers, nurses, caregivers, nursing educators, and clinicians. Health professionals in nursing homes should learn how to competently use the nurse-patient interaction as a health promoting asset for self-transcendence, meaning and thus well-being. Nursing home nurses should be given more time for interacting with the residents, continuity and mutuality in nurse-patient relationships should be prioritized and facilitated.

scholarly journals What Factors Predict Falls in Older Adults Living in Nursing Homes: A Pilot Study

2018 ◽  
Vol 4 (1) ◽  
pp. 3
Author(s):  
Aditi Datta ◽  
Rahul Datta ◽  
Jeananne Elkins
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Cognitive Function ◽  
Significant Relationship ◽  
Gait Speed ◽  
Nursing Home Residents ◽  
Independent Variables ◽  
Environmental Causes ◽  
Mobility Device ◽  
Fear Of Falls

Background: In community-dwelling older adults, slow gait speed is linked to falls; however, little is known about the use of gait speed to predict falls in nursing home residents. The prevalence of risk factors for falls in nursing home residents is multifactorial. Objective: The purpose of this study was to examine the relationship between falls and multiple factors such as age, sex, gait speed, mobility device, fear of falling, cognitive function, medication, and environmental causes in a nursing home setting. Material and Methods: Participants were recruited from a nursing home. Independent variables such as age, sex, gait speed for 40 feet, use of a mobility device, fear of falls, cognitive function, medication, and environmental causes of falls were measured and recorded. The dependent variable was falls. Participants were followed-up for a period of six months for falls. Falls were documented from the computerized medical records at the facility. Results: Five of the 16 participants had falls in the follow-up period. Exact logistic regression, bivariate analysis, showed no significant relationship between falls and the independent variables of age, sex, gait speed, mobility device, fear of falls, cognitive function, and medication. More than 30% of recorded falls had an environmental cause, which was significant at p = 0.0005. Conclusion: Environmental causes had a significant relationship with falls in nursing home participants. Environment hazard monitoring is therefore important to ensure the safety of nursing home residents.

scholarly journals RACIAL DISPARITIES IN COMMUNITY- AND INSTITUTION-BASED LONG-TERM SERVICES AND SUPPORTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S779-S780
Author(s):  
Chanee D Fabius
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Health Outcomes ◽  
Racial Disparities ◽  
Nursing Home Residents ◽  
Home Health ◽  
Services And Supports ◽  
The Impact

Abstract Long-term services and supports (LTSS) are services provided to individuals with functional limitations and chronic conditions who need assistance to perform daily activities such as bathing, dressing, preparing meals, and administering medications, and can be provided in community settings via services such as home health, as well as institutions such as nursing homes. Racial disparities are persistent across systems of LTSS, with older adults of color receiving lower quality care and experiencing worse health outcomes than their white counterparts. Given the increasing diversity of the aging population, and the need to ensure equity in quality and health outcomes in LTSS, there is a greater need for more understanding of how experiences of care vary across multiple settings for diverse groups of older adults and the people who help them. This symposium will feature 5 presentations that provide novel insight regarding racial disparities in community- and institution-based LTSS. We focus on racial differences in functional needs and disparities among those receiving home health services and living in nursing homes. Individual presentations will describe 1) race and gender differences in physical functioning needs of older adults; 2) disparities in home health quality across racially diverse and low income geographic areas; 3) racial disparities in nursing home residents overtime; 4) racial and ethnic disparities in rates of 30-day rehospitalization from skilled nursing facilities among Medicare Fee-For-Service and Medicare Advantage patients; and 5) the impact of the unequal burden of care provided to minority nursing home residents by staff of color.

The effects of a control-enhancing intervention for nursing home residents: Cognition and locus of control as moderators

2003 ◽  
Vol 1 (2) ◽  
pp. 111-120 ◽  
Author(s):  
CAY ANDERSON-HANLEY ◽  
SARAH R. MESHBERG ◽  
MELISSA A. MARSH
Keyword(s):  
Older Adults ◽  
Life Satisfaction ◽  
Nursing Home ◽  
Cognitive Function ◽  
Locus Of Control ◽  
Cognitive Functioning ◽  
Comparison Group ◽  
Nursing Home Residents ◽  
Standard Of Care ◽  
Perceived Health

Objective: This study aimed to clarify which older adults benefit most from a control-enhancing intervention; in particular, whether cognitive functioning or locus of control might moderate the benefit derived.Methods: Nursing home residents were randomly assigned to two conditions: (1) a control-enhanced condition that provided the option of caring for a plant (n = 10), and (2) a comparison condition that monitored any change under the standard of care (n = 10). Comparison group participants were subsequently offered the intervention, which led to a total of 17 intervention participants.Results: Cognitive function and locus of control were found to significantly moderate the effects of the control-enhancing intervention on residents' perceived health competency, but not depression or life satisfaction.Significance of results: Interventions for nursing home residents could be tailored to fit specific needs. Screening for cognitive function and locus of control may help predict who is likely to benefit from control-enhancing interventions.

scholarly journals Assessing Body Composition and Dietary Intake of Nursing Home Residents (NHR): A Case for Concern

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 27-27
Author(s):  
Irena Keser ◽  
Selma Cvijetić ◽  
Martina Knezović ◽  
Jasna Jurasović ◽  
Irena Colić Barić ◽  
...  
Keyword(s):  
Body Composition ◽  
Nursing Home ◽  
Dietary Intake ◽  
Body Fat ◽  
Saturated Fatty Acids ◽  
Nursing Home Residents ◽  
Volumetric Bone Mineral Density ◽  
Mineral Density ◽  
Funding Sources ◽  
High Prevalence

Abstract Objectives Elderly are at the highest risk for COVID-19 infections. The risk is heightened among NHR for several reasons, including unhealthy body composition and poor nutrition. Previously, we showed high prevalence of osteosarcopenic adiposity (OSA; concomitant osteoporosis, sarcopenia and adiposity) in NRH. Objective of this study was to assess body composition and dietary intake of NHR in one Croatian nursing home. Methods Participants, n = 84 (81.2 ± 6.8 y), were 82.1% females. Body composition, assessed with bio-impedance, BIA-ACC (BioTekna®, Marcon, Italy), yielded fat, lean/muscle tissue and volumetric bone mineral density (BMD g/cm3). Dietary intake, estimated via 24-hour recall, was analyzed with “Nutrition” (Infosistem, d.d., Croatia). All NHR signed the informed consent. Results Both women and men were overweight with corresponding BMI of 29.6 ± 5.2 and 27.2 ± 3.2 kg/m2 (P = 0.027). Women, compared to men, had higher body fat (42.1 ± 5.9% vs. 36.6 ± 5.4%; ranking as obese), but lower skeletal muscle (11.3 ± 3.3 kg vs. 17.3 ± 3.1 kg). The respective BMD (1.006 ± 0.012 vs. 1.018 ± 0.012 g/cm3) was also low (all P ≤ 0.001) influencing high OSA prevalence (&gt;50%). There was no difference in energy and macronutrient intake between women and men. Protein (0.71 and 0.68 g/kg for women and men) and fiber (∼16 g/day) were below recommendation. Fat intake was ∼35% of energy, with high saturated fatty acids (∼14%); cholesterol was within recommendations. Most of the minerals (calcium, magnesium, potassium, iron) were below, while sodium and phosphorus were above recommendations for both women and men. About 42% women were taking vitamin supplements which increased the average intake above recommendations except for vitamin A. Men were below recommendations for all vitamins. Conclusions High body fat and low muscle and bone mass leading to high prevalence of OSA, as well as poor dietary intake placed these NHR at higher risk for COVID-19. Their diet should be planned with higher nutrient-dense food, particularly protein and multiple minerals and vitamins, possibly through intake of fresh foods/vegetables and/or supplements. Personalized diets and exercise should be implemented to prevent further weight gain and improve muscle and bones, to render them less susceptible to COVID-19 infections. Funding Sources None

scholarly journals Developing and evaluating online COVID-centric advance care planning training and information resources for nursing staff and family members in nursing homes: the necessary discussions study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrew Harding ◽  
Nancy Preston ◽  
Julie Doherty ◽  
Emily Cousins ◽  
Sandra Varey ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Advance Care Planning ◽  
Family Members ◽  
Nursing Home Residents ◽  
Online Training ◽  
Information Resources ◽  
Care Planning ◽  
Advance Care

Abstract Background Nursing home residents are typically older adults with high levels of chronic illness and impairment. As such, they are particularly susceptible to severe complications and mortality from COVID-19. Since all nursing home residents are at increased risk, nursing home care staff need to know what residents would want to happen should they become infected with COVID-19. This study aims to develop and evaluate advance care planning (ACP) COVID-centric online training and information resources for nursing home staff and family members of residents, to improve care at the end of life during a COVID-19 outbreak. Based on the findings we will develop implementation guidelines for nursing homes to ensure wider impact and application during the pandemic and beyond. Methods The content of the training and information resources will be based on a rapid review of literature and guidance on ACP in the context of COVID-19 and consultation with the study expert reference group. An integrated communications company will then work alongside the research team to design the online training and information resources. To evaluate the resources, we will employ a multiple case study design where a nursing home (defined as an institutional setting in which nursing care is provided to older adults on-site 24 h a day) will be the unit of analysis or ‘case’. The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will guide the evaluation of implementation of the training and information resources. We will recruit and interview staff and family members from between 6 and 9 nursing homes across Northern Ireland, England and Scotland and gather quantitative data from a feedback survey included in the training and information resources. Discussion The Necessary Discussions study is very timely given the challenging experiences of nursing homes, their staff, residents and their family members during the COVID-19 pandemic. It meets a key need and addresses an important gap in research and practice. The training and information resources will be ‘COVID-centric’, but they will also have a longstanding relevance for future ACP practice in UK care homes. Trial registration ISRCTN registry (ID 18003630) on 19.05.21

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.

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