scholarly journals Variations in Rates of Discharges to Nursing Homes after Acute Hospitalization for Stroke and the Influence of Service Heterogeneity: An Anglia Stroke Clinical Network Evaluation Study

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 390
Author(s):  
Michelle Tørnes ◽  
David McLernon ◽  
Max O Bachmann ◽  
Stanley D Musgrave ◽  
Diana J Day ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Evaluation Study ◽  
Nursing Home Placement ◽  
Hospital Size ◽  
Clinical Network ◽  
Acute Hospitals ◽  
Home Placement ◽  
Hospital Characteristics

Nursing home placement after stroke indicates a poor outcome but numbers placed vary between hospitals. The aim of this study is to determine whether between-hospital variations in new nursing home placements post-stroke are reliant solely on case-mix differences or whether service heterogeneity plays a role. A prospective, multi-center cohort study of acute stroke patients admitted to eight National Health Service acute hospitals within the Anglia Stroke and Heart Clinical Network between 2009 and 2011 was conducted. We modeled the association between hospitals (as a fixed-effect) and rates of new discharges to nursing homes using multiple logistic regression, adjusting for important patient risk factors. Descriptive and graphical data analyses were undertaken to explore the role of hospital characteristics. Of 1335 stroke admissions, 135 (10%) were discharged to a nursing home but rates varied considerably from 6% to 19% between hospitals. The hospital with the highest adjusted odds ratio of nursing home discharges (OR 4.26; 95% CI 1.69 to 10.73), was the only hospital that did not provide rehabilitation beds in the stroke unit. Increasing hospital size appeared to be related to an increased odds of nursing home placement, although attenuated by the number of hospital stroke admissions. Our results highlight the potential influence of hospital characteristics on this important outcome, independently of patient-level factors.

scholarly journals Early- versus Late-Onset Alzheimer Disease: Long-Term Functional Outcomes, Nursing Home Placement, and Risk Factors for Rate of Progression

2017 ◽  
Vol 7 (1) ◽  
pp. 172-187 ◽  
Author(s):  
Carina Wattmo ◽  
Åsa K. Wallin
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Nursing Homes ◽  
Alzheimer Disease ◽  
Late Onset ◽  
Age At Onset ◽  
Clinical Importance ◽  
Nursing Home Placement ◽  
Antidepressant Use ◽  
Home Placement

Background/Aims: Whether age at onset influences functional deterioration in Alzheimer disease (AD) is unclear. We, therefore, investigated risk factors for progression in activities of daily living (ADL) and nursing home placement (NHP) in cholinesterase inhibitor (ChEI)-treated patients with early-onset AD (EOAD) versus late-onset AD (LOAD). Methods: This 3-year, prospective, observational, multicenter study included 1,017 participants with mild-to-moderate AD; 143 had EOAD (onset <65 years) and 874 LOAD (onset ≥65 years). Possible sociodemographic and clinical factors that could affect functional outcome and NHP were analyzed using mixed-effects models and logistic regression, respectively. Results: Younger individuals exhibited longer illness duration before AD diagnosis, whereas 6-month functional response to ChEI therapy, 3-year changes in ADL capacities, time from diagnosis to NHP, and survival time in nursing homes were similar between the groups. In LOAD, a higher ChEI dose, no antidepressant use, and lower education level were protective factors for slower instrumental ADL (IADL) decline. In EOAD, antihypertensives/cardiac therapy implied faster IADL progression but lower risk of NHP. Conclusion: This study highlights the clinical importance of an earlier diagnosis and treatment initiation and the need for functional evaluations in EOAD. Despite the age differences between EOAD and LOAD, a similar need for nursing homes was observed.

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 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
Sign in / Sign up

Export Citation Format

Share Document