Predictors of skilled nursing placement in a multilevel long-term-care facility.
OBJECTIVE
To determine if cognitive and functional data gathered before admission to residential care (i.e., board and care) placement can predict nursing home placement.


METHODS
Retrospective study using Cox proportional hazards analysis and pairwise assessment of adjusted relative risk factors to determine which independent variables predicted skilled nursing placement. Subjects were followed for an average of 23.7 months (SD = 18.6 months).


METHODS
Multilevel 1,735-bed long-term care facility, Jewish Home for the Aging, Reseda, California.


METHODS
Of the 248 consecutive residential care admissions studied, 80% were women. Subject's mean age was 84.8 years (SD = 5.0); 67% had no significant cognitive impairment.


METHODS
Categorical variables were classifications with respect to dementia status, incontinence, hearing, and ambulation. Interval variables were number of medications, Katz ADL, and five neuropsychological tests. Demographic variables were gender, age, language of origin, and education.


METHODS
Time between preadmission testing and the move up to skilled nursing placement.


RESULTS
Pairwise assessment of adjusted potential risk factors indicated that cognitive dysfunction, less than perfect Katz ADL performance, and hearing loss were the most important independent risk factors for nursing placement.


CONCLUSIONS
The findings remind us to pay careful attention to residents exhibiting even relatively mild cognitive deficits upon admission because these residents are likely to need increased environmental support.
Osterweil
D
D
Jewish Home for the Aging, Reseda, CA 91335-3798.
Martin
M
M
Syndulko
K
K
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis; D003704:Dementia / Q000175:diagnosis; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D010343:Patient Admission; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012866:Skilled Nursing Facilities; D014549:Urinary Incontinence / Q000175:diagnosis; D016138:Walking