[Mental impairment in nursing home residents].
BACKGROUND
Nursing homes are the corner stones in long-term institutional care for frail elderly people. Expansion and strengthening of community-based services during the last decade has enabled frail elderly who earlier would have moved into a nursing home to stay in their own home or in service apartments.


METHODS
In a cross-sectional, anonymised study, changes in nursing homes in the city of Bergen between 1985 and 1996/97 were analysed with regard to prevalence of mentally impaired residents. The following items were assessed by nurses who were in daily contact with the residents: mental capacity by means of Clinical Dementia Rating (CDR), activities of daily living (ADL), and behaviour. The study population consisted of 1,296 residents from 21 institutions in 1985 and 1,141 residents from 16 institutions i 1996/97.


RESULTS
The percentage of mentally impaired residents increased significantly, from 75 to 82, and the percentage of residents who were in need of extended nursing care rose from 87 to 91. The median duration of stay did not change significantly, but was reduced for residents with slight mental impairments (CDR 1), from 871 to 721 days.


CONCLUSIONS
Today, predominately mentally impaired and physically disabled elderly are cared for in general nursing homes. These are patients in need of continuous medical care and supervision, and do not fit into an ideology which "demedicalizes" severe medical conditions in old people. Both nursing homes and sheltered livings are needed.
Nygaard
H A
HA
Seksjon for geriatri Institutt for samfunnsmedisinske fag, Bergen. harald.nygaard@isf.uib.no
Naik
M
M
Ruths
S
S
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D005852:Geriatric Psychiatry / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008603:Mental Health; D008609:Mental Status Schedule; D009664:Norway / Q000453:epidemiology; D009730:Nursing Assessment / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000706:statistics & numerical data*; D019989:Persons with Intellectual Disabilities / Q000706:statistics & numerical data*