Health status and assessed need for a cohort of older people admitted to nursing and residential homes.
OBJECTIVE
to investigate dependency and health status of a cohort of older people admitted for long term nursing or residential care and to compare these findings with assessments conducted by social services departments prior to placement.


METHODS
retrospective cohort study.


METHODS
residential, nursing and dual registered homes within Nottingham Health Authority boundaries.


METHODS
205 residents placed over 3 months.


METHODS
levels of disability, cognitive impairment and behavioural disturbance identified by assessment before and after admission.


RESULTS
cognitive impairment and physical disability were significantly higher in nursing homes, although a third of residents in residential care had substantial physical disability. In nursing homes, a quarter of residents had low dependency needs but these had greater cognitive impairment than those in residential homes with the same level of dependency. Most residents had some degree of behavioural disturbance (particularly in nursing homes) and more severe disturbance was associated with greater cognitive impairment and more depressed mood, but not physical disability. A moderate level of agreement was found between preadmission and follow-up assessments of health status.


CONCLUSIONS
a case-mix which includes higher dependency residents in residential homes and lower dependency residents in nursing homes is likely to reflect changes in the health status of residents following placement but also suggests that a range of placement criteria were used together, rather than individual indicators of need. Although pre-placement measures of disability and dependency were supported by follow-up assessments, it is essential that the needs of residents in long-term care are adequately monitored and managed, in particular those in residential care with higher dependency needs.
Section of Old Age Psychiatry, Division of Psychiatry, A-Floor, South Block, Queen's Medical Centre, Nottingham NG7 2UH, UK. ian.rothera@nottingham.ac.uk
Ian
I
Rothera
Rob
R
Jones
Rowan
R
Harwood
Anthony
A
Avery
Jonathan
J
Waite
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand; D006304:Health Status; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission; D012189:Retrospective Studies; D012947:Social Work; D006113:United Kingdom / Q000453:epidemiology