Risk factors for entry into residential care after a support-needs assessment.
OBJECTIVE
To establish the influence of risk factors derived from the national 'Support Needs Assessment Form' for entry into residential care in New Zealand.


METHODS
Using a retrospective cohort design, data was obtained for assessments of people aged over 65 years over a 12-month interval (August 2001 to August 2002) from an administrative database developed by the Needs Assessment and Service Co-ordination Service for Wellington, New Zealand. The risk factors for entry into residential care were examined by logistic regression.


RESULTS
2060 assessments were carried out over this period for people were aged over 65 years; 67.9% were female. The median age was 83 years, inter-quartile range 78 to 88 years. For 33.4% of people, residential care was recommended. For those aged 80 years or older, the relative risk of residential care was 2.95 (95% CI: 2.27 to 3.82) if continence problems were present, and 3.75 (95% CI: 2.99 to 4.73) for those aged 80 years or younger if continence problems were present. For those with mobility problems who had cognitive impairment the relative risk of residential care was 2.95 (95% CI: 2.25 to 3.87), and 1.77 (95% CI: 1.35 to 2.33) if there were no mobility problems.


CONCLUSIONS
All of older age, continence problems, mobility problems and dementia predicted residential care after assessment. The effect of continence was more prominent for those aged under 80 years of age. The effect of dementia was more prominent for those with mobility problems. Intervention for continence problems and mobility problems has the potential to reduce the use of residential care.
Weatherall
Mark
M
Rehabilitation Research and Teaching Unit, Department of Medicine, Wellington School of Medicine and Health Sciences, Otago University, Wellington, New Zealand. markw@wnmeds.ac.nz
Slow
Timothy
T
Wiltshire
Kimmo
K
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003704:Dementia; D005260:Female; D015577:Geriatric Assessment; D006301:Health Services Needs and Demand; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D020380:Needs Assessment; D009520:New Zealand; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014549:Urinary Incontinence