title: Transition through the continuum of care in a continuing care retirement community: can a functional rating scale be a decision-making tool?
abstract: This retrospective descriptive study was done to determine if the Geriatric Functional Rating Scale (GFRS) can be used as an objective measure of a resident's need for a higher level of care in a continuing care retirement community (CCRC). A total of 290 of the 300 available independent living residents in a CCRC underwent assessment with the GFRS. At the end of the study period (February 2000 through December 2003), 84% of those who initially had a score of > or =40 were still living independently (alone or with a spouse), of those scoring 20 to <40, 11% were living independently, 40% required some assistance, and 20% entered a Long-Term Care Facility (LTC). Of those scoring <20 initially, none were living independently at the end of the study period. GFRS scores of > or =40 seemed to correlate with continued independence and <40 with an increasing need for assistance. The GFRS provides a functional database on each resident and may be a good objective predictor of future level of care. The sensitivity and specificity of GFRS scores <40 were 42% and 96%, respectively, for either admission to a facility or death. The positive predictive value was 87% and the negative predictive value was 72%.
authors.affiliation: Arcadia Retirement Residence, Honolulu, HI 96822, USA. Janderson@arcadia-hi.org
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Anderson
authors.forename: Linda
authors.initials: L
authors.lastname: Tom
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology* / Q000523:psychology; D040561:Assisted Living Facilities / Q000458:organization & administration*; D015331:Cohort Studies; D003266:Continuity of Patient Care; D003657:Decision Making; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D016852:Housing for the Elderly / Q000458:organization & administration*; D006801:Humans; D008297:Male; D010347:Patient Care Planning / Q000458:organization & administration; D010349:Patient Compliance; D012189:Retrospective Studies; D012648:Self Care