title: Nursing home involuntary relocation: clinical outcomes and perceptions of residents and families.
abstract: OBJECTIVE
  To examine the physical and mental health characteristics of 120 residents 3 months following their discharge from 1 transferring nursing home to 23 facilities, to compare these characteristics to their pre-transfer status, and to describe resident and family perceptions of the transfer.
  
  
  METHODS
  Secondary analysis of a longitudinal, prospective quasi-experimental intervention and a qualitative description of resident and family views.
  
  
  METHODS
  The setting was 23 nursing homes in the Philadelphia metropolitan area.
  
  
  METHODS
  Participants included 120 nursing home residents and 56 family members.
  
  
  METHODS
  Minimum Data Set (MDS) and data from the Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare Web site
  
  
  RESULTS
  There was a statistically significant increase in the number of residents who fell during the post-transfer (76.9%) compared to the pre-transfer (51.2%) period (P = .0001): 76.3% of those with a history of falling prior to transfer fell during the post-transfer period while 77.4% of those without a history of falling prior to transfer fell. Residents were 3.78 times more likely to fall if they required more than supervision while walking (95% confidence interval [CI] 1.57-9.06) and 2.65 times more likely if they required more than supervision while transferring (95% CI 1.09-6.44). Logistic regression demonstrated that the mobility was also associated with falls (odds ratio 1.15, 95% CI 1.05-1.26). Residents did not demonstrate any other significant physical or mental health changes during the 3 months following the involuntary transfer when compared with their pre-transfer status. Residents and family members clearly voiced their dismay over the process of involuntary relocation.
  
  
  CONCLUSIONS
  Relocation is a stressful event; however, a move to a higher quality care environment does not result in any significant physical or mental health changes. The high incidence of falls post-transfer in both those with and without a fall history points to the need for extra fall precautions in newly admitted residents. In particular, frequent reorientation reminders for the cognitively intact and a high level of staff surveillance for all new residents is indicated during the first few weeks of admission.
authors.affiliation: John A. Hartford Foundation Institute for Geriatric Nursing, New York University College of Nursing, New York, NY 10003-6677, USA. ec65@nyu.edu <ec65@nyu.edu>
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Capezuti
authors.forename: Marie
authors.initials: M
authors.lastname: Boltz
authors.forename: Susan
authors.initials: S
authors.lastname: Renz
authors.forename: David
authors.initials: D
authors.lastname: Hoffman
authors.forename: Robert G
authors.initials: RG
authors.lastname: Norman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D010360:Patient Transfer; D010361:Patients; D015143:Philadelphia; D011446:Prospective Studies; D013315:Stress, Psychological