Residents' involvement in the admission process in long-term care settings in France: results of the "EHPA 2000" survey.
In order to identify the factors influencing residents' involvement in the decision-making process prior to admission to a long-term care setting, we analyzed results of a national survey of residents of long-term care settings in France. We interviewed 3538 residents in 584 long-term care settings. Only 38.1% of residents said they had taken part in the admission process. Risk factors for non-involvement were the care level of the long-term care settings (odds ratio=OR=8.11 [5.63-11.68] and 2.73 [2.26-3.30], respectively, for long-term care units and retirements homes as compared to residential homes), lack of autonomy (dressing/washing) (OR=1.95 [1.66-2.30] versus autonomous), inability to answer questions on income (OR=2.16 [1.83-2.56]), age under 80 (OR=1.29 [1.04-1.61]) versus >90 years old patients, and being married (OR=1.60 [1.13-2.26]). Resident involvement in the decision-making process influenced subsequent feelings about institutional life. Older adults said that they were frequently not involved in the decision-making process prior to admission to a long-term care setting. This was particularly true for the high-care level long-term care settings, where organizational factors might intervene and for vulnerable elders for whom loss of autonomy could be lived as a loss of citizenship.
Somme
Dominique
D
Hôpital Européen Georges Pompidou, Service de Gériatrie, 20-40 rue Leblanc, 75908 Paris Cedex 15, France. dominique.somme@egp.aphp.fr
Thomas
Hélène
H
de Stampa
Matthieu
M
Lahjibi-Paulet
Hayat
H
Saint-Jean
Olivier
O
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D005602:France; D006707:Homes for the Aged; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes; D010343:Patient Admission; D026684:Personal Autonomy