Predictors of nursing home admission for persons with dementia.
OBJECTIVE
The objective of this systematic review was to identify factors that consistently predict nursing home admission (NHA) in persons with dementia.


METHODS
Studies published in English were retrieved by searching the MEDLINE (1966-2006), PSYCINFO (1950-2006), CINAHL (1982-2006), and Digital Dissertations (1950-2006) databases. Bibliographies of retrieved studies were also searched. Information on study characteristics and empirical results were extracted using a standardized protocol.


RESULTS
Of 782 relevant studies identified 80 were selected for review based upon eligibility criteria. The most consistent predictors of NHA in persons with dementia included severity of cognitive impairment, Alzheimer disease diagnosis, basic activity of daily living dependencies, behavioral symptoms, and depression. Caregivers who indicated greater emotional stress, a desire to institutionalize the care recipient, and feelings of being "trapped" in care responsibilities were more likely to admit persons with dementia to nursing homes. Demographic variables, incontinence, and service use did not consistently predict NHA.


CONCLUSIONS
Several results seemed to challenge conventional assumptions of what precipitates NHA among persons with dementia. Caregiver stressors in conjunction with care recipient characteristics are important to consider when assessing NHA risk. The findings emphasize the need to construct more complex models of institutionalization when designing risk measures to target interventions.
Gaugler
Joseph E
JE
Center on Aging, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA. gaug0015@umn.edu
Yu
Fang
F
Krichbaum
Kathleen
K
Wyman
Jean F
JF
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D017028:Caregivers / Q000706:statistics & numerical data; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000706:statistics & numerical data; D014481:United States