title: Profiling the multidimensional needs of new nursing home residents: evidence to support planning.
abstract: BACKGROUND
  Nursing home (NH) residents have various needs that affect the care they require. This article describes the diverse needs that new NH residents have, emphasizing the proportion of people with milder needs in multiple areas.
  
  
  METHODS
  Research was conducted on all older adults newly admitted to not-for-profit NHs in the Winnipeg Health Region, between April 1, 2005, and March 31, 2007, provided that they were assessed using the Resident Assessment Instrument Minimum Data Set (RAI/MDS 2.0) within 30 days of admission (n = 1061). Using the Activities of Daily Living (ADL) Hierarchy scale, residents were first defined as low, intermediate, or high ADL dependent. Residents' needs were also defined using the RAI/MDS 2.0 cognitive performance (CPS) and pain scales, by their degree of behavioral problems and visual challenges, and by their frequency of bladder and bowel incontinence. Cluster analysis was used to create subgroups of residents by their severity of clinical challenges.
  
  
  RESULTS
  Of our cohort, 26.8% were low ADL dependent. Although some of these residents had moderate to severe needs in another area, many (46.8% of low ADL-dependent residents; 12.5% of our entire cohort) had milder needs across all clinical domains. Conversely, about one-third of our cohort was high ADL dependent; 31.7% of these residents had moderate to severe challenges in one clinical domain, and 35.5% had moderate to severe comorbid challenges.
  
  
  CONCLUSIONS
  Overall, 12.5% of our cohort had lower needs, demonstrating the capacity for community-based programs to offset NH demands. Also, the diversity of residents' needs highlights the importance of having both the appropriate resources and strategies available to provide quality NH care. Future research is discussed for both low- and higher-need NH residents.
authors.affiliation: Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. Malcolm_Doupe@cpe.umanitoba.ca
authors.forename: Malcolm
authors.initials: M
authors.lastname: Doupe
authors.forename: Phillip
authors.initials: P
authors.lastname: St John
authors.forename: Dan
authors.initials: D
authors.lastname: Chateau
authors.forename: David
authors.initials: D
authors.lastname: Strang
authors.forename: Sandra
authors.initials: S
authors.lastname: Smele
authors.forename: Songul
authors.initials: S
authors.lastname: Bozat-Emre
authors.forename: Randy
authors.initials: R
authors.lastname: Fransoo
authors.forename: Natalia
authors.initials: N
authors.lastname: Dik
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D008350:Manitoba; D020380:Needs Assessment / Q000458:organization & administration*; D009735:Nursing Homes; D010347:Patient Care Planning