title: A model of risk reduction for older adults vulnerable to nursing home placement.
abstract: Because of the cost of nursing home care and desire of older adults to stay in their homes, it is important for health care providers to understand the factors that place older adults at risk for nursing home placement. This integrative review of 12 years of research, as published in 148 articles, explores the risk factors for nursing home placement of older adults. Using the framework of the vulnerable populations conceptual model developed by Flaskerud and Winslow (1998), we explored factors related to resource availability, relative risks, and health status. Important factors include socioeconomic status, having a caregiver, the availability and use of home- and community-based support services, race, acute illness particularly if hospitalization is required, medications, dementia, multiple chronic conditions, functional disability, and falls. Few intervention studies were identified. Development of evidence-based interventions and creation of policies to address modifiable risk factors are important next steps.
authors.forename: Janice L
authors.initials: JL
authors.lastname: Palmer
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Langan
authors.forename: Jean
authors.initials: J
authors.lastname: Krampe
authors.forename: Mary
authors.initials: M
authors.lastname: Krieger
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Lorenz
authors.forename: Joanne K
authors.initials: JK
authors.lastname: Schneider
authors.forename: Judith M
authors.initials: JM
authors.lastname: Smith
authors.forename: Helen W
authors.initials: HW
authors.lastname: Lach
mesh_terms: D000368:Aged; D017028:Caregivers; D004522:Educational Status; D005382:Financing, Personal; D006304:Health Status; D006801:Humans; D007348:Insurance, Health; D008962:Models, Theoretical; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission; D040242:Risk Reduction Behavior; D012944:Social Support; D014481:United States