title: Restorative Care's Effect on Activities of Daily Living Dependency in Long-stay Nursing Home Residents.
abstract: OBJECTIVE
  (a) Identify the prevalence of nursing homes providing Medicare supported restorative care programs and of long stay participants, (b) compare characteristics between restorative care participants and nonparticipants, and (c) assess restorative care's effect on change in activities of daily living (ADL) dependency.
  
  
  METHODS
  Longitudinal analysis of Minimum Data Set assessments linked to the 2004 National Nursing Home Survey using a sample of 7,735 residents, age ≥ 65 years living in 1,097 nursing homes for at least 6 months. Receipt of any restorative care was used as a time varying predictor to estimate change in ADL dependency over 18 months using linear mixed models.
  
  
  RESULTS
  The sample was 75% female, 89% non-Hispanic White, with a mean age of 85±8, and average length of stay of 3.2±3.4 years. Most nursing homes had restorative care programs (67%), but less than one-third of long-stay residents participated. After controlling for resident and nursing home characteristics, the predicted mean ADL dependency score (range 0-28) at baseline was 18 for restorative care participants and 14 for nonparticipants. Over 18 months, ADL dependency increased 1 point for both participants and nonparticipants (p = .12).
  
  
  CONCLUSIONS
  A minority of long-stay residents participated in Medicare supported restorative care programs despite their availability and potential benefits. Even though participants had greater vulnerability for deterioration in physical, mental, and functional health than nonparticipants, both groups had similar rates of ADL decline. Future research is needed to determine if providing restorative care to less dependent long-stay residents is effective.
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis carl0106@umn.edu.
authors.forename: Kristine M C
authors.initials: KM
authors.lastname: Talley
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis.
authors.forename: Jean F
authors.initials: JF
authors.lastname: Wyman
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis.
authors.forename: Kay
authors.initials: K
authors.lastname: Savik
authors.affiliation: Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kane
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis.
authors.forename: Christine
authors.initials: C
authors.lastname: Mueller
authors.affiliation: Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhao
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000379:methods*; D005853:Geriatrics; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D006278:Medicare; D009735:Nursing Homes; D015995:Prevalence; D012046:Rehabilitation; D014481:United States
keywords: Activities of daily living; Function focused care; Long-stay nursing home residents; Minimum data set; Restorative care nursing