Risk factors for entry into residential care after a support-needs assessment

To establish the influence of risk factors derived from the national 'Support Needs Assessment Form' for entry into residential care in New Zealand.

Using a retrospective cohort design, data was obtained for assessments of people aged over 65 years over a 12-month interval (August 2001 to August 2002) from an administrative database developed by the Needs Assessment and Service Co-ordination Service for Wellington, New Zealand. The risk factors for entry into residential care were examined by logistic regression.

2060 assessments were carried out over this period for people were aged over 65 years; 67.9% were female. The median age was 83 years, inter-quartile range 78 to 88 years. For 33.4% of people, residential care was recommended. For those aged 80 years or older, the relative risk of residential care was 2.95 (95% CI: 2.27 to 3.82) if continence problems were present, and 3.75 (95% CI: 2.99 to 4.73) for those aged 80 years or younger if continence problems were present. For those with mobility problems who had cognitive impairment the relative risk of residential care was 2.95 (95% CI: 2.25 to 3.87), and 1.77 (95% CI: 1.35 to 2.33) if there were no mobility problems.

All of older age, continence problems, mobility problems and dementia predicted residential care after assessment. The effect of continence was more prominent for those aged under 80 years of age. The effect of dementia was more prominent for those with mobility problems. Intervention for continence problems and mobility problems has the potential to reduce the use of residential care.