Health promotion for the nursing home patient

The current nursing home population numbers at least 1.5 million and is growing. Although care of the nursing home patient has been emphasized recently, health promotion activities for these patients appear underused. Current recommendations for health promotion are based on expert opinion, because well-controlled studies to support such activities in the elderly are lacking for most practices.

Using the key words "health promotion" and "preventive health services," cross-referenced with "aged," articles were selected from MEDLINE files from 1979 to the present. Bibliographies of these references were reviewed to select additional references.

A review of the literature shows that although health promotion activities are not appropriate for every nursing home patient, many patients live for years in the long-term care facility and can benefit from health promotion. Health promotion activities can be organized around patients' length of stay. Procedures that should be considered include breast cancer screening, Papanicolaou smears for cervical cancer, hearing and vision loss screening, fall prevention assessment, immunizations, screening for dementia and depression, drug evaluation, screening for thyroid disease, and advance directives.

Physicians who practice in nursing homes should consider health promotion for select nursing home patients.