Functional transitions of nursing home residents with middle-stage dementia

Nurses and family members are key players responding to changes in the functional abilities of nursing home residents. This study compares families' and nurses' attributions and actions in the period immediately following the functional transitions of nursing home residents with middle-stage dementia. The walking and eating abilities of 120 residents were monitored every 2 weeks for a year. Observed functional losses triggered a total of 72 interviews with family members and nurses. Data were analyzed using quantitative description. Although both groups were more likely to attribute eating disability to dementia and walking disability to something other than dementia, there was less agreement in attributions for individual residents. Differences in attributions for functional losses can lead to disagreements about the appropriate course of action. Nurses working with family members toward a common understanding of the cause of functional decline will help inform a coordinated therapeutic response.