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Decision making by high functional status elders regarding nursing home placement
S A Forbes1, N Hoffart, L J Redford
1University of Kansas School of Nursing, Kansas City 66160-7502, USA.
Journal of Case Management
|January 1, 1997
Summary
Many high-functioning elders enter nursing homes but could be served affordably in the community. Specific events and health needs, like 24-hour care, often precipitate nursing home entry for these individuals.
Area of Science:
- Gerontology
- Health Services Research
- Qualitative Research
Background:
- Analysis of Minimum Data Set Plus (MDS+) identified "high functional elders" entering nursing homes.
- These individuals may be candidates for lower-cost community-based services.
Purpose of the Study:
- To identify and understand the reasons why high-functioning elders enter nursing homes.
- To explore factors influencing nursing home placement for functionally independent older adults.
Main Methods:
- Qualitative study using in-depth, face-to-face, semi-structured interviews.
- Analysis of 1995 MDS+ data from urban and rural counties to identify participants.
- Qualitative content analysis of interview data.
Main Results:
- Of 33 high-functional elders identified, only 36% remained in the nursing home after 3-6 months.
- Most participants utilized extensive community services and informal support networks prior to admission.
- Specific precipitating events and health needs, particularly the need for 24-hour care, were primary reasons for nursing home entry.
- All interviewed elders showed some cognitive impairment.
Conclusions:
- Nursing facilities house individuals potentially suitable for community-based services like assisted living.
- Case managers are crucial for assessing, coordinating, and advocating for affordable services to maintain elder functional status.