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Related Experiment Videos

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
PubMed
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.

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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:

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  • 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.