Shall I Stay or Shall I Go? The Choice to Remain in the Nursing Home Among Residents With High Potential for Discharge

Kathleen Abrahamson, Zachary Hass, Gregory Arling

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Minnesota’s Return to Community Initiative (RTCI) assists private-pay nursing home (NH) residents to return to the community. Using data from a 1-year admission cohort of RTCI-targeted NH residents, we examined why residents who at admission expressed a desire for discharge, were paying privately, and had relatively low-care needs chose to remain in the NH. Characteristics of those who remained were compared with those who discharged using logistic regression, and barriers to discharge were summarized. Residents who were older, more cognitively impaired (OR = 1.8), unmarried (OR = 1.4), had behavior problems (OR = 1.6), or diagnosed with dementia (OR = 2.0) were more likely to remain than discharge to the community. Between admission and their 90-day assessment, residents remaining in the facility had a small decline in cognitive status, yet their continence improved and they became more independent in activities of daily living (ADLs). Seventy-four percent reported a perception of health-related barriers to discharge.

Original languageEnglish (US)
JournalJournal of Applied Gerontology
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Fingerprint

Nursing Homes
Activities of Daily Living
Dementia
Logistic Models
Health

Keywords

  • community
  • decision making
  • institutional care
  • long-term services & supports

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology

Cite this

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abstract = "Minnesota’s Return to Community Initiative (RTCI) assists private-pay nursing home (NH) residents to return to the community. Using data from a 1-year admission cohort of RTCI-targeted NH residents, we examined why residents who at admission expressed a desire for discharge, were paying privately, and had relatively low-care needs chose to remain in the NH. Characteristics of those who remained were compared with those who discharged using logistic regression, and barriers to discharge were summarized. Residents who were older, more cognitively impaired (OR = 1.8), unmarried (OR = 1.4), had behavior problems (OR = 1.6), or diagnosed with dementia (OR = 2.0) were more likely to remain than discharge to the community. Between admission and their 90-day assessment, residents remaining in the facility had a small decline in cognitive status, yet their continence improved and they became more independent in activities of daily living (ADLs). Seventy-four percent reported a perception of health-related barriers to discharge.",
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