-
Journal of the American Geriatrics... Oct 2018
Topics: Aged; Homes for the Aged; Humans; Long-Term Care; Nursing Homes; Skilled Nursing Facilities
PubMed: 30286251
DOI: 10.1111/jgs.15546 -
Journal of the American Geriatrics... Sep 2022
Topics: Humans; Leadership; Nursing Homes; Nursing Staff; Skilled Nursing Facilities
PubMed: 35770904
DOI: 10.1111/jgs.17938 -
Soins; La Revue de Reference Infirmiere Oct 2018The internal/external audit method in a nursing home is a lever for improving quality which varies greatly depending on the homes' management and contexts. It remains a...
The internal/external audit method in a nursing home is a lever for improving quality which varies greatly depending on the homes' management and contexts. It remains a useful quality management tool but does not necessarily respond to the specific nature of these facilities. The guidelines and populations are evolving towards the medicalisation of nursing homes and a risk prevention policy similar to that found in hospitals.
Topics: Aged; Aged, 80 and over; Homes for the Aged; Humans; Nursing Audit; Nursing Homes
PubMed: 30366704
DOI: 10.1016/j.soin.2018.07.013 -
Journal of the American Medical... Apr 2023To examine the nursing home to nursing home transfer rates before and during the early COVID-19 pandemic and to identify risk factors associated with those transfers in...
OBJECTIVES
To examine the nursing home to nursing home transfer rates before and during the early COVID-19 pandemic and to identify risk factors associated with those transfers in a state with a policy to create COVID-19-care nursing homes.
DESIGN
Cross-sectional cohorts of nursing home residents in prepandemic (2019) and COVID-19 (2020) periods.
SETTING AND PARTICIPANTS
Michigan long-term nursing home residents were identified from the Minimum Data Set.
METHODS
Each year, we identified transfer events as a resident's first nursing home to nursing home transfer between March and December. We included residents' characteristics, health status, and nursing home characteristics to identify risk factors for transfer. Logistic regression models were conducted to determine risk factors for each period and changes in transfer rates between the 2 periods.
RESULTS
Compared to the prepandemic period, the COVID-19 period had a higher transfer rate per 100 (7.7 vs 5.3, P < .05). Age ≥80 years, female sex, and Medicaid enrollment were associated with a lower likelihood of transfer for both periods. During the COVID-19 period, residents who were Black, with severe cognitive impairment, or had COVID-19 infection were associated with a higher risk of transfer [adjusted odds ratio (AOR) (95% CI): 1.46 (1.01-2.11), 1.88 (1.11-3.16), and 4.70 (3.30-6.68), respectively]. After adjusting for resident characteristics, health status, and nursing home characteristics, residents had 46% higher odds [AOR (95% CI): 1.46 (1.14-1.88)] of being transferred to another nursing home during the COVID-19 period compared to the prepandemic period.
CONCLUSIONS AND IMPLICATIONS
In the early COVID-19 pandemic, Michigan designated 38 nursing homes to care for residents with COVID-19. We found a higher transfer rate during the pandemic than during the prepandemic period, especially among Black residents, residents with COVID-19 infection, or residents with severe cognitive impairment. Further investigation is warranted to understand the transfer practice better and if any policies would mitigate the transfer risk for these subgroups.
Topics: United States; Humans; Female; Aged, 80 and over; Pandemics; Cross-Sectional Studies; COVID-19; Nursing Homes; Skilled Nursing Facilities
PubMed: 36878263
DOI: 10.1016/j.jamda.2023.01.028 -
BMC Health Services Research Nov 2020Knowledge about the relationship between the residents' Quality of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the...
BACKGROUND
Knowledge about the relationship between the residents' Quality of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes.
METHODS
The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple linear regression analyses were conducted to examine the research question.
RESULTS
The multiple linear regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P < 0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes.
CONCLUSION
Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents' QOL.
Topics: Attitude to Health; Belgium; Cross-Sectional Studies; Female; Humans; Linear Models; Male; Nursing Homes; Quality of Health Care; Quality of Life; Surveys and Questionnaires
PubMed: 33161901
DOI: 10.1186/s12913-020-05833-y -
Health Affairs (Project Hope) Apr 2014Close to two-thirds of all US nursing home residents have some type of cognitive impairment such as Alzheimer's disease, and the quality of care and quality of life of... (Review)
Review
Close to two-thirds of all US nursing home residents have some type of cognitive impairment such as Alzheimer's disease, and the quality of care and quality of life of these people has long been called into question. In this overview we first clarify the ongoing importance of nursing home care for people with Alzheimer's, even as policy makers "rebalance" long-term supports and services with home and community-based programs. We next identify the components of optimal care for people with Alzheimer's in nursing homes, and we highlight care innovations already in use. Finally, we summarize policy-relevant challenges to implementing best practices and innovations and explore potential policy solutions. Federal and state policy makers have a critical role to play in ensuring that nursing home residents with Alzheimer's disease have access to the appropriate, high-quality care that they and their families expect.
Topics: Aged; Alzheimer Disease; Health Policy; Humans; Nursing Homes; Organizational Culture; Practice Guidelines as Topic; Quality of Health Care; United States
PubMed: 24711327
DOI: 10.1377/hlthaff.2013.1268 -
BMC Palliative Care Jan 2016Most Canadians die in hospital, and yet, many express a preference to die at home. Place of death is the result of the interaction among sociodemographic, illness- and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Most Canadians die in hospital, and yet, many express a preference to die at home. Place of death is the result of the interaction among sociodemographic, illness- and healthcare-related factors. Although home death is sometimes considered a potential indicator of end-of-life/palliative care quality, some determinants of place of death are more modifiable than others. The objective of this systematic review was to evaluate the determinants of home and nursing home death in adult patients diagnosed with an advanced, life-limiting illness.
METHODS
A systematic literature search was performed for studies in English published from January 1, 2004 to September 24, 2013 that evaluated the determinants of home or nursing home death compared to hospital death in adult patients with an advanced, life-limiting condition. The adjusted odds ratios, relative risks, and 95% confidence intervals of each determinant were extracted from the studies. Meta-analyses were performed if appropriate. The quality of individual studies was assessed using the Newcastle-Ottawa scale and the body of evidence was assessed according to the GRADE Working Group criteria.
RESULTS
Of the 5,900 citations identified, 26 retrospective cohort studies were eligible. The risk of bias in the studies identified was considered low. Factors associated with an increased likelihood of home versus hospital death included multidisciplinary home palliative care, preference for home death, cancer as opposed to other diagnoses, early referral to palliative care, not living alone, having a caregiver, and the caregiver's coping skills.
CONCLUSIONS
Knowledge about the determinants of place of death can be used to inform care planning between healthcare providers, patients and family members regarding the feasibility of dying in the preferred location and may help explain the incongruence between preferred and actual place of death. Modifiable factors such as early referral to palliative care, presence of a multidisciplinary home palliative care team were identified, which may be amenable to interventions that improve the likelihood of a patient dying in the preferred location. Place of death may not be a very good indicator of the quality of end-of-life/palliative care since it is determined by multiple factors and is therefore dependent on individual circumstances.
Topics: Attitude to Death; Canada; Death; Health Planning; Home Care Services; Humans; Nursing Homes; Outcome Assessment, Health Care; Retrospective Studies; Terminal Care
PubMed: 26791258
DOI: 10.1186/s12904-016-0077-8 -
BMC Geriatrics Jan 2023Adjusting to nursing homes contributes to successful aging in older adults. However, the effect of stress on psychological adjustment in nursing home residents is...
PURPOSE
Adjusting to nursing homes contributes to successful aging in older adults. However, the effect of stress on psychological adjustment in nursing home residents is unclear. Therefore, this study aimed to explore the relationship between stress and psychological adjustment among nursing home residents.
METHODS
This was a cross-sectional, multicenter survey. A total of 386 residents from 11 nursing homes were included in the study. Bootstrapping with resampling strategies was used to examine multiple mediators and the moderator effect. This research conforms with the STROBE checklist.
RESULTS
Path analysis demonstrated that stress directly negatively predicted the psychological adjustment of nursing home residents. It also indirectly predicted psychological adjustment through the mediating role of learned resourcefulness and self-efficacy, as well as the chain mediating role of both. Social support played a moderating role in the path of stress to learned resourcefulness.
CONCLUSION
This study revealed the mechanism underlying the effect of stress on psychological adjustment in nursing home residents without cognitive impairment and walking difficulties. It further suggests that health providers could enhance older adults' learned resourcefulness, self-efficacy, and social support to assist them in adjusting to nursing home life.
Topics: Humans; Aged; Cross-Sectional Studies; Quality of Life; Nursing Homes; Skilled Nursing Facilities; Learning; China
PubMed: 36707794
DOI: 10.1186/s12877-023-03758-9 -
Inquiry : a Journal of Medical Care... 2019This special collection explores the organizational and environmental factors influencing nursing home performance. The papers in this special collection fall into 3...
This special collection explores the organizational and environmental factors influencing nursing home performance. The papers in this special collection fall into 3 broad themes. The first theme addresses issues related to nursing home quality measures and public reporting. The second group of papers examines how organizational resources and the environment may influence nursing home performance. The third group of papers examines the relationships among management, strategy, and performance. Findings from this special collection can inform managers and policy makers on best practices and policies that can enhance organizational performance and ultimately ensure access to long-term care.
Topics: Environment; Financial Management; Humans; Medicaid; Medicare; Nursing Homes; Organizational Objectives; Quality of Health Care; United States
PubMed: 31104573
DOI: 10.1177/0046958019850732 -
Journal of Health Economics Mar 2022The COVID-19 pandemic in the US has been particularly devastating for nursing home residents. A key question is how have some nursing homes been able to effectively...
The COVID-19 pandemic in the US has been particularly devastating for nursing home residents. A key question is how have some nursing homes been able to effectively protect their residents, while others have not? Using data on the universe of US nursing homes, we examine whether establishment quality is predictive of COVID-19 mortality. Higher-quality nursing homes, as measured by CMS overall five-star rating, have substantially lower COVID-19 mortality through September of 2020. Quality does not predict the ability to prevent any COVID-19 resident or staff cases, but higher-quality establishments prevent the spread of resident infections conditional on having one. Preventing COVID-19 cases and deaths may come at some cost, as high-quality homes have substantially higher non-COVID deaths. The positive correlation between establishment quality and non-COVID mortality is strong enough that high-quality homes also have more total deaths than their low-quality counterparts and this relationship has grown with time. As of late April 2021, five-star homes have experienced 8.4 percent more total deaths than one-star homes.
Topics: COVID-19; Humans; Nursing Homes; Pandemics; Skilled Nursing Facilities
PubMed: 35104669
DOI: 10.1016/j.jhealeco.2022.102592