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Profiling the multidimensional needs of new nursing home residents: evidence to support planning.
J Am Med Dir Assoc. 2012 Jun; 13(5):487.e9-17.JA

Abstract

INTRODUCTION

Nursing home (NH) residents have various needs that affect the care they require. This article describes the diverse needs that new NH residents have, emphasizing the proportion of people with milder needs in multiple areas.

METHODS

Research was conducted on all older adults newly admitted to not-for-profit NHs in the Winnipeg Health Region, between April 1, 2005, and March 31, 2007, provided that they were assessed using the Resident Assessment Instrument Minimum Data Set (RAI/MDS 2.0) within 30 days of admission (n = 1061). Using the Activities of Daily Living (ADL) Hierarchy scale, residents were first defined as low, intermediate, or high ADL dependent. Residents' needs were also defined using the RAI/MDS 2.0 cognitive performance (CPS) and pain scales, by their degree of behavioral problems and visual challenges, and by their frequency of bladder and bowel incontinence. Cluster analysis was used to create subgroups of residents by their severity of clinical challenges.

RESULTS

Of our cohort, 26.8% were low ADL dependent. Although some of these residents had moderate to severe needs in another area, many (46.8% of low ADL-dependent residents; 12.5% of our entire cohort) had milder needs across all clinical domains. Conversely, about one-third of our cohort was high ADL dependent; 31.7% of these residents had moderate to severe challenges in one clinical domain, and 35.5% had moderate to severe comorbid challenges.

CONCLUSIONS

Overall, 12.5% of our cohort had lower needs, demonstrating the capacity for community-based programs to offset NH demands. Also, the diversity of residents' needs highlights the importance of having both the appropriate resources and strategies available to provide quality NH care. Future research is discussed for both low- and higher-need NH residents.

Authors+Show Affiliations

Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. Malcolm_Doupe@cpe.umanitoba.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22483678

Citation

Doupe, Malcolm, et al. "Profiling the Multidimensional Needs of New Nursing Home Residents: Evidence to Support Planning." Journal of the American Medical Directors Association, vol. 13, no. 5, 2012, pp. 487.e9-17.
Doupe M, St John P, Chateau D, et al. Profiling the multidimensional needs of new nursing home residents: evidence to support planning. J Am Med Dir Assoc. 2012;13(5):487.e9-17.
Doupe, M., St John, P., Chateau, D., Strang, D., Smele, S., Bozat-Emre, S., Fransoo, R., & Dik, N. (2012). Profiling the multidimensional needs of new nursing home residents: evidence to support planning. Journal of the American Medical Directors Association, 13(5), e9-17. https://doi.org/10.1016/j.jamda.2012.02.005
Doupe M, et al. Profiling the Multidimensional Needs of New Nursing Home Residents: Evidence to Support Planning. J Am Med Dir Assoc. 2012;13(5):487.e9-17. PubMed PMID: 22483678.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Profiling the multidimensional needs of new nursing home residents: evidence to support planning. AU - Doupe,Malcolm, AU - St John,Phillip, AU - Chateau,Dan, AU - Strang,David, AU - Smele,Sandra, AU - Bozat-Emre,Songul, AU - Fransoo,Randy, AU - Dik,Natalia, Y1 - 2012/04/05/ PY - 2011/11/17/received PY - 2012/01/13/revised PY - 2012/02/17/accepted PY - 2012/4/10/entrez PY - 2012/4/10/pubmed PY - 2012/10/24/medline SP - 487.e9 EP - 17 JF - Journal of the American Medical Directors Association JO - J Am Med Dir Assoc VL - 13 IS - 5 N2 - INTRODUCTION: Nursing home (NH) residents have various needs that affect the care they require. This article describes the diverse needs that new NH residents have, emphasizing the proportion of people with milder needs in multiple areas. METHODS: Research was conducted on all older adults newly admitted to not-for-profit NHs in the Winnipeg Health Region, between April 1, 2005, and March 31, 2007, provided that they were assessed using the Resident Assessment Instrument Minimum Data Set (RAI/MDS 2.0) within 30 days of admission (n = 1061). Using the Activities of Daily Living (ADL) Hierarchy scale, residents were first defined as low, intermediate, or high ADL dependent. Residents' needs were also defined using the RAI/MDS 2.0 cognitive performance (CPS) and pain scales, by their degree of behavioral problems and visual challenges, and by their frequency of bladder and bowel incontinence. Cluster analysis was used to create subgroups of residents by their severity of clinical challenges. RESULTS: Of our cohort, 26.8% were low ADL dependent. Although some of these residents had moderate to severe needs in another area, many (46.8% of low ADL-dependent residents; 12.5% of our entire cohort) had milder needs across all clinical domains. Conversely, about one-third of our cohort was high ADL dependent; 31.7% of these residents had moderate to severe challenges in one clinical domain, and 35.5% had moderate to severe comorbid challenges. CONCLUSIONS: Overall, 12.5% of our cohort had lower needs, demonstrating the capacity for community-based programs to offset NH demands. Also, the diversity of residents' needs highlights the importance of having both the appropriate resources and strategies available to provide quality NH care. Future research is discussed for both low- and higher-need NH residents. SN - 1538-9375 UR - https://www.unboundmedicine.com/medline/citation/22483678/Profiling_the_multidimensional_needs_of_new_nursing_home_residents:_evidence_to_support_planning_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1525-8610(12)00080-1 DB - PRIME DP - Unbound Medicine ER -