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Restorative Care's Effect on Activities of Daily Living Dependency in Long-stay Nursing Home Residents.
Gerontologist. 2015 Jun; 55 Suppl 1:S88-98.G

Abstract

PURPOSE OF THE STUDY

(a) Identify the prevalence of nursing homes providing Medicare supported restorative care programs and of long stay participants, (b) compare characteristics between restorative care participants and nonparticipants, and (c) assess restorative care's effect on change in activities of daily living (ADL) dependency.

DESIGN AND METHODS

Longitudinal analysis of Minimum Data Set assessments linked to the 2004 National Nursing Home Survey using a sample of 7,735 residents, age ≥ 65 years living in 1,097 nursing homes for at least 6 months. Receipt of any restorative care was used as a time varying predictor to estimate change in ADL dependency over 18 months using linear mixed models.

RESULTS

The sample was 75% female, 89% non-Hispanic White, with a mean age of 85±8, and average length of stay of 3.2±3.4 years. Most nursing homes had restorative care programs (67%), but less than one-third of long-stay residents participated. After controlling for resident and nursing home characteristics, the predicted mean ADL dependency score (range 0-28) at baseline was 18 for restorative care participants and 14 for nonparticipants. Over 18 months, ADL dependency increased 1 point for both participants and nonparticipants (p = .12).

IMPLICATIONS

A minority of long-stay residents participated in Medicare supported restorative care programs despite their availability and potential benefits. Even though participants had greater vulnerability for deterioration in physical, mental, and functional health than nonparticipants, both groups had similar rates of ADL decline. Future research is needed to determine if providing restorative care to less dependent long-stay residents is effective.

Links

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Authors+Show Affiliations

Talley KM
School of Nursing, University of Minnesota, Minneapolis carl0106@umn.edu.
Wyman JF
School of Nursing, University of Minnesota, Minneapolis.
Savik K
School of Nursing, University of Minnesota, Minneapolis.
Kane RL
Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis.
Mueller C
School of Nursing, University of Minnesota, Minneapolis.
Zhao H
Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis.

MeSH

Activities of Daily LivingAgedAged, 80 and overFemaleGeriatric AssessmentGeriatric NursingGeriatricsHumansLength of StayLong-Term CareLongitudinal StudiesMaleMedicareNursing HomesPrevalenceRehabilitationUnited States

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26055785

Citation

Talley, Kristine M C., et al. "Restorative Care's Effect On Activities of Daily Living Dependency in Long-stay Nursing Home Residents." The Gerontologist, vol. 55 Suppl 1, 2015, pp. S88-98.
Talley KM, Wyman JF, Savik K, et al. Restorative Care's Effect on Activities of Daily Living Dependency in Long-stay Nursing Home Residents. Gerontologist. 2015;55 Suppl 1:S88-98.
Talley, K. M., Wyman, J. F., Savik, K., Kane, R. L., Mueller, C., & Zhao, H. (2015). Restorative Care's Effect on Activities of Daily Living Dependency in Long-stay Nursing Home Residents. The Gerontologist, 55 Suppl 1, S88-98. https://doi.org/10.1093/geront/gnv011
Talley KM, et al. Restorative Care's Effect On Activities of Daily Living Dependency in Long-stay Nursing Home Residents. Gerontologist. 2015;55 Suppl 1:S88-98. PubMed PMID: 26055785.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Restorative Care's Effect on Activities of Daily Living Dependency in Long-stay Nursing Home Residents. AU - Talley,Kristine M C, AU - Wyman,Jean F, AU - Savik,Kay, AU - Kane,Robert L, AU - Mueller,Christine, AU - Zhao,Hong, PY - 2015/6/10/entrez PY - 2015/6/10/pubmed PY - 2016/7/12/medline KW - Activities of daily living KW - Function focused care KW - Long-stay nursing home residents KW - Minimum data set KW - Restorative care nursing SP - S88 EP - 98 JF - The Gerontologist JO - Gerontologist VL - 55 Suppl 1 N2 - PURPOSE OF THE STUDY: (a) Identify the prevalence of nursing homes providing Medicare supported restorative care programs and of long stay participants, (b) compare characteristics between restorative care participants and nonparticipants, and (c) assess restorative care's effect on change in activities of daily living (ADL) dependency. DESIGN AND METHODS: Longitudinal analysis of Minimum Data Set assessments linked to the 2004 National Nursing Home Survey using a sample of 7,735 residents, age ≥ 65 years living in 1,097 nursing homes for at least 6 months. Receipt of any restorative care was used as a time varying predictor to estimate change in ADL dependency over 18 months using linear mixed models. RESULTS: The sample was 75% female, 89% non-Hispanic White, with a mean age of 85±8, and average length of stay of 3.2±3.4 years. Most nursing homes had restorative care programs (67%), but less than one-third of long-stay residents participated. After controlling for resident and nursing home characteristics, the predicted mean ADL dependency score (range 0-28) at baseline was 18 for restorative care participants and 14 for nonparticipants. Over 18 months, ADL dependency increased 1 point for both participants and nonparticipants (p = .12). IMPLICATIONS: A minority of long-stay residents participated in Medicare supported restorative care programs despite their availability and potential benefits. Even though participants had greater vulnerability for deterioration in physical, mental, and functional health than nonparticipants, both groups had similar rates of ADL decline. Future research is needed to determine if providing restorative care to less dependent long-stay residents is effective. SN - 1758-5341 UR - https://www.unboundmedicine.com/medline/citation/26055785/Restorative_Care's_Effect_on_Activities_of_Daily_Living_Dependency_in_Long_stay_Nursing_Home_Residents_ DB - PRIME DP - Unbound Medicine ER -