Identifying potential long-stay residents in veterans health administration nursing homes.
Whitney L Mills, Jun Ying, Mark E Kunik
PMID 30054095WHAT IT FOUND
Among VHA nursing home residents, greater ADL and cognitive impairment, dementia, schizophrenia, depression, renal failure, cancer, financial power of attorney, and living alone, in another facility, or assisted living before admission were linked to longer stays.
Key findings
01In the analyzed cohort, 27,230 residents (77.6%) were short-stay, 5,574 (15.9%) were moderate-stay, and 2,309 (6.6%) were long-stay.
02Veterans were more likely to be in the moderate- or long-stay group if they were Black, Hispanic, or other race, had a financial power of attorney, had renal failure, Alzheimer's disease or dementia, schizophrenia, or depression, had lived alone or in another facility before admission, or had greater ADL impairments.
03Residents were more likely to be long-stay if they were older, had a financial power of attorney, had greater cognitive impairment, had cancer, Alzheimer's disease or dementia, or schizophrenia, had lived in assisted living before admission, or had higher ADL impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was an observational analysis of MDS administrative records, so it identifies associations rather than causes. The authors excluded residents who died within one year, so the results do not apply to residents who die soon after admission. The MDS data did not include everyday competence, executive function, built environment details, sex offender registration, felony conviction, chronic homelessness, instability, loneliness, or local community service availability. The authors note that with a very large sample some statistically significant differences may not be clinically meaningful. The study did not test a screening tool or discharge intervention, and the factors are not sufficient to decide the most appropriate care setting.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not read these factors as proof that dementia, financial power of attorney, or living arrangements cause long stays, or as a validated tool for deciding discharge. This was an observational administrative-record analysis, and the authors say the factors are not sufficient to determine a more appropriate care environment.