Age and Ageing, Vol 29, 255-260, Copyright © 2000 by British Geriatrics Society
D Challis, C Mozley, C Sutcliffe, H Bagley, L Price, A Burns, P Huxley and L Cordingley
Objective. To investigate dependency and general
health status of a cohort of older people admitted to residential or
nursing homes for long-term care.Method. We assessed
308 people aged over 65 years within 2 weeks of admission for long-term
care to one of 30 nursing or residential homes in north-west England.
Dependency was assessed using the Barthel activities of daily living index
and the Crichton Royal Behaviour Rating Scale. We collected information
from the homes' records on diagnosed conditions and current
medication.Results. 50% of the cohort were in a 'low
dependency' band (Barthel score 13-20): 31% of those in nursing homes and
71% of those in residential homes. In nursing homes, low-dependency
residents were more likely to be self-funding than those with higher
dependency. Of a number of broad diagnostic groupings, only a diagnosis of
dementia was associated with nursing- rather than residential-home
admission. Of 47 residents who scored 9 or less on the Mini-Mental State
Examination (indicating severe cognitive impairment), 85% had no diagnosis
of dementia, neurological disorder or other psychiatric
disorder.Discussion. The high proportion of new
admissions of subjects with low dependency needs raises questions about the
effective targeting of resources and about management of the boundary
between home-based and institutional care. The existence of an important
group of self-funded, low-dependency new admissions to nursing homes
suggests a need to provide better assessment and placement services for
those who are financially independent of local authorities. Many new
admissions had conditions which might benefit from rehabilitation but there
were almost no therapy staff in the studied homes. In some cases where
severe cognitive impairment was evident, there was no evidence that the
result of any formal pre-admission psychiatric evaluation had been
communicated to nursing or care staff.Keywords:
admission, dependency, nursing homes, residential homes
ARTICLES
Dependency in older people recently admitted to care homes
Personal Social Services Research Unit, Dover Street Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK; Corresponding author; Fax: (+44) 161 275 392
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