Predictors of Institutionalization of Cognitively Impaired Elders: Family Help and the Timing of Placement

Abstract

Although predictors of nursing home placement have attracted a good deal of attention in gerontological research, the type and amount of family assistance offered to caregivers prior to institutionalization has not been extensively examined. This study analyzed the impact of family help on the timing of placement among cognitively impaired care recipients. Using longitudinal data from the Adult Day Care Collaborative Study, an event-history analysis was performed to determine the effects of family help after sociodemographic characteristics, caregiving stressors, and indicators of caregiver well-being were taken into account. Results showed that caregivers were far less likely to institutionalize their relatives when family members provided overnight help and assisted with activities of daily living care. These findings suggest that specific types of family help play an important role in delaying nursing home placement among older adults suffering from dementia.

Criterios Para La Asignación De Servicios Sociales a Personas en Situación De Dependencia

“…Características que se asocian con el uso de servicios sociales son: la dependencia funcional, especialmente a nivel básico (Gaugler, Edwards, Femia, Zarit, Stephens, Townsend, et al, 2000;Serrano y de Tena-Dávila, 2004;Soldevila y March, 2002;), el deterioro cognitivo (Gaugler, Edwards, Femia, Zarit, Stephens, Townsend, et al, 2000;Soldevila y March, 2002;Zank y Schake, 2002, etc. ) y el bajo apoyo social (Dizy, 2008;Freedman, Berkman, Rapp y Ostfelf, 1994;Martínez, Dávila y Vicente, 2003, etc.…”

Systematic review of respite care in the frail elderly

“…29, These are summarised in tabular format in Appendices 4-7, classified according to study design (26 RCT/quasiexperimental papers; 29, 14 longitudinal beforeand-after papers; [57][58][59][60][61][62][63][64][65][66][67][68][69][70] 19 longitudinal papers; [71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89] and 45 cross-sectional observational papers ). In some cases more than one paper refers to the same study and so the number of studies at each level of evidence was seven RCTs, 12 quasiexperimental studies, 13 longitudinal before-andafter studies, 13 observational longitudinal studies and 40 observational cross-sectional studies.…”

“…Tests for heterogeneity were still significant for burden but not for depression and quality of life. [77][78][79][80][81][82][83] The majority of the research (nine studies) was carried out in the USA with one study carried out in the UK, 71 one in Canada 72 and two in Australia 73,87 ( Table 7). All except two examined mixed respite provision; the remaining two examined in-home care.…”

“…74,77,[84][85][86]88 The methods and results of these studies were heterogeneous and it is difficult, therefore, to draw any firm conclusions because of the lack of definitions and the variation in study contexts. One further study 87 reported on institutionalisation but did not have data linking respite and institutionalisation.…”

“…The MADDE study [77][78][79][80][81][82][83] These papers, carried out in the USA, report on the MADDE project and explore the relationship between service use and institutionalisation in dementia care recipients. The service of most interest to the present review is ADC.…”