Selection for Long-Term Hospital Care

Ramsay, Fiona; Horsfall, Ruth; Rudd, Alison Bealle

doi:10.1093/ageing/16.5.301

Age Ageing

1987

DOI: 10.1093/ageing/16.5.301

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Selection for Long-Term Hospital Care

Fiona Ramsay

Ruth Horsfall²,

Alison Bealle Rudd

Abstract: A formalized system for selecting patients requiring long-term hospital accommodation is described and our first two years' experience presented. Fifty patients were considered by the panel of whom 25 were designated as being suitable to be transferred to a long-term bed. Alternative solutions were considered more appropriate for the remaining 25; only 0.95% of all admissions to the unit finally required long-term hospital care.

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Cited by 4 publications

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“…Studies have pointed out differences betweenlong-term care patients in nursing homes and those cared for in home settings. Nursing home patients have been described as having poorer ADL functions (Andersson, 1989;Wachtel et al, 1987), more diseases causing hemiparesis (Ramsay et al, 1987). and poorer cognitive function (Kiveli, 1985) thanthosecmd for at home.…”

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confidence: 99%

Physical Health and Cognitive Ability Among Married Long-Term-Care Patients and Among Their Spouses—A Comparison Between Home Care and Nursing Home Care

Löfgren

Bucht

Eriksson

et al. 1993

Int. Psychogeriatr.

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The purpose of this study was to establish whether physical health and cognitive function in married long-term patients or in their spouses determines why some patients are cared for in home care while others reside in nursing homes. Out of 38 married couples with a sick spouse cared for in a nursing home, 23 couples were studied; out of 34 couples with a sick spouse cared for in home care, 22 patients and 25 spouses were studied. The results showed no significant differences in physical health score either between the two groups of patients, or between the two groups of spouses. Both home-care patients and nursing home patients had low cognitive function scores, but nursing home patients had significantly lower scores. A multivariate analysis showed that physical health and cognitive function explained only 20% of patients' residence. Between the two groups of spouses there was no difference in cognitive function score. The conclusion is that physical health status and cognitive function explain only to a small extent why married long-term care patients are cared for in nursing homes or in home care.

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confidence: 99%

Physical Health and Cognitive Ability Among Married Long-Term-Care Patients and Among Their Spouses—A Comparison Between Home Care and Nursing Home Care

Löfgren

Bucht

Eriksson

et al. 1993

Int. Psychogeriatr.

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Assessing the residential care needs of nursing home applicants

Quartararo

O’Neill

Tang

et al. 1991

Australian Journal of Public Health

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In a study of nursing home applicants, residential care decisions made by a multidisciplinary assessment team were examined. The team agreed that of the 296 applicants assessed, 54 per cent required the high level of physical and supportive care provided in a nursing home. Hostel care was recommended for 17 per cent, continuing care at home for 17 per cent, hospice care for 1 subject, and in 13 per cent of cases the team postponed their decision. A decision for nursing home care was associated with low Barthel Index of Activities of Daily Living scores, dementia, incontinence and the absence of a carer willing to continue care. A decision to delay was associated, in most cases, with a requirement for further in-patient assessment and/or rehabilitation, and therefore with a potential for functional improvement. A decision for hostel care instead of home care was associated with a low level of informal support and the absence of a carer who was a spouse or daughter. The findings suggest that a program of geriatric assessment will accurately identify the differing care needs of nursing home applicants. The initial value of such an assessment program may be to contribute to the planning of residential and other long-term care services rather than to reduce inappropriate nursing home admissions. (Awt J Public Health 1991; 15: 222-7) benefit of geriatric assessment programs is a reduction in the number of nursing home A admissions required by dependent elderly people. The evidence for this has been summarised in a review of available studies and includes a number of randomised controlled trials of in-patient geriatric assessment units.' The issue of whether or not assessment programs should be specifically targeted at nursing home applicants to prevent inappropriate nursing home admissions is less clear. Descriptive studies involving assessment of nursing home applicants do suggest that in the absence of adequate assessment, treatment and/or rehabilitation, elderly people are being admitted to nursing homes when they could be cared for in less supportive settings.2-6 A similar situation has been reported in the United Kingdom for long-term hospital care.' One British study, however, found only a 7 per cent discrepancy between the application for residential care and the assessed need for residential care and suggested that this was the real case as the sample included all applicants in the area.' Also, apart from descriptive

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Long term care for elderly people.

Ebrahim

Wallis²,

Brittis³

et al. 1993

Quality and Safety in Health Care

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Selection for Long-Term Hospital Care

Cited by 4 publications

References 0 publications

Physical Health and Cognitive Ability Among Married Long-Term-Care Patients and Among Their Spouses—A Comparison Between Home Care and Nursing Home Care

Physical Health and Cognitive Ability Among Married Long-Term-Care Patients and Among Their Spouses—A Comparison Between Home Care and Nursing Home Care

Assessing the residential care needs of nursing home applicants

Long term care for elderly people.

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