JAMDA
Volume 8, Issue 6 , Pages 409-412, July 2007

Care Needs of Higher-Functioning Nursing Home Residents

  • Matthew K. McNabney, MD

      Affiliations

    • Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD
    • Corresponding Author InformationAddress correspondence to Matthew K. McNabney, MD, 5505 Hopkins Bayview Circle, Baltimore, MD 21224.
    • ,
  • Jennifer L. Wolff, PhD

      Affiliations

    • Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD
    • Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
    • ,
  • Lisa M. Semanick, BS

      Affiliations

    • Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
    • ,
  • Judith D. Kasper, PhD

      Affiliations

    • Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
    • ,
  • Chad Boult, MD, MPH, MBA

      Affiliations

    • Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD
    • Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.

Objectives

To quantify and characterize the chronic conditions of older Americans who live in nursing homes (NHs) but have minimal disability and might be able to live in less restrictive and less expensive settings.

Design

Secondary analysis of the 1999 National Nursing Home Survey.

Participants

NH staff memebers familiar with the care of residents who were 65 years or older and had resided in the NH for more than 100 days.

Measurements

We defined “higher-functioning” residents as those who received help from NH staff in 0-2 activities of daily living. We then classified these higher-functioning residents according to their conditions requiring chronic care: impaired mobility, conditions requiring rehabilitation, mental health disorders, incontinence, severe sensory impairment, and medical conditions (congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, Parkinson’s disease).

Results

One-fifth (19.8%) of the NH residents met the criteria for “higher-functioning” (n=1145). Of these, 64.1% had mental disorders, 40.4% had impaired mobility, 20.6% were incontinent, 18% had conditions requiring rehabilitative therapy, 8.7% had severe sensory impairment, and 43.0% had one or more of the four medical diagnoses.

Conclusion

Many higher-functioning long-stay nursing home residents have chronic care needs that are similar to those of older adults who live in private residences. Many such persons may be able to live in community settings.

Keywords: care needs, function, nursing home

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 Support for this study was provided by the Division of Geriatric Medicine and Gerontology of Johns Hopkins University School of Medicine and the Roger C. Lipitz Center for Integrated Health Care of the Bloomberg School of Public Health, Baltimore, MD.

 None of the authors had financial support for research, consultantships, speakers’ forums, or other holdings that might be a conflict of interest with respect to this study.

PII: S1525-8610(07)00200-9

doi:10.1016/j.jamda.2007.03.001

JAMDA
Volume 8, Issue 6 , Pages 409-412, July 2007

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