Nursing Home Dementia Research

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ORIGINAL ARTICLE Predictors of Nursing Home Admission for Persons with Dementia Joseph E. Gaugler, PhD,*† Fang Yu, PhD, AP, RN, GNP-BC, RN,‡ Kathleen Krichbaum, PhD, RN,§ and Jean F. Wyman, PhD, AP, RN, GNP-BC, FAAN¶ Objective: The objective of this systematic review was to identify factors that consistently predict nursing home admission (NHA) in persons with dementia. Methods: Studies published in English were retrieved by searching the MEDLINE (1966 –2006), PSYCINFO (1950 –2006), CINAHL (1982–2006), and Digital Dissertations (1950 –2006) databases. Bibliographies of retrieved studies were also searched. Information on study characteristics and empirical results were extracted using a standardized protocol. Results: Of 782 relevant…show more content…
The objective of this systematic review is to identify factors that consistently predict NHA in persons with dementia. Providing a synthesis of factors that trigger institutionalization in persons with dementia is important for several reasons. Institutionalization is considered a key clinical marker of dementia progression.6 As with other clinical markers of progression, identifying factors that are consistent in their prediction of NHA may lead to enhanced prognostic tool development. Such information may also inform the targeting of clinical interventions (pharmacological or nonpharmacological) that allow persons with dementia to preserve their ability to live at home. Improvements in screening and intervention could help to delay the costly NH transition, as 62% of all NH costs in the United States are publicly financed.7 Recent systematic reviews found that the presence of dementia and cognitive impairment precipitated institutionalization in older adults.4,5 The studies included in these reviews were not stratified by disease type and caregiving stressors were not considered. In contrast,…show more content…
no drug (n 2)† Caregiver sociodemographics Caregiver is spouse (n 11) High quality (n 4) Caregiver is wife (n 2) High quality (n 2) Caregiver is husband (n 2) High quality (n 2) Caregiver is adult child (n 3)† Caregiver is related to patient (n 2) High quality (n 2) Caregiver age (n 11) High quality (n 6) Caregiver education (n 9) High quality (n 4) Caregiver is female (n 8) High quality (n 4) Caregiver income (n 5) High quality (n 2) Duration of caregiving (n 5) High quality (n 3) Caregiver is employed (n 2)b Caregiving Stressors Caregiver stress (n 16) High quality (n 5) Caregiver desire to institutionalize (n 6) High quality (n 2) Role overload (n 4) High quality (n 2) Role captivity (n 4) High quality (n 2) Caregiver unmet need (n 3)† Caregiving hours (n 3) High quality (n 2) Caregiver economic strain (n 2)† Caregiver reaction to behavioral symptoms of dementia (n 2)† Caregiver Well-being Caregiver psychological distress (n 15) High quality (n 6) Caregiver health (n 12) High quality (n 6) Caregiving Psychosocial Resources Social support (n 11) High quality (n 4) Negative* Positive* Nonsignificant 50.0% 50.0% 50.0% 33.3% 0.0% 50.0% 16.7% 50.0%

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