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PubMed2004

Evaluating institutionalization by comparing the use of health services before and after admission to a long-term-care facility.

Despite concern over increased health services utilization with population aging, few studies describe health services utilization by long-term-care (LTC) residents. An investigation was designed to compare health services use before and after LTC admission. Comprehensive 1988 to 1999 data for all LTC residents (N = 47,510) in Alberta, Canada, were obtained. Utilization comparisons involved equal pre/post timeframes. Only non-hospital physician services increased post-LTC admission. Home care was not provided after admission (51% had been recipients). Hospital and ambulatory services use declined, with these patterns stable for 5 years pre- and post-LTC admission. When hospital or ambulatory care was sought by LTC residents, they were not disadvantaged in the type or scope of care as compared to the care received prior to LTC admission. These findings should raise interest in the services provided by LTC facilities and the outcomes of long-term, facility-based care. LTC services could be beneficial for people with advanced age and dependency.

Aged↗
PubMed1995

The process and consequences of institutionalizing an elder.

This qualitative study was conducted to examine the decision-making process and its immediate consequences for family members who placed an elderly loved one in a long-term care facility. To explore issues related to the placement process, in-depth interviews were conducted with 7 individuals who had recently (6 weeks or less) placed an older relative. Content analyses of the interviews were conducted, and several common themes related to the decision-making process and outcomes emerged. Most of the subjects had provided personal care for their elderly relative, so placing their loved one in a nursing home often conflicted with their view of themselves as an ideal caregiver. During the process of making the decision, although family members were given advice and suggestions by health care professionals, this input was viewed as inadequate or even detrimental. Ultimately, subjects described making the decision to place an elderly relative in a long-term care facility as a singular process involving "I" rather than "we." The positive and negative role of friends emerged as an important influence during and after the placement process. The informal validation of the decision to place by peers was the one interaction that family members identified as helpful during this process.

Adult↗
PubMed1989

Healthy and institutionalized: health and related conditions among older persons with developmental disabilities.

The life expectancy of mentally retarded citizens has increased significantly in recent decades. At the same time, we have learned that this special population is nearly twice as likely as the general population to develop severe mental illness. These facts, coupled with the psychological and physiological changes that accompany aging in general, are increasingly challenging the mental health professionals of today. We provide an overview of mental retardation in the elderly, as well as the types, treatments, and attendant challenges of associated mental illness.

Aged↗
PubMed1990

Agitation and falls in institutionalized elderly persons.

The occurrence of falls and the manifestations of three dimensions of agitation (aggressive behaviors, physically nonaggressive behaviors, verbal behaviors) were recorded in 408 nursing home residents during each of the three nursing shifts. Falls occurred most frequently during the busiest shift (the day shift) and least frequently during the night shift when most residents were sleeping and nursing staff were not as busy, a result that confirms previous reports. In comparison to residents who did not fall, residents who fell manifested significantly more physically nonaggressive behaviors, more aggressive behaviors, more verbally agitated behaviors, and overall, a greater total number of agitated behaviors.

Accidental Falls↗
PubMed1992

A comparison of the impact of institutionalization on spouse and nonspouse caregivers.

We report on a study of 106 spouse and nonspouse primary caregivers of cognitively impaired older people. Half of these caregivers cared for someone in a community setting, half cared for someone in an institution (a nursing home or hospital). The study used the multidimensional Caregiver Burden Inventory (CBI) to measure the burden that these caregivers felt. A 2 x 2 multivariate analysis of variance found an effect of the interaction of relationship and living arrangement on two CBI subscales: Time Dependence Burden and Developmental Burden. Spouses showed a significantly greater difference in Time Dependence Burden scores than did nonspouses in both living arrangement groups, and nonspouses showed a significantly greater difference in Developmental Burden than did spouses in both groups. We conclude with a discussion of how programs can help different types of caregivers cope with feelings of burden.

Analysis of Variance↗
PubMedDate not supplied

Voices from the margin: the nurse aide's role in pain management of institutionalized elders.

The training and function of Certified Nurse Aides (CNAs) has traditionally focused on safe, hygienic, direct care and concrete, practical task completion. These two basic premises have directed training and job criteria and have evolved without much regard for the personal opinions, desires, and thoughts of the nurse aides themselves. However, CNA roles are expanding and changing daily, and what this expansion means in terms of patient care has ever-increasing relevance. How and what CNAs think and feel about their role and their training, and how both could be improved to meet the needs of patients and the demands of the healthcare system, are of vital interest to all those who rely upon their expertise.

Adolescent↗
PubMed1981

Institutionalization and the defects of schizophrenia.

Patients conforming to the Feighner criteria for schizophrenia who had been discharged from hospital were traced after 5-9 years. They were assessed in terms of mental state and cognitive, behavioural and neurological functioning; the results of these assessments were related to information obtained from casenotes. The findings of this study of 120 discharged patients were compared with those of an earlier study of 510 in-patients with schizophrenia. When factors of age and duration of illness were taken into account, there was no difference between the two groups in terms of positive or negative schizophrenic features or behavioural performance, although the in-patients performed less well on cognitive tests. This study indicates that the deficits of chronic schizophrenia are an integral feature of the disease process, and that any effects of institutionalisation are relatively small.

Adult↗