Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-18T05:56:57.742Z Has data issue: false hasContentIssue false
  • English
  • Français

A comparison of cognitive functioning in long-term care and short-stay nursing home residents

Published online by Cambridge University Press:  01 October 2015

WILLIAM E. MANSBACH ,
RYAN A. MACE ,
KRISTEN M. CLARK  and
ISABELLA M. FIRTH
WILLIAM E. MANSBACH*
Affiliation:
Mansbach Health Tools, Simpsonville, Maryland, USA.
RYAN A. MACE
Affiliation:
Mansbach Health Tools, Simpsonville, Maryland, USA.
KRISTEN M. CLARK
Affiliation:
Mansbach Health Tools, Simpsonville, Maryland, USA.
ISABELLA M. FIRTH
Affiliation:
The Beacon Institute, Columbia, Maryland, USA.
*
Address for correspondence: William E. Mansbach, Mansbach Health Tools, LLC, P.O. Box 307, Simpsonville, MD 21150, USA E-mail: wmansbach@thebcat.com
Get access Rights & Permissions [Opens in a new window]

Abstract

It can be challenging to provide person-centred care for individuals with cognitive impairment if they are unable to communicate their needs to facility providers clearly. The high base rates of dementia and mild cognitive impairment (MCI) in US nursing homes is well documented; however, our understanding of the unique prevalence of cognitive levels in long-term care and short-stay residents is limited. Our aim is to determine whether there are significant differences in specific cognitive levels between these two groups. Long-term care and short-stay residents (N = 579) were randomly selected from 18 Maryland, US skilled nursing facilities; 345 met inclusion criteria for participation (mean age 79.41) and completed a cognitive test (Brief Cognitive Assessment Tool (BCAT)). Based on BCAT scores, 78.9 per cent of the long-term care residents had dementia compared to 61.4 per cent for short-stay residents. The proportions of MCI, mild, and moderate to severe dementia were significantly different between the two groups (p = 0.00). The odds of residents having moderate to severe dementia were 2.76 times greater for long-term care compared to short-stay residents. BCAT total and factor scores were significantly different between long-term care and short-stay nursing home residents (p < 0.001). We discuss the implications of these empirical findings in terms of facilitating person-centred care in nursing homes.

Keywords

long-term careshort stayperson-centredcognitive assessmentdementianursing homesBrief Cognitive Assessment Tool (BCAT)
Type
Articles
Information
Ageing & Society , Volume 37 , Issue 1 , January 2017 , pp. 1 - 13
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Administration for Community Living 2014. Guidance for Implementing Standards for Person-centered Planning and Self-direction in Home and Community-based Services Programs. Available online at http://www.acl.gov/Programs/CDAP/OIP/docs/2402-a-Guidance.pdf [Accessed 17 December 2014].Google Scholar
Cahill, S., Diaz-Ponce, A. M., Coen, R. F. and Walsh, C. 2010. The underdetection of cognitive impairment in nursing homes in the Dublin area. The need for on-going cognitive assessment. Age and Ageing, 39, 1, 128–31.Google Scholar
Department of Health and Human Services, Centers for Medicare & Medicaid Services 2013. Nursing Home Data Compendium (2013 Edition). Available online at http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/downloads/nursinghomedatacompendium_508.pdf.Google Scholar
Deutschman, M. 2000. What you hear when you listen to staff. Nursing Homes Long Term Care Management, 49, 6, 37–43.Google Scholar
Dodge, H. H., Kadowaki, T., Hayakawa, T., Yamakawa, M., Sekikawa, A. and Ueshima, H. 2005. Cognitive impairment as a strong predictor of incident disability in specific ADL–IADL tasks among community-dwelling elders: the Azuchi Study. The Gerontologist, 45, 2, 222–30.Google Scholar
Gaugler, J. E., Ascher-Svanum, H., Roth, D. L., Fafowora, T., Siderowf, A. and Beach, T. G. 2013. Characteristics of patients misdiagnosed with Alzheimer's disease and their medication use: an analysis of the NACC-UDS database. BMC Geriatrics, 13, 137, 1–23.Google Scholar
Grabowski, D. C., Elliot, A., Leitzell, B., Cohen, L. W. and Zimmerman, S. 2014. Who are the innovators? Nursing homes implementing culture change. The Gerontologist, 54, supplement, S65–75.CrossRefGoogle ScholarPubMed
Gravetter, F. and Wallnau, L. 2008. Essentials of Statistics for the Behavioral Sciences. Sixth edition, Thomas Wadsworth, Belmont, California.Google Scholar
Gurnik, M. and Hollis-Sawyer, L. 2003. Empowering assisted living front-line care staffs to better care for Alzheimer's and dementia residents. Ageing International, 28, 1, 82–97.Google Scholar
Kitwood, T. 1997. Dementia Reconsidered. Open University Press, Bristol, Pennsylvania.Google Scholar
Lowry, R. 2012. Concepts & Applications of Inferential Statistics. Available online at http://vassarstats.net/textbook/ [Accessed 17 December 2014].Google Scholar
MacDougall, E. E., Mansbach, W. E., Clark, K. M. and Mace, R. A. 2015. The Brief Cognitive Assessment Tool (BCAT): cross-validation in a community dwelling older adult sample. International Psychogeriatrics, 27, 2, 243–50.Google Scholar
Magaziner, J., German, P., Zimmerman, S. I., Hebel, J. R., Burton, L., Gruber-Baldini, A. L., May, C. and Kittner, S. 2000. The prevalence of dementia in a statewide sample of new nursing home admissions aged 65 and older: diagnosis by expert panel. Epidemiology of Dementia in Nursing Homes Research Group. Gerontologist, 40, 6, 663–72.Google Scholar
Mansbach, W. E., MacDougall, E. E. and Rosenzweig, A. S. 2012. The Brief Cognitive Assessment Tool (BCAT): a new test emphasizing contextual memory, executive functions, attentional capacity, and the prediction of instrumental activities of daily living. Journal of Clinical and Experimental Neuropsychology, 34, 2, 183–94.Google Scholar
Mansbach, W. E., Mace, R. A. and Clark, K. M. 2014. Differentiating levels of cognitive functioning: a comparison of the Brief Interview for Mental Status (BIMS) and the Brief Cognitive Assessment Tool (BCAT) in a nursing home sample. Aging and Mental Health, 18, 7, 921–8.Google Scholar
McKenzie, C. S. and Peragine, G. 2003. Measuring and enhancing self-efficacy among professional caregivers of individuals with dementia. American Journal of Alzheimer's Disease & Other Dementias, 18, 5, 291–9.Google Scholar
Noël-Miller, C. 2010. Spousal loss, children, and the risk of nursing home admission. Journals of Gerontology: Psychological Sciences and Social Sciences, 65B, 3, 370–80.Google Scholar
Rahman, A. N. and Schnelle, J. F. 2008. The nursing home culture-change movement: recent past, present, and future directions for research. The Gerontologist, 48, 2, 142–8.Google Scholar
Sloane, S. D., Hoeffer, B., Mitchell, C. M., McKenzie, D. A., Barrick, A. L., Rader, J., Stewart, B. J., Talerico, K. A., Rasin, J. H., Zink, R. C. and Koch, G. G. 2004. Effect of person-centered showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: a randomized, controlled trial. Journal of American Geriatric Society, 52, 11, 1795–804.CrossRefGoogle ScholarPubMed
Snow, V., Beck, D., Budnitz, T., Miller, D. C., Potter, J., Wears, R. L., Weiss, K. B., Williams, M. V. and Williams, M. V. 2009. Transitions of Care Consensus policy statement: American College of Physicians, Society of General Internal Medicine, Society of Hospital Medicine, American Geriatrics Society, American College of Emergency Physicians, and Society for Academic Emergency Medicine. Journal of Hospital Medicine, 4, 6, 364–70.Google Scholar
Williams, J., Hadjistavropoulos, T., Ghandehari, O. O., Yao, X. and Lix, L. 2013. An evaluation of a person-centred care programme for long-term care facilities. Ageing & Society, 35, 3, 457–88.Google Scholar
Zimmerman, S., Williams, C. S., Reed, P. S., Boustani, M., Preisser, J. S., Heck, E. and Sloane, P. D. 2005. Attitudes, stress, and satisfaction of staff who care for residents with dementia. The Gerontologist, 45, supplement 1, 96–105.Google Scholar