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Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis

  • Sandeep Toot (a1), Tom Swinson (a1), Mike Devine (a2), David Challis (a3) and Martin Orrell (a4)...
Abstract
Background:

Up to half of people with dementia in high income countries live in nursing homes and more than two-thirds of care home residents have dementia. Fewer than half of these residents report good quality of life and most older people are anxious about the prospect of moving into a nursing home. Robust evidence is needed as to the causes of admission to nursing homes, particularly where these risk factors are modifiable.

 Methods:

We conducted a systematic literature search to identify controlled comparison studies in which the primary outcome was admission to nursing home of older adults with dementia. Identified studies were assessed for validity and 26 (17 cohort and 9 case-control) were included. Qualitative and quantitative analyses were conducted, including meta-analysis of 15 studies.

 Results:

Poorer cognition and behavioral and psychological symptoms of dementia (BPSD) were consistently associated with an increased risk of nursing home admission and most of our meta-analyses demonstrated impairments in activities of daily living as a significant risk. The effects of community support services were unclear, with both high and low levels of service use leading to nursing home placement. There was an association between caregiver burden and risk of institutionalization, but findings with regard to caregiver depression varied, as did physical health associations, with some studies showing an increased risk of nursing home placement following hip fracture, reduced mobility, and multiple comorbidities.

 Conclusion:

We recommend focusing on cognitive enhancement strategies, assessment and management of BPSD, and carer education and support to delay nursing home placement.
Copyright
COPYRIGHT: © International Psychogeriatric Association 2016 
Corresponding author
Correspondence should be addressed to: Sandeep Toot, Research & Development Department, North East London NHS Foundation Trust, Goodmayes Hospital, Barley Lane, Goodmayes, Essex IG3 8XJ, UK. Phone: +44344 1200 555 ext. 64453. Email: Sandeep.toot@nelft.nhs.uk.
References
Hide All
Afram, B. et al. (2014). Reasons for institutionalization of people with dementia: informal caregiver reports from 8 European countries. Journal of American Medical Directors Association, 15, 108–116. doi:10.1016/j.jamda.2013.09.012.
Alzheimer's Society (2011). Optimising Treatment and Care for People with Behavioural and Psychological Symptoms of Dementia: A Best Practice Guide for Health and Social Care Professionals. London: Alzheimer's Society.
Alzheimer's Society (2013). Low Expectations: Attitudes on Choice, Care and Community for People with Dementia in Care Homes. London: Alzheimer's Society.
Andel, R., Hyer, K. and Slack, A. (2007). Risk factors for nursing home placement in older adults with and without dementia. Journal of Aging and Health, 19, 213–228. doi:10.1177/0898264307299359.
Ballard, C. G. et al. (2009). Management of agitation and aggression associated with Alzheimer disease 67. Nature Reviews Neurology, 5, 245–255. doi:10.1038/nrneurol.2009.39.
Banerjee, S. (2009). The Use of Antipsychotic Medication for People with Dementia: Time for Action. London: Department of Health.
Blessed, G., Tomlinson, B. E. and Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry 114, 797–811. doi:10.1192/bjp.114.512.797.
Brodaty, H., Draper, B. M. and Low, L.-F. (2003). Behavioural and psychological symptoms of dementia: a seven-tiered model of service delivery. Medical Journal of Australia, 178, 231–234.
Buhr, G. T., Kuchibhatla, M. and Clipp, E. C. (2006). Caregivers’ reasons for nursing home placement: clues for improving discussions with families prior to the transition. Gerontologist 46, 52–61. doi:46/1/52.
Coehlo, D. P., Hooker, K. and Bowman, S. (2007). Institutional placement of persons with dementia: what predicts occurrence and timing? Journal of Family Nursing, 13, 253–277. doi:10.1177/1074840707300947.
Cooper, C., Selwood, A. and Livingston, G. (2008). The prevalence of elder abuse and neglect: a systematic review. Age and Ageing. doi:10.1093/ageing/afm194.
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314. doi:10.1212/WNL.44.12.2308.
de Vugt, M. E., Stevens, F., Aalten, P., Lousberg, R., Jaspers, N. and Verhey, F. R. J. (2005). A prospective study of the effects of behavioral symptoms on the institutionalization of patients with dementia. International Psychogeriatrics, 17, 577–589. doi:10.1017/S1041610205002292.
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. doi:10.1016/0022-3956(75)90026-6.
Gaugler, J. E. et al. (2000). Predictors of institutionalization of cognitively impaired elders: family help and the timing of placement. Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 55, 247–255. doi:http://dx.doi.org/10.1093/geronb/55.4.P247.
Gaugler, J. E., Kane, R. L., Kane, R. A., Clay, T. and Newcomer, R. (2003). Caregiving and institutionalization of cognitively impaired older people: utilizing dynamic predictors of change. Gerontologist, 43, 219–229. doi:10.1093/geront/43.2.219.
Gaugler, J. E., Kane, R. L., Kane, R. A. and Newcomer, R. (2005). Early community-based service utilization and its effects on institutionalization in dementia caregiving. The Gerontologist, 45, 177–185. doi:10.1093/geront/45.2.177.
Gibbons, L. E. et al. (2002). Anxiety symptoms as predictors of nursing home placement in patients with Alzheimer's disease. Journal of Clinical Geropsychology, 8, 335–342.
Giebel, C. M., Sutcliffe, C. and Challis, D. (2015). Activities of daily living and quality of life across different stages of dementia: a UK study. Aging & Mental Health, 19, 63–71. doi:10.1080/13607863.2014.915920.
Gilley, D. W., Bienias, J. L., Wilson, R. S., Bennett, D. A., Beck, T. L. and Evans, D. A. (2004). Influence of behavioral symptoms on rates of institutionalization for persons with Alzheimer's disease. Psychological Medicine, 34, 1129–1135. doi:10.1017/S0033291703001831.
Gilley, D. W., McCann, J. J., Bienias, J. L. and Evans, D., (2005). Caregiver psychological adjustment and institutionalization of persons with Alzheimer's disease. Journal of Aging and Health 17, 172–189. doi:10.1177/0898264304274252.
Guerchet, M., Prina, M. and Prince, M. (2013). Policy Brief for Heads of Government: The Global Impact of Dementia 2013–2050 (pp. 1–8). London: Alzheimer's Disease International.
Harboun, M., Dorenlot, P., Cohen, N., Steinhagen-Thiessen, E. and Ankri, J. (2008). Impact of hip fracture, heart failure and weight loss on the risk of institutionalization of community-dwelling patients with dementia. International Journal of Geriatric Psychiatry, 23, 1245–1252. doi:10.1002/gps.2058.
Haupt, M. and Kurz, A. (1993). Predictors of nursing home placement in patients with Alzheimer's disease. International Journal of Geriatric Psychiatry, 8, 741–746. doi:10.1002/gps.930080906.
Jolley, D. and Arie, T. (1992). Developments in psychogeriatric services. In Arie, T. (ed.), Recent Advances in Psychogeriatrics, vol. 2. London: Churchill Livingstone.
Kales, H. C., Gitlin, L. N. and Lyketsos, C. G. (2015). Assessment and management of behavioral and psychological symptoms of dementia. BMJ, 350, 369–369. doi:10.1136/bmj.h369.
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. and Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. Journal of American Medical Association, 185, 914–919. doi:10.1001/jama.1963.03060120024016.
Kunik, M. E. et al. (2010). Consequences of aggressive behavior in patients with dementia. Journal of Neuropsychiatry and Clinical Neurosciences, 22, 40–47. doi:10.1176/appi.neuropsych.22.1.40.
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186. doi:10.1093/geront/9.3_Part_1.179.
Lawton, M. P., Moss, M., Kleban, M. H., Glicksman, A. and Rovine, M. (1991). A two-factor model of caregiving appraisal and psychological well-being. Journal of Gerontology, 46, 181–189. doi:10.1093/geronj/46.4.P181.
Lieberman, M. A. and Kramer, J. H. (1991). Factors affecting decisions to institutionalize demented elderly. Gerontologist, 31, 371–374.
Lopez, O. L. et al. (2009). Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer disease. Journal of Neurology, Neurosurgery & Psychiatry, 80, 600–607. doi:10.1136/jnnp.2008.158964.
Luppa, M. et al. (2012). Predictors of institutionalisation in incident dementia-results of the German study on ageing cognitive and dementia in primary care patients (AgeCoDe study). Dementia and Geriatric Cognitive Disorders, 33, 282–288.
Mattis, S. (1988). Dementia Rating Scale (DRS). Odessa, FL: Psychological Assessment Resources.
Morris, J. N. et al. (1997). Comprehensive clinical assessment in community setting: applicability of the MDS-HC. Journal of American Geriatric Society, 45, 1017–1024. doi:10.1111/j.1532-5415.1997.tb02975.x.
Pot, A. M., Deeg, D. J. H. and Knipscheer, C. P. M. (2001). Institutionalization of demented elderly: the role of caregiver characteristics. International Journal of Geriatric Psychiatry, 16, 273–280. doi:10.1002/gps.331.
Prince, M., Prina, M. and Guerchet, M. (2015). World Alzheimer Report 2013: Journey of Caring-Analysis of Long-Term Care for Dementia, London: Alzheimer's Disease International.
Reilly, S. et al. (2015). Case management approaches to home support for people with dementia. Cochrane database Systematic Reviews 1, CD008345. doi:10.1002/14651858.CD008345.pub2.
Roth, M., Tym, E. and Mountjoy, C. Q. (1986). CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 698–709. doi:10.1192/bjp.149.6.698.
Scarmeas, N. et al., (2007). Disruptive behavior as a predictor in Alzheimer disease. Archives of Neurology, 64, 1755–1761. doi:10.1001/archneur.64.12.1755.
Scott, W. K., Edwards, K. B., Davis, D. R., Cornman, C. B. and Macera, C. A. (1997). Risk of institutionalization among community long-term care clients with dementia. Gerontologist, 37, 46–51. doi:10.1093/geront/37.1.46.
Severson, M. A. et al. (1994). Patterns and predictors of institutionalization in community-based dementia patients. Journal of American Geriatrics Society, 42, 181–185.
Smith, G. E., Kokmen, E. and O'Brien, P. C. (2000). Risk factors for nursing home placement in a population-based dementia cohort. Journal of American Geriatric Society, 48, 519–525.
Smith, G. E., O'Brien, P. C., Ivnik, R. J., Kokmen, E. and Tangalos, E. G. (2001). Prospective analysis of risk factors for nursing home placement of dementia patients. Neurology, 57, 1467–1473. doi:10.1212/WNL.57.8.1467.
Spruytte, N., Van Audenhove, C. and Lammertyn, F. (2001). Predictors of institutionalization of cognitively-impaired elderly cared for by their relatives. International Journal of Geriatric Psychiatry, 16, 1119–1128. doi:10.1002/gps.484.
Steele, C., Rovner, B., Chase, G. A. and Folstein, M. (1990). Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. The American of Journal of Psychiatry, 147, 1049–1051. doi:10.1176/ajp.147.8.1049.
Sury, L., Burns, K. and Brodaty, H. (2013). Moving in: adjustment of people living with dementia going into a nursing home and their families. International Psychogeriatrics, 25, 867–876. doi:10.1017/S1041610213000057.
Toot, S., Devine, M., Akporobaro, A. and Orrell, M. (2013). Causes of hospital admission for people with dementia: a systematic review and meta-analysis. Journal of American Medical Directors Association, 14, 463–470, doi: 10.1016/j.jamda.2013.01.011.
Verbeek, H. et al. (2015). Inter-country exploration of factors associated with admission to long-term institutional dementia care: evidence from the RightTimePlaceCare study. Journal of Advanced Nursing, 71, 1338–1350. doi:10.1111/jan.12663.
Weintraub, S. (1986). The record of independent living: an informant-completed measure of activities of daily living and behavior in elderly patients with cognitive impairment. American Journal of Alzheimers Disease & Other Dementias, 1, 35–39. doi:10.1177/153331758600100210.
Wells, G. et al. (2012). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomized Studies in Meta-Analyses. Available at: http//www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
Whitlatch, C. J., Feinberg, L. F. and Stevens, E. J. (1999). Predictors of institutionalization for persons with Alzheimer's disease and the impact on family caregivers. Journal of Mental Health & Aging, 5, 275–288.
WHO (2012). Dementia: A Public Health Priority. Geneva, Switzerland: WHO publication.
Wilkinson, I.M. and Graham-White, J. (1980). Psychogeriatric dependency rating scales (PGDRS). A method of assessment for use by nurses. British Journal of Psychiatry, 137, 558–565. doi:10.1192/bjp.137.6.558.
Yaffe, K. et al. (2002). Patient and caregiver characteristics and nursing home placement in patients with dementia. JAMA, 287, 2090–2097. doi:10.1001/jama.287.16.2090.
Young, R. F., Kosloski, K. and Montgomery, R. J. (1998). Psychosocial factors in institutionalization of Alzheimer's patients. Journal of Clinical Geropsychology, 4, 241–251.
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International Psychogeriatrics
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