Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-27T19:43:20.854Z Has data issue: false hasContentIssue false
  • English
  • Français

A Case Control Study of the Risks for Institutionalization of Elderly People in Nova Scotia*

Published online by Cambridge University Press:  29 November 2010

Katherine Glazebrook ,
Kenneth Rockwood ,
Paul Stolee ,
John Fisk  and
J. M. Gray
Katherine Glazebrook
Affiliation:
Dalhousie University
Kenneth Rockwood
Affiliation:
Dalhousie University
Paul Stolee
Affiliation:
University of Waterloo and Dalhousie University
John Fisk
Affiliation:
Dalhousie University
J. M. Gray
Affiliation:
Dalhousie University
Get access Rights & Permissions [Opens in a new window]

Abstract

Few studies of the risks of institutionalization of the elderly have had fully specified models using multivariate analysis, and several studies have examined highly selected populations, making their generalizability uncertain. We set out to examine the risks of institutionalization in elderly people in Nova Scotia. A case-control study, executed as part of the Canadian Study of Health and Aging examined 108 incident institutional cases and 533 community-dwelling elderly controls, using a standardized assessment interview conducted by trained interviewers. Multiple logistic regression analysis showed that advancing age, presence of dementia, functional impairment, poor self-rated health, recent hospital admission, and absence of a caregiver were important risks for entry into long term care. Institutions providing long-term care for the elderly need to be able to look after populations with a high prevalence of dementia and functional impairment.

Résumé

De rares études sur les risques de placer les aînés en établissement ont utilisé des modèles d'analyse multifactorielle, tandis que plusieurs se sont concentrées sur des groupes très précis, ce qui rend leurs généralisations incertaines. Nous avons tenté d'examiner les facteurs de risque inhérents au placement en établissement d'aînés en Nouvelle-Écosse. Une étude de cas témoins, effectuée dans le cadre de «l'Enquête canadienne sur la santé et le vieillissement,» a examiné 108 cas expérimentaux et 533 cas témoins dans des habitations pour aînés au sein de la communauté, au moyen d'une entrevue d'évaluation normalisée menée par des enquêteurs formés. Une analyse de régression logistique multiple a révélé qu'un âge avancé, une manifestation de démence sénile, une incapacité fonctionnelle, la perception d'une mauvaise santé, une récenté hospitalisation et l'absence d'un pourvoyeur de soins représentaient d'importants facteurs de risque quant au placement dans un établissement de soins de longue durée. Les établissements offrant ce type de service aux aînés doivent être en mesure de prendre soin de populations affichant un taux élevé de démence senile et d'incapacité fonctionnelle.

Keywords

AgedInstitutionalizationCSHADementia.AînéplacementE.C.S.V.démence.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 13 , Issue 1 , Printemps/Spring 1994 , pp. 104 - 117
Copyright
Copyright © Canadian Association on Gerontology 1994

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

1.McDaniel, S.Canada's Aging Population. Toronto: Butterworths, 1986.Google Scholar
2.Forbes, WF, Jackson, JA, Kraus, AS. Institutionalization of the Elderly in Canada. Toronto: Butterworths, 1987.Google Scholar
3.Hanley, RJ, Alecxih, LMB, Wiener, JM, Kennell, DL. Predicting Elderly Nursing Home Admissions: Results from the 1982-National Long-Term Care Survey. Research on Aging 1990; 12: 199–228.CrossRefGoogle ScholarPubMed
4.Eastwood, R, Nobbs, H, Lindsay, J, McDowell, I. Canadian Study of Health and Aging. Dementia 1992; 3: 209–12.Google Scholar
5.Canadian Study of Health and Aging. Methods and Prevalence of Dementia. Can Med Assoc J 1994. In Press.Google Scholar
6.Mulrow, CD. The Medical Review Article: State of the Science. Ann Int Med 1987; 106: 485–8.CrossRefGoogle ScholarPubMed
7.Wingard, DL, Jones, DW, Kaplan, RM. Institutional Care Utilization by the Elderly: A Critical Review. Gerontologist 1987; 27: 156–63.CrossRefGoogle ScholarPubMed
8.Shapiro, E, Tate, R. Who is really at risk of institutionalization? Who is really at risk of institutionalization 1988; 28: 237–45.Google ScholarPubMed
9.Cohen, M, Tell, E, Wallack, S. The risk factors of nursing home entry among residents of six continuing care retirement communities. J Gerontology 1988; 43: 515–21.CrossRefGoogle ScholarPubMed
10.Morris, JN, Sherwood, S, Gutkin, CE. Inst-Risk II: An approach to forecasting relative risk of future institutional placement. Health Serv Res 1988; 23: 511–36.Google Scholar
11.Pruchno, RA, Michaels, JE, Potashnik, SL. Predictors of institutionalization among Alzheimer disease victims with caregiving spouses. J Gerontology 1990; 45: S259–66.CrossRefGoogle ScholarPubMed
12.Leiberman, MA, Kramer, JH. Factors affecting decisions to institutionalize demented elderly. Gerontologist 1991; 31: 371–4.CrossRefGoogle Scholar
13.Ford, AB, Roy, AW, Haug, MR, Folmar, SJ. Impaired and disabled elderly in the community. Am J Public Health 1991; 81: 1207–9.CrossRefGoogle ScholarPubMed
14. O'Donnell, BF, Drachman, DA, Barnes, HJ, Peterson, KE, Swearer, JM, Lew, RA. Incontinence and troublesome behaviours predict institutionalization in dementia. J Ger Psych Neur 1992; 5: 45–52.CrossRefGoogle Scholar
15.Foley, DJ, Ostfeld, AM, Branch, LG, et al. The Risk of Nursing Home Admission in Three Communities. J Aging Health 1992; 4: 155–73.CrossRefGoogle ScholarPubMed
16.McFall, S, Miller, BH. Caregiver Burden and Nursing Home Admission of Frail Elderly Persons. J Geront 1992; 47: S73–79.CrossRefGoogle ScholarPubMed
17.Weissert, WG, Cready, CM. Toward a model for improved targeting of aged at risk for institutionalization. Health Serv Res 1989; 24: 485–510.Google Scholar
18.Branch, LG, Jette, AM. A prospective study of long-term care institutionalization among the aged. Am J Public Health 1982; 72: 1371–9.CrossRefGoogle ScholarPubMed
19.Pfeffer, E. A Short portable mental status questionnaire. J Amer Geriatr Soc 1975; 22: 433–40.CrossRefGoogle Scholar
20.Teng, EL, Chui, HC. The modified Mini-Mental State (3MS) Examination. J Clin Psychiatry 1987; 48: 314–8.Google ScholarPubMed
21.American Psychiatric Association. Diagnostic and Statistical Manual. 3rd ed. rev. Washington: American Psychiatric Association, 1987.Google Scholar
22.Granger, CV, Albrecht, GL, Hamilton, BL. Outcome of comprehensive medical rehabilitation: Measurement of PULSES Profile and the Barthel Index. Arch Phys Med Rehab 1979; 60: 145–54.Google ScholarPubMed
23.Fillenbaum, GG. Multidimensional Functional Assessment of Older Adults: the Duke Older Americans Resources and Services Program. L Erilbaum Associates Incorporated, Hillsdale, NJ, 1988.Google Scholar
24.Mossey, J, Shapiro, E. Self-rated Health: A Predictor of mortality among the elderly. Am J Public Health 1982; 72: 800–8.CrossRefGoogle Scholar
25.Kleinbaum, DG, Kupper, LL, Morgenstern, H. Epidemiologie Research: Principles and Quantitative Analysis. New York: Van Nostrand-Reinhold, 1982.Google Scholar
26.Zarit, SH. Do We need Another Stress and Caregiving Study? Do We need Another Stress and Caregiving Study 1989; 24: 147–8.Google Scholar
27.Barer, BM, Johnson, CL. A Critique of the Caregiving Literature. Gerontologist 1990; 30: 26–29.CrossRefGoogle ScholarPubMed
28.Baumgarten, M. The Health of Persons Giving Care to the Demented Elderly: A Critical Review of the Literature. J Clin Epidemiol 1989; 42: 1137–48.CrossRefGoogle Scholar
29. O'Connor, DW, Pollitt, PA, Brook, CPB, Reiss, BB, Roth, M. Does early intervention reduce the number of elderly people with dementia admitted to institutions for long term care? Does early intervention reduce the number of elderly people with dementia admitted to institutions for long term care 1991; 302: 871–5.Google Scholar
30.Shapiro, E, Tate, RB. Predictors of long term care facility use among the elderly. Canadian Journal on Aging 1985; 4: 11–18.CrossRefGoogle Scholar
31.Brocklehurst, JC. The Day Hospital. In: Brocklehurst, J.C., Textbook of Geriatric Medicine and Gerontology (3rd ed.). London: Churchill Livingstone, 1985.Google Scholar