Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T08:15:31.808Z Has data issue: false hasContentIssue false
  • English
  • Français

A Profile of Residents in Prairie Nursing Homes*

Published online by Cambridge University Press:  06 August 2013

Carole A. Estabrooks ,
Jeff W. Poss ,
Janet E. Squires ,
Gary F. Teare ,
Debra G. Morgan ,
Norma Stewart ,
Malcolm B. Doupe ,
Greta G. Cummings  and
Peter G. Norton
Carole A. Estabrooks*
Affiliation:
University of Alberta, Faculty of Nursing
Jeff W. Poss
Affiliation:
University of Waterloo
Janet E. Squires
Affiliation:
Ottawa Hospital Research Institute, University of Ottawa
Gary F. Teare
Affiliation:
Health Quality Council (Saskatchewan)
Debra G. Morgan
Affiliation:
University of Saskatchewan
Norma Stewart
Affiliation:
University of Saskatchewan
Malcolm B. Doupe
Affiliation:
University of Manitoba, Faculty of Medicine
Greta G. Cummings
Affiliation:
University of Alberta, Faculty of Nursing
Peter G. Norton
Affiliation:
University of Calgary, Faculty of Medicine
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Carole A. Estabrooks, Ph.D. University of Alberta Faculty of Nursing 11405 87 Avenue Edmonton, AB T6G 1C9 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Nursing homes have become complex care environments where residents have significant needs and most have age-related dementia. Building on research by Hirdes et al. (2011), we describe a resident profile in a representative sample of 30 urban nursing homes in the prairie provinces using Resident Assessment Instrument – Minimum Data Set 2.0 data from 5,196 resident assessments completed between 1 October 2007 and 31 December 2011. Residents were chiefly over age 85, female, and with an age-related dementia. We compared facility support and related services and resident characteristics by province, owner-operator model, and number of facility units. We observed differences in support and related services by both unit count and province. We also found that public facilities tend to care for residents with more demanding characteristics: notably cognitive impairment, aggressive behaviours, and incontinence. No clear trends associating the number of units in a facility with resident characteristics were observed.

Résumé

Les maisons de soins infirmiers sont devenues des environnements offrant des soins complexes, dont les habitants ont des besoins importants et la plupart souffrent de la démence liée a l’âge. S’appuyant sur les recherches de Hirdes et al. (2011), nous décrivons un profil des résidents dans un échantillon représentatif de 30 maisons de soins infirmiers en milieu urbain dans les provinces des Prairies, en utilisant des données de L’Instrument d’évaluation des résidents/le recueil de données minimum (Resident Assistant Instrument – Minimum Data Set 2.0) de 5 196 évaluations résidents accomplies entre le 1ier octobre et le 31ieme décembre 3011. Les résidents avaient principalement plus de 85 ans, étaient des femmes, et souffraient d’une démence liée à l’âge. Nous avons comparé le soutien et les services connexes des établissements et les caractéristiques des résidents par province, par les modèles du propriétaire-gérant, et par le nombre d’unités dans une installation. Nous avons également constaté que les établissements publics ont tendance à s’occuper des résidents ayant des caractéristiques plus exigeants : notamment, la déficience cognitive, un comportement aggressif, et l’incontinence. Aucune tendance claire n’a été observée reliant le nombre d’unités dans un établissement aux caractéristiques des résidents.

Keywords

vieillissmentmaisons de soins infirmierssoins de longue duréesoins de santéinstrument d’évaluation des résidents/recueil de données minimum (RAI-MDS)caractéristiques des résidentsagingnursing homeslong-term carehealth servicesRAI-MDSresident characteristics
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 32 , Issue 3 , September 2013 , pp. 223 - 231
Copyright
Copyright © Canadian Association on Gerontology 2013 

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.)

Footnotes

*

Funding for this study was provided by the Canadian Institutes of Health Research (CIHR) (MOP #53107). Carole Estabrooks is supported by a CIHR Canada Research Chair in Knowledge Translation. The authors also acknowledge the Translating Research in Elder Care (TREC) team for its contributions to this study. The TREC Team at the time of the study included the following: Carole A. Estabrooks (PI); investigators: Greta G. Cummings, Lesley Degner, Sue Dopson, Heather Laschinger, Kathy McGilton, Verena Menec, Debra Morgan, Peter Norton, Joanne Profetto-McGrath, Jo Rycroft-Malone, Malcolm Smith, Norma Stewart, and Gary Teare; decision makers: Caroline Clarke, Gretta Lynn Ell, Belle Gowriluk, Lori Lamont, Sue Neville, Corinne Schalm, Donna Stelmachovich, Gina Trinidad, Juanita Tremeer, and Luana Whitbread; collaborators: David Hogan, Chuck Humphrey, Michael Leiter, and Charles Mather; special advisors: Judy Birdsell, Phyllis Hempel (deceased), Dorothy Pringle (chair, Scientific Advisory Committee), and Jack Williams.

References

Alzheimer Society of Canada. (2010). Rising tide: The impact of dementia on Canadian society. Toronto, ON: Author.Google Scholar
Bernabei, R., Gambassi, G., Lapane, K., Sgadari, A., Landi, F., Gatsonis, C., et al. (1999). Characteristics of the SAGE database: A new resource for research on outcomes in long-term care. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 54(1), M25–M33. doi: 10.1093/gerona/54.1.M25.Google Scholar
Berta, W., Laporte, A., Zarnett, D., Valdmanis, V., & Anderson, G. (2006). A pan-Canadian perspective on institutional long-term care. Health Policy, 79(2–3), 175–194. doi: 10.1016/j.healthpol.2005.12.006.Google Scholar
British Columbia Office of the Ombudsperson. (2010). The best of care: Getting it right for seniors in British Columbia (Part 2). Victoria, BC: Author.Google Scholar
Canadian Institutes of Health Research. (2010). Turning the tide: A Canadian strategy for international leadership in the prevention and early treatment of Alzheimer’s disease and related dementias. Ottawa, ON: Author.Google Scholar
Canadian Study of Health and Aging Working Group. (1994). Canadian study of health and aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150(6), 899–913.Google Scholar
Doupe, M., Brownell, M., Kozyrskyj, A., Dik, N., Burchill, C., Dahl, M., et al. (2006). Using administrative data to develop indicators of quality care in personal care homes. Winnipeg, MB: Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba.Google Scholar
Doupe, M., Brownell, M., St. John, P., Strang, D.G., Chateau, D., & Dik, N. (2011). Nursing home adverse events: Further insight into highest risk periods. Journal of the American Medical Directors Association, 12(6), 467–474. doi: 10.1016/j.jamda.2011.02.002.Google Scholar
Doupe, M., Fransoo, R., Chateau, D., Dik, N., Burchill, C., Soodeen, R.-A., et al. (2011). Population aging and the continuum of older adult care in Manitoba. Winnipeg, MB: Manitoba Centre for Health Policy.Google Scholar
Dunn, F. (2005). Report of the auditor general on seniors care and programs. Edmonton, AB: Auditor General.Google Scholar
Estabrooks, C.A., Hutchinson, A., Squires, J., Birdsell, J., Cummings, G., Degner, L., et al. (2009). Translating Research in Elder Care: An introduction to a study protocol series. Implementation Science, 4(51). doi: 10.1186/1748-5908-4-51.CrossRefGoogle ScholarPubMed
Estabrooks, C.A., Morgan, D., Squires, J., Boström, A.-M., Slaughter, S., Cummings, G., et al. (2011). The care unit in nursing home research: Evidence in support of a definition. BMC Medical Research Methodology, 11(46). doi: 10.1186/1471-2288-11-46.Google Scholar
Estabrooks, C.A., Squires, J., Hayduk, L., Cummings, G., & Norton, P. (2011). Advancing the argument for validity of the Alberta Context Tool with healthcare aides in residential long-term care. BMC Medical Research Methodology, 11(107). doi: 10.1186/1471-2288-11-107.CrossRefGoogle ScholarPubMed
Estabrooks, C.A., Squires, J.E., Cummings, G.G., Teare, G.F., & Norton, P.G. (2009). Study protocol for the Translating Research in Elder Care (TREC): Building context - an organizational monitoring program in long-term care project (project one). Implementation Science, 4(52). doi: 10.1186/1748-5908-4-52.Google Scholar
Gruber-Baldini, A.L., Stuart, B., Zuckerman, I.H., Hsu, V.D., Boockvar, K.S., Zimmerman, S., et al. (2009). Sensitivity of nursing home cost comparisons to method of dementia diagnosis ascertainment. International Journal of Alzheimer’s Disease, 2009, article 780720. doi: 10.4061/2009/780720.Google Scholar
Hawes, C., Morris, J.N., Phillips, C.D., Mor, V., Fries, B.E., & Nonemaker, S. (1995). Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). The Gerontologist, 35(2), 172–178. doi: 10.1093/geront/35.2.172.Google Scholar
Hirdes, J.P., Mitchell, L., Maxwell, C.J., & White, N. (2011). Beyond the ‘iron lungs of gerontology’: Using evidence to shape the future of nursing homes in Canada. Canadian Journal on Aging, 30(3), 371–390. doi: 10.1017/S0714980811000304.CrossRefGoogle ScholarPubMed
Human Resources and Skills Development Canada. (2012). Canadians in context: Aging population. Retrieved November 22, 2012, fromhttp://www4.hrsdc.gc.ca/[email protected]?iid=33.Google Scholar
Hutchinson, A., Milke, D., Maisey, S., Johnson, C., Squires, J., Teare, G., et al. (2010). The Resident Assessment Instrument-Minimum Data Set 2.0 quality indicators: A systematic review. BMC Health Services Research, 10(166). doi: 10.1186/1472-6963-10-166.Google Scholar
Jones, R., Hirdes, J., Poss, J., Kelly, M., Berg, K., Fries, B., et al. (2010). Adjustment of nursing home quality indicators. BMC Health Services Research, 10(96). doi: 10.1186/1472-6963-10-96.CrossRefGoogle ScholarPubMed
Jonsson, T., Atwal, J.K., Steinberg, S., Snaedal, J., Jonsson, P.V., Bjornsson, S., et al. (2012). A mutation in APP protects against Alzheimer’s disease and age-related cognitive decline. Nature, 488(7409), 96–99. doi: 10.1038/nature11283.Google Scholar
Kjøs, B., Botten, G., Gjevjon, E., & Romøren, T. (2010). Quality work in long-term care: The role of first-line leaders. International Journal of Quality Health Care, 22(5), 351–357. doi: 10.1093/intqhc/mzq035.Google Scholar
Long-Term Care Task Force Ontario. (2012). Long-Term Care Task Force on Residential Care and Safety: An action plan to address abuse and neglect in long-term care homes. Toronto, ON:.Author.Google Scholar
Menec, V.H., MacWilliam, L., Soodeen, R.-A., & Mitchell, L. (2002). The health and health care use of Manitoba’s seniors: Have they changed over time? Winnipeg, MB: Manitoba Centre for Health Policy, University of Manitoba.Google Scholar
Mohr, J., Batalden, P., & Barach, P. (2004). Integrating patient safety into the clinical microsystem. Quality and Safety in Health Care, 13(Suppl 2), ii34–ii38. doi: 10.1136/qhc.13.suppl_2.ii34.CrossRefGoogle ScholarPubMed
National Advisory Council on Aging. (2005). Press Release. NACA demands improvement to Canada’s long term care institutions. Ottawa, ON: Author.Google Scholar
Nelson, E., Batalden, P., & Godfrey, M. (Eds.). (2007). Quality by design: A clinical microsystems approach. San Francisco: Jossey-Bass.Google Scholar
Nelson, E., Batalden, P., Huber, T., Mohr, J., Godfrey, M., Headrick, L., et al. (2002). Microsystems in health care: Part 1. Learning from high performing front-line clinical units. Journal of Quality Improvement, 28, 472–493.Google ScholarPubMed
Organisation for Economic Co-operation and Development (OECD) (2013). A good life in old age? Monitoring and improving quality in long-term care. Paris: OECD Health Policy Studies.Google Scholar
Phillips, C.D., & Morris, J. N. (1997). The potential for using administrative and clinical data to analyze outcomes for the cognitively impaired: An assessment of the Minimum Data Set for nursing homes. Alzheimer Disease and Associated Disorders, 11(Suppl 6), 162–167.Google Scholar
Poss, J.W., Jutan, N.M., Hirdes, J.P., Fries, B. E., Morris, J.N., Teare, G.F., et al. (2008). A review of evidence on the reliability and validity of Minimum Data Set data. Healthcare Management Forum, 21(1), 33–39. doi: 10.1016/s0840-4704(10)60127-5.CrossRefGoogle ScholarPubMed
Snowden, M., McCormick, W., Russo, J., Srebnik, D., Comtois, K., Bowen, J., et al. (1999). Validity and responsiveness of the Minimum Data Set. Journal of the American Geriatrics Society, 47(8), 1000–1004.Google Scholar
Statistics Canada. (2012a). Focus on geography series: 2011 Census. Retrieved September 10, 2012, fromhttp://www12.statcan.gc.ca/census-recensement/2011/as-sa/fogs-spg/Index-eng.cfm?LANG=Eng.Google Scholar
Statistics Canada. (2012b). Life expectancy at birth and at age 65 by sex and by province and territory, Canada. Ottawa, ON: Author.Google Scholar
Williams, I., Dickinson, H., Robinson, S., & Allen, C. (2009). Clinical microsystems and the NHS: A sustainable method for improvement. Journal of Health Organization and Management, 23(1), 119–132. doi: 10.1108/14777260910942597.Google Scholar