Purdue University, West Lafayette, IN, USA.
J Appl Gerontol. 2020 Aug;39(8):863-870. doi: 10.1177/0733464818807818. Epub 2018 Oct 26.
Minnesota's Return to Community Initiative (RTCI) assists private-pay nursing home (NH) residents to return to the community. Using data from a 1-year admission cohort of RTCI-targeted NH residents, we examined why residents who at admission expressed a desire for discharge, were paying privately, and had relatively low-care needs chose to remain in the NH. Characteristics of those who remained were compared with those who discharged using logistic regression, and barriers to discharge were summarized. Residents who were older, more cognitively impaired (OR = 1.8), unmarried (OR = 1.4), had behavior problems (OR = 1.6), or diagnosed with dementia (OR = 2.0) were more likely to remain than discharge to the community. Between admission and their 90-day assessment, residents remaining in the facility had a small decline in cognitive status, yet their continence improved and they became more independent in activities of daily living (ADLs). Seventy-four percent reported a perception of health-related barriers to discharge.
明尼苏达州重返社区倡议 (RTCI) 帮助自费入住养老院 (NH) 的居民返回社区。本研究使用 RTCI 目标 NH 居民入院 1 年的入院队列数据，考察了那些在入院时表达出院意愿、自费入住、且护理需求相对较低的居民为何选择留在 NH。使用逻辑回归比较了仍留在 NH 的居民和出院居民的特征，并总结了出院障碍。与出院相比，年龄较大、认知障碍更严重 (OR = 1.8)、未婚 (OR = 1.4)、有行为问题 (OR = 1.6) 或被诊断为痴呆症 (OR = 2.0) 的居民更有可能留在 NH 而不是出院到社区。在入院和 90 天评估之间，留在机构的居民认知状态略有下降，但他们的大小便自理能力有所改善，日常生活活动 (ADL) 更独立。74%的人报告存在与健康相关的出院障碍。
