Cynthia L. Port

Dementia as a risk factor for falls and fall injuries among nursing home residents.

Objectives: To compare rates of falling between nursing home residents with and without dementia and to examine dementia as an independent risk factor for falls and fall injuries.

Mortality and Adverse Health Events in Newly Admitted Nursing Home Residents with and without Dementia

Objectives: To evaluate the association between dementia and mortality, adverse health events, and discharge disposition of newly admitted nursing home residents. It was hypothesized that residents with dementia would die at a higher rate and develop more adverse health events (e.g., infections, fevers, pressure ulcers, falls) than residents without dementia because of communication and self‐care difficulties.

Factors Related to the Long-Term Course of PTSD in Older Ex–Prisoners of War

This study examined relationships between socioenvironmental factors occurring in later-life and current and changing PTSD symptom levels in a sample of 177 community-dwelling World War II and Korean era ex–prisoners of war. Factors examined included negative life events, negative health events, social support, and death acceptance. PTSD was assessed at Time 1. PTSD and the later-life factors were then assessed 4 years later (Time 2). Cross-sectional analysis examined the relationship of the later-life factors to current PTSD symptomatology. Longitudinal analysis examined their relationship to changing PTSD symptomatology over the 4-year interval. Negative health changes, social support, and death acceptance were significantly related to current and changing PTSD symptomatology, but negative life events were not. The authors conclude that health and psychosocial factors that may occur in later-life can be related to PTSD symptom levels even many decades after a traumatic experience.

Measuring the frequency of contact between nursing home residents and their family and friends

BackgroundThe involvement of family and friends in nursing home care represents an important resource for an overburdened long-term care system. However, little guidance exists for researchers interested in measuring family involvement. ObjectivesThis methodological report provides an overview of approaches to measuring family involvement in nursing home care and examines agreement between family and staff on the frequency of visits and telephone calls to a resident by family and friends. Agreement is also assessed for subgroups of the sample based on characteristics of the family, staff, facility, and resident. MethodsFrom a large and representative sample of nursing home residents, 823 pairs of significant others and staff were interviewed. Primary variables were reports of visitation and telephone contact received by the resident in the preceding 2 weeks according to the significant other and staff person. ResultsSignificant other reports of visitation and telephone contact were significantly higher than staff reports (p < .001 and p < .01). Agreement (via intraclass correlation) between significant others and staff was moderate for reports of visit and telephone call frequency. With one exception, no significant differences in agreement were found between subgroups defined by characteristics of the family, staff, facility, or resident. For visits, agreement between nurse’s aides and significant others was lower than between other staff persons (e.g., LPNs and RNs) and significant others (p < .05). DiscussionDue to the complexity of nursing home settings as well as of the social support system of residents, researchers need to carefully consider their approach to the measurement of the involvement of family and friends in the nursing home.

The Role of Nursing Home Admission and Dementia Status on Care for Diabetes Mellitus

OBJECTIVES: To study the role of nursing home (NH) admission and dementia status on the provision of five procedures related to diabetes mellitus.

Short‐Stay Nursing Home Rehabilitation Patients: Transitional Care Problems Pose Research Challenges

A clinical intervention pilot study to improve depression care for short‐stay nursing home Medicare‐reimbursed rehabilitation patients funded by the National Institute on Aging was conducted. Despite solid theoretical and clinical grounding and the support of a large nursing home company, several roadblocks to implementation were encountered, including involving patients and families, communication between providers, involving community primary care physicians, staff time constraints, and conducting research with short‐stay patients. Although frustrating from a research standpoint, these roadblocks closely reflect problems identified by the American Geriatrics Society as impeding the delivery of high‐quality transitional care in geriatrics. These research roadblocks are described as they were encountered in the clinical setting, and each is placed within the larger context of challenges associated with care transitions, especially for older persons with complex health needs receiving nursing home rehabilitation. Finally, recommendations are offered for researchers conducting much‐needed research within geriatric transitional care settings, including starting early in the care transition chain and assisting patients and families with providing continuity across care settings.