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作者 Piggee, Tommy Bernard, Sr
書名 Predictors of transition among older assisted living residents
國際標準書號 9781124710808
book jacket
說明 165 p
附註 Source: Dissertation Abstracts International, Volume: 72-09, Section: A, page: 3449
Advisers: J. Kevin Eckert; Leslie A. Morgan
Thesis (Ph.D.)--University of Maryland, Baltimore County, 2011
Purpose. The purpose of this study was to examine the association of proxy and performance-based measures of physical and cognitive status and the effects of changes in these statuses on residential transitions from AL. Design and method. The study used a prospective design that looks at the relationship of AL residents' initial physical function and cognitive status and change in these statuses over time and eventual transition out of assisted living, employing both direct measures of performance and proxy data. Comparison between performance and proxy data was used to determine which method is more likely to predict transition. Data are derived from a supplemental analysis to the "Transition from Assisted Living" study, which included six Maryland AL facilities that were part of the Collaborative Studies of Long-Term Care (CS-LTC) sampling frame. Residents were assessed sequentially, starting in 2002, by both proxy and performance-based measures and were followed up for up to three additional assessments over 18 months. Results: A comparison between proxy-rated physical function scores (ADL) and those for performance evaluation of four specific tasks (balance, chair rise, gait and grip strength) found notable disagreement. While proxies rated a majority of AL residents (80%) as independent in all ADL tasks, based on performance-based measures, a sizable percentage of residents were notably limited in some or all of these tasks. On the other hand, comparison of proxy and performance-based cognitive measures (MDS-COGS and MMSE) showed a strong association (r = -.685, p = .000) in the expected direction, supporting a conclusion of agreement. Neither baseline physical function nor cognitive status was significant predictors of a resident's later transition. In fact, those with noticeable limitations were just as likely to age in place as they were to transition. Similarly, change in physical function and cognitive status over time did not significantly predict resident transition. Implications. When care providers do not detect changes in status, impairments associated with physical function and cognitive status may results in limitations that may have a negative impact on residents' quality of life. In this case, allowing residents to age in place may or may not be good for the resident. Further, subjective assessments by proxies may over- or underestimate the resident's condition, resulting in retention when discharge to an environment capable of providing higher levels of care is indicated
School code: 0434
Host Item Dissertation Abstracts International 72-09A
主題 Gerontology
Health Sciences, Aging
0351
0493
Alt Author University of Maryland, Baltimore County. Gerontology
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