Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T01:32:58.655Z Has data issue: false hasContentIssue false
  • English
  • Français

Transferring to an Institution — An Analysis of Factors behind the Transfer to Institutional Long-Term Care

Published online by Cambridge University Press:  29 November 2010

Mårten Lagergren
Mårten Lagergren
Affiliation:
Kronan Health Centre
Get access Rights & Permissions [Opens in a new window]

Abstract

An analysis is made concerning the relation of different factors to client transfer between levels of care in an area-based system of long-term care for the elderly and the disabled. Special emphasis is given to the transfer from non-institutional to institutional care. The analysis uses data collected through the application of the ASIM monitoring system from 1985 to 1991 in the municipality of Solna, Sweden. Factors analysed include age, sex, marital status, co-habitation, accessibility of housing, informal social support and different aspects of disability. Multivariate analysis regarding factors related to institutionalization — i.e. transfer from domiciliary care or sheltered housing to residential home or long-term hospital care/nursing home — showed level of disability, staff assessment of appropriate level of care and age to be the most significant factors. Dementia was the strongest individual disability factor with functional disability and incontinence also having some influence on the probability of transfer. Deficiencies in the social environment in terms of living alone, inadequate housing accessibility or lack of social support did not show up — presumably because they were adequately compensated for by the public home help services

Résumé

L'analyse vise à déterminer l'incidence de divers facteurs sur le transfert de patients entre les différents niveaux de soins d'un système local de soins de longue durée aux personnes âgées et aux invalides. Une attention particulière est attachée au passage de soins non-institutionnels aux soins instutionnels. Cette analyse utilise des données recueillies, entre 1985 et 1991, dans la commune de Solna, Suède, au moyen de l'application du système de contrôle ASIM. L'analyse porte sur les facteurs âge, sexe, situation de famille, cohabitation, accessibilité au logement, soutien social informel et différentes forme d'invalidité. Il résulte de l'analyse à multivariées portant sur les facteurs relatifs à l'institutionnalisation — c'est-à-dire le transfert de personnes ayant bénéficié de soins à domicile ou ayant occupé un appartement dans un immeuble à services intégrés à une maison de retraite ou à un établissement hospitalier de soins de longue durée ou à une maison de soins — que le niveau d'invalidité, le jugement porté par le personnel sur le niveau de soins approprié et l'âge étaient les facteurs les plus significatifs. La démence sénile était le facteur d'invalidité individuel le plus important, des handicaps fonctionnels et l'incontinence influant également dans une certaine mesure sur la probabilité de transfert. La déficience de l'environnement social, telles que célibat, accessibilité insuffisante au logement ou manque de soutien social ne semblaient pas pertinents — probablement parce qu'elles étaient compensées de manière adéquate par le service public d'aide familiale.

Keywords

Long-term CareElderlyDisabledInstitutionalizationSoins de longue duréepersonnes âgéesinvalidesinstitutionnalisation
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 15 , Issue 3 , Automne/Fall 1996 , pp. 427 - 441
Copyright
Copyright © Canadian Association on Gerontology 1996

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

Branch, L., & Jette, A. (1982). A prospective study of long-term care institutionalization among the aged. American Journal of Public Health, 72, 1373–1379.CrossRefGoogle ScholarPubMed
Brown, L., Potter, J., & Foster, B. (1990). Caregiver burden should be evaluated during geriatric assessment. Journal of American Geriatric Society, 38, 455–460.CrossRefGoogle ScholarPubMed
Canadian Study of Health and Aging, The. (1994). Patterns of caring for people with dementia in Canada. Canadian Journal on Aging, 13(4), 470–487.CrossRefGoogle Scholar
Cohen, M., Tell, E., & Wallack, S. (1986). Client-related risk factors of nursing home entry among elderly adults. Journal of Gerontology, 41, 785–792.CrossRefGoogle ScholarPubMed
Cohen, M., Tell, E., & Wallack, S. (1988). The risk factors of nursing home entry among residents of six continuing care retirement communities. Journal of Gerontology: SOCIAL SCIENCES, 43, S15–S21.CrossRefGoogle ScholarPubMed
Davies, B. (1991). Problems and methods in evaluating strategic innovations and reform in community care for the elderly. In Kraan, R.J. et al., Care for the elderly — significant innovations in three European countries. Frankfurt am Main: Campus-Westview.Google Scholar
Falconer, J., Naughton, B., Hughes, S., Chang, R., Singer, R., & Sinacore, J. (1992). Self-reported functional status predicts change in level of care in independent living residents of a continuing care retirement community. Journal of American Geriatrics Society, 40, 255–258.CrossRefGoogle ScholarPubMed
Foley, D.J., Ostfeld, A.M., Branch, L.G., Wallace, R.B., McGloin, J., & Cornoni-Huntley, J.C. (1992). The risk of nursing home admission in three communities. Journal of Aging and Health, 4, 155–173.CrossRefGoogle ScholarPubMed
Goldberg, E.M., & Connelly, N. (1982). The effectiveness of social care for the elderly. London: Heinemann Educational Books.Google Scholar
Heyman, A., Wilkinson, W.E., Hurwitz, B.J. et al. (1987). Early-onset Alzheimer's disease: Clinical predictors of institutionalization and death. Neurology, 37, 980–984.CrossRefGoogle ScholarPubMed
Kelman, H., & Thomas, C. (1990). Transitions between community and nursing home residence in an urban elderly population. Journal of Community Health, 15, 105–122.CrossRefGoogle Scholar
Knopman, D.S., Kitto, J., Deinard, S., & Heiring, J. (1988). Longitudinal study of death and institutionalization in patients with primary degenerative dementia. Journal of American Geriatrics Society, 36, 108–112.CrossRefGoogle ScholarPubMed
Lagergren, M. (1993a). ASIM — a system for monitoring and evaluation of the care of the elderly and disabled in a municipality. Health Services Research, 28, 27–44.Google Scholar
Lagergren, M. (1993b). The residential home — what difference does it make? Scandinavian Journal of Social Welfare, 2, 26–33.CrossRefGoogle Scholar
Lagergren, M. (1994a). Allocation of care and services in an area-based system of long-term care for the elderly and disabled. Aging and Society, 14, 357–381.CrossRefGoogle Scholar
Lagergren, M. (1994b). De-institutionalisation and aging — monitoring the effects in an area-based system of long-term care for the elderly and disabled. Health and Social Care in the Community, 2, 19–30.CrossRefGoogle Scholar
Lagergren, M. (1994c). Disability transitions in an area-based system of long-term care for the elderly and disabled. Health Policy, 28, 153–174.CrossRefGoogle Scholar
Lagergren, M. (1994d). Disability development and the structure of care — some results from simulation of an area-based system of long-term care for elderly people. Health Policy, 29, 229–246.CrossRefGoogle ScholarPubMed
Lagergren, M. (1994e). The ASIM system — A tool for monitoring, evaluation and planning of the long-term care for elderly and disabled people. Doctoral thesis at Karolinska Institute, Department of International Health and Social Medicine, Kronan Health Centre, Sundbyberg, Sweden.Google Scholar
Lagergren, M., (1996). Transfers between levels of care in a system of long-term care for the elderly and disabled. Canadian Journal on Aging, 15(1), 97–111.CrossRefGoogle Scholar
Lane, D., Uyeno, D., Stark, A., Gutman, G., & McCashin, B. (1987). Forecasting client transitions in British Columbia's long-term care program. Health Services Research, 22, 671–706.Google ScholarPubMed
Lane, D., Uyeno, D., Stark, A., Kliewer, E., & Gutman, G. (1985). Forecasting demand for long-term care services. Health Services Research, 20, 435–460.Google ScholarPubMed
Morycz, R.K. (1985). Caregiving strain and the desire to institutionalize family members with Alzheimer's disease. Possible predictors and model development. Res Aging, 7, 329–361.CrossRefGoogle ScholarPubMed
Sandman, P.O., Adolfsson, R., Norberg, A., Nyström, L., & Winblad, B. (1988). Long-term care of the elderly — a descriptive study of 3600 institutionalized patients in the county of Västerbotten, Sweden. Comprehensive Gerontology Archives, 2, 120–133.Google ScholarPubMed
Severson, M.A., Smith, G.E., Tangalos, E.G., Peterson, R.C., Kokmen, E., Ivnik, R.J., Atkinson, E.J., & Kurland, L.T. (1994). Patterns and predictors of institutionalization in community-based dementia patients. Journal of American Geriatrics Society, 42, 181–185.Google ScholarPubMed
Shapiro, E., & Tate, R. (1988). Who is really at risk of institutionalization? The Gerontologist, 28, 237–245.CrossRefGoogle ScholarPubMed
Stark, A.J., & Gutman, G.M. (1986). Client transfers in long-term care: Five years' experience. American Journal of Public Health, 76, 1312–1316.CrossRefGoogle ScholarPubMed
Stark, A.J., Kliewer, E., Gutman, G., & McCashin, B. (1984). Placement changes in long-term care: three years' experience. American Journal of Public Health, 74, 459–463.CrossRefGoogle ScholarPubMed
Thorslund, M. (1988). The de-institutionalization of care of the elderly: Some notes about implementation and outcome of a Swedish case-study. Health Policy, 10, 44–56.CrossRefGoogle ScholarPubMed
Thorslund, M., Norström, T., & Wernberg, K. (1991). The utilization of home help in Sweden: A multivariate analysis. The Gerontologist, 31, 116–119.CrossRefGoogle ScholarPubMed
Tilquin, C, & Vanderstraeten, G. (1988). Health and social resources planning based on activity analysis — A Quebec experience in the long-term care and services sector for the elderly. In Zweifel, P. (Ed.), Beiträge zur Gesundheitsökonomie Band 17: Bedarf und angebotsplanung im Gesundheitswesen. Gerlingen: Bleicher Verlag.Google Scholar
Wan, T., & Weissert, W. (1981). Social support networks, patient status and institutionalization. Research on Aging, 3, 240–256.CrossRefGoogle Scholar
Wolinsky, F.D., Callahan, C.M., Fitzgerald, J.F., & Johnson, R.J. (1993). Changes in functional status and the risks for subsequent nursing home placement and death. Journal of Gerontology: Social Sciences, 48, S93–S101.Google ScholarPubMed