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Transitions between community and nursing home residence in an urban elderly population

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Abstract

Over the course of a three year observation and study period, some 6% of a representative community residing urban elderly population were admitted to nursing homes. Nearly half of this group were still living in nursing homes at the end of this observation period. One third had died after entering the nursing home, and the remaining people had returned to their own homes in the community. These three groups had significantly different mean lengths of stay in nursing homes; nearly two years for those whose stays were more permanent, 50 days for those whose stays were short-term, and 153 days on average for those who died following admission.

At baseline, the three groups also tended to have different patterns of health, functional and social characteristics. The short term stayers and those who died following admission to a nursing home differed from respondents who did not enter nursing homes—primarily in terms of prior living arrangements and levels of social support. The permanent stayers differed from the two other nursing home sub-groups, and from community residents, in that they tended to be older and more functionally and mentally impaired. However, at baseline they appeared at less risk to expire than those people who later died following admission to nursing homes.

Clinical and research implications based on these findings are discussed.

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Howard R. Kelman, Ph.D. is Director, and Cynthia Thomas, Ph.D. is Senior Research Associate, Division of Health Services Organization and Policy, Department of Epidemiology and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York 10467

This work was supported by grants PO1 AGO3424 and RO1 AGO8125 from the National Institute on Aging

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Kelman, H.R., Thomas, C. Transitions between community and nursing home residence in an urban elderly population. J Community Health 15, 105–122 (1990). https://doi.org/10.1007/BF01321315

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