Clinical outcomes of aging in place

Karen Marek, Lori Popejoy, Greg Petroski, David Mehr, Marilyn Rantz, Wen Chieh Lin

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background: Programs such as Medicaid Home and Community-based Services (HCBS) have provided an alternative to institutionalization through community-based, long-term care services; however, there are limited studies on the clinical outcomes of participants in these programs as compared to nursing home (NH) residents. Objective: To compare clinical outcomes of individuals in a community-based, long-term care program to individuals of similar case mix in institutional-based, long-term care. Methods: A program called Aging in Place (AIP) was developed by the Sinclair School of Nursing in cooperation with the state of Missouri's HCBS program. The AIP intervention consisted of nurse coordination of the HCBS program and Medicare home health services. A total of 78 AIP participants were matched with 78 NH residents on admission period, activities of daily living (ADLs), cognitive status, and age. The Minimum Data Set (MDS) was collected on the AIP group at admission and every 6 months over a 30-month period. Cognition was measured by the MDS Cognitive Performance Scale (CPS), ADLs by the sum of 5 MDS ADL items, depression by the MDS-Depression Rating Scale, and incontinence by rating on 2 MDS items related to urinary continence. The Cochran-Mantel-Haenszel method was used to test the association between the AIP intervention and clinical outcomes. Results: The AIP group clinical outcomes were better at a statistically significant level (less than .05) for the following outcomes: (a) cognition at 6, 12, and 18 months (p = .00); (b) depression at 6 and 12 months (p = .00); (c) ADL at 6 (p = .02), 12 (p = .04), and 24 (p = .00) months; and (d) incontinence at 24 (p = .02) months. In all 4 outcome measures, the AIP group stabilized or improved outcome scores whereas the NH group's outcome scores deteriorated. Discussion: Study results suggest that community-based care with nurse coordination enhances clinical outcomes of long-term care participants.

Original languageEnglish (US)
Pages (from-to)202-211
Number of pages10
JournalNursing Research
Volume54
Issue number3
StatePublished - May 2005
Externally publishedYes

Fingerprint

Independent Living
Long-Term Care
Activities of Daily Living
Social Welfare
Nursing Homes
Depression
Cognition
School Nursing
Institutionalization
Community Health Nurses
Diagnosis-Related Groups
Medicaid
Medicare
Health Services
Nurses
Outcome Assessment (Health Care)
Datasets

Keywords

  • Home and community based services
  • Long-term care
  • Nursing case management

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Marek, K., Popejoy, L., Petroski, G., Mehr, D., Rantz, M., & Lin, W. C. (2005). Clinical outcomes of aging in place. Nursing Research, 54(3), 202-211.

Clinical outcomes of aging in place. / Marek, Karen; Popejoy, Lori; Petroski, Greg; Mehr, David; Rantz, Marilyn; Lin, Wen Chieh.

In: Nursing Research, Vol. 54, No. 3, 05.2005, p. 202-211.

Research output: Contribution to journalArticle

Marek, K, Popejoy, L, Petroski, G, Mehr, D, Rantz, M & Lin, WC 2005, 'Clinical outcomes of aging in place', Nursing Research, vol. 54, no. 3, pp. 202-211.
Marek K, Popejoy L, Petroski G, Mehr D, Rantz M, Lin WC. Clinical outcomes of aging in place. Nursing Research. 2005 May;54(3):202-211.
Marek, Karen ; Popejoy, Lori ; Petroski, Greg ; Mehr, David ; Rantz, Marilyn ; Lin, Wen Chieh. / Clinical outcomes of aging in place. In: Nursing Research. 2005 ; Vol. 54, No. 3. pp. 202-211.
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