Permanent transition of homecare recipients with dementia to nursing homes in New York State: Risk factors.

• This study examine determinants associated with the permanent transition to nursing home among home care recipients with dementia. We identified two potentially preventable risk factors associated with permanent transition to nursing homes: depression and incontinence. In addition, having hip fracture and higher number of hospitalizations necessitated the transition. • Decision to make permanent transition from homes in the community to nursing homes is often not a personal choice, but driven by other factors, such as cognitive impairment, severe functional disabilities, availability of informal caregivers, cost, etc. The burden of disease and human toll of dementia is not only affected the individual with dementia, their caregivers, but also the society as well. • We anticipate that this study will refocus attention on the early diagnosis and treatment of depression and incontinence among older adults with dementia. Intervention strategies designed to prevent falls and hospitalizations may delay permanent transition to nursing homes. This retrospective cohort study uses the Minimum Data Set (MDS) and Outcome and Assessment Information Set (OASIS) to determine predictors associated with permanent transition to nursing homes among home care recipients with dementia. Study participants include older adults age 65+ with dementia who received home health services in New York State for at least 2 months prior to permanent transition to nursing homes. Multivariate logistic regression was used to quantify the association between predictors and permanent transition to nursing homes. Risk factors associated with permanent transition included increasing age (OR = 1.1; 95% CI 1.03-1.18); white compared to black (OR = 1.25; 95%CI 0.83-0.94), urinary and bowel incontinence vs. continence (OR = 1.46; 95% CI 1.37-1.56); depression vs. no depression (OR = 1.2; 95% CI 1.11-1.25); hip fracture vs. no hip fracture (OR = 2.63; 95% CI 2.27-3.05), and 3+ hospitalizations vs. no hospitalizations (OR = 3.02; 95% CI 2.77-3.29). Early diagnosis and treatment may delay or avert nursing home entry. [ABSTRACT FROM AUTHOR]