Paper
Thursday, July 12, 2007
This presentation is part of : Sub-Acute Care Strategies
Predictive Variables for Mortality Following Involuntary Interinstitutional Relocation
Ann Laughlin, PhD, RN and Mary Parsons. Creighton University School of Nursing, Omaha, NE, USA
Learning Objective #1: Identify specific characteristics of individuals considered high risk for mortality following involuntary interinstitutional relocation
Learning Objective #2: Discuss strategies health care providers can implement prior to and following involuntary relocation with "high risk" individuals.

 

 

 

 

 

Moving is hard work.  Even planned and desired moves can be disruptive.  While a great deal of research has been conducted on the negative effects of involuntary relocation, there is a paucity of literature related to characteristics of individuals most susceptible to those effects.  Data from two separate studies (Parsons, 2004 & Laughlin, 2005) were analyzed in order to determine if relocation had a significant effect on mortality and to identify risk factors for death.  Mortality statistics were computed after a nursing home closed unexpectedly, forcing the relocation of residents.  Forty six percent of individuals who were relocated died within the first year.  By comparison, only 19% in the control group died.  This difference was significant (Laughlin, 2005).  Data from the Minimum Data sets were obtained three months prior to relocation.  Total scores were computed for cognitive abilities, mood and behavior patterns, and physical functioning.  A Cox regression model was utilized in order to identify predictive variables for mortality.  Individuals with higher scores on the cognitive performance scale, mood and behavior patterns, and physical functioning were more likely to die.  Higher scores in these areas indicated more cognitive impairments, increased reports of anxious or depressed behaviors, and a greater degree of assistance needed with activities of daily living.  In addition, age was correlated with mortality, with the old-old (85-90 years old) most likely to die.  Findings suggest that health care providers need to be pro-active and implement strategies, especially with high risk individuals, in the event of involuntary relocation.  These strategies should include encouraging the resident to verbalize their feelings related to the move, assisting them to develop effective coping mechanisms, identifying and utilizing support systems, and providing opportunities for success in the new environment.