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P3‐365: PREVALENCE AND RELATED FACTORS OF ADVANCED DIRECTIVES AMONG NURSING HOME RESIDENTS WITH DEMENTIA IN NORTHERN TAIWAN
Author(s) -
Huang HsiuLi,
Shyu Yeaing,
Weng LiChueh,
Chang Mei,
Wang WanShuan
Publication year - 2014
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2014.05.1459
Subject(s) - dementia , medicine , nursing homes , family medicine , cross sectional study , family caregivers , family member , gerontology , nursing , disease , pathology
Background: Previous research suggested that missed and delayed dementia diagnosis were substantial among residential care facility (RCF) clients. In recent decades,many countries around theworld, includingCanada, experienced a major shift in health care restructuring where home care (HC) was heavily promoted as a cost-efficient alternative to traditional institutionalstyle care. However, little has been explored to compare the welfares of individuals who received these services. The purpose of this study was to compare the levels of cognitive function and their ability to perform dayto-day activities at the time of diagnosis of dementia, between RCF and HC clients. We hypothesized that RCF clients were more likely to have a diagnosis at later stages of decline in both cognitive function and ability to perform activities of daily living than HC clients. Methods: We utilized a population-based secondary data analysis approach, using data from the Canadian Institute for Health Information’s Continuing Care Reporting System and Home Care Reporting System from 2009-2011. Main variables of interest were cognitive function (CF) and activity of daily living (ADL) at the time of diagnosis. CF within 30 days of diagnosis was measured by a 7-point cognitive performance scale (CPS) 0 (intact) to 6 (very severe impairment). ADL score was measure by a 7-point scale 0 (independent) to 6 (total dependence). Results: Data were extracted from 24,574 RCF clients and 11,746 HC clients, all with a diagnosis of dementia. Average CPS scorewas higher for the RCF group (3.1 vs. 2.3, p1⁄40.0001). Proportion of diagnosis at CPS 4 (moderately severe to very severe impairment) was also higher in the RCF group (29.4% vs. 9.7%, p1⁄40.0001). Average ADL scorewas 3.4 for RCF clients and 1.1 for HC clients (p1⁄40.0001). Proportion of diagnosis at ADL 3 (required extensive assistance to total dependence) was 71.2% for RCF clients and 14.7% for HC clients (p1⁄40.0001). Proportion of diagnosis made at CPS 4 and ADL 3 were significantly higher in the RCF group than in the HC group (26.9% vs. 4.9%, p1⁄40.0001). Conclusions:Our findings suggest that RCF clients are more likely to experience diagnoses at poorer stages of CF and ADL than HC clients.