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Cited by 22Geriatric Care and Nursing HomesDementia and Cognitive Impairment ResearchHealthcare Quality and Management

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Monitoring Quality of Care for Nursing Home Residents With Behavioral and Psychological Symptoms Related to Dementia

Nazir, Arif, Arling, Greg, Perkins, Anthony J., Boustani, Malaz·2011·Journal of the American Medical Directors Association
DOI 10.1016/j.jamda.2010.11.005
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Abstract

Background Behavioral and psychological symptoms associated with dementia are common in nursing home residents. Quality indicators (QI) assessing quality of care for these residents are minimally risk adjusted and can provide inaccurate information regarding the quality of care provided by the facility. Objective Evaluate the performance of a new QI for the incidence of worsening behaviors in nursing home residents with behavioral and psychological symptoms association with dementia. Design Retrospective cohort study. Setting A total of 381 Minnesota nursing homes with 26,165 residents. Data sources Minimum Data Set records for the first 2 calendar quarters of 2008. Measurements We calculated incidence of worsening behaviors QI by comparing items from the "behavior" section of the Minimum Data Set records from 2 consecutive quarters and reported the incidence rates by both the residents' level of cognitive impairment and the presence or absence of special care unit for dementia (SCU). Results The incidence rates of the worsening behavior QI in SCU ranged from 14% in residents with very severe cognitive impairment (a cognitive performance score = 6) to 30% in those with moderate cognitive impairment (a cognitive performance score = 3). The incidence QI rates among residents residing in conventional unit ranged from 15% among those with very severe cognitive impairment to 20% among those with moderate cognitive impairment. These differences in QI rates between the 2 units were statistically significant with a P value = .001. After risk adjustment for level of cognitive impairment, number of facilities with SCUs that flagged for problem behaviors dropped from 18.4% to 12.4% and the number of conventional units in the low-risk category from 16.8% to 4.7%. Conclusion Resident cognitive function and the facility utility of SCU are associated with worsening behavior QI and should be adjusted for in any nursing home quality reporting measure.

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Metadata

Authors
Nazir, A., Arling, G., Perkins, A. J., & Boustani, M.
Affiliations
  • Indiana University Indianapolis (US)
  • Regenstrief Institute (US)
Corresponding author
Nazir, Arif
ORCID
Venue
Journal of the American Medical Directors Association
Publisher
Elsevier BV
Published
2011-11
Volume
12
Issue
9
Pages
660-667
ISSN
1525-8610 (ISSN-L)
DOI
10.1016/j.jamda.2010.11.005
OpenAlex
W2093331310
Cited by
22
References
1
Citations by year
2025: 1 · 2024: 1 · 2023: 2 · 2021: 1 · 2018: 1 · 2017: 1 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 4
FWCI
6.82
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Medical Directors Association (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
Keywords
behavioral and psychological symptoms of dementia, nursing home quality of care, quality indicators, risk adjustment, cognitive impairment severity, Minimum Data Set
MeSH terms
Aged, Aged, 80 and over, Mental Disorders, Dementia, Female, Humans, Male, Minnesota, Nursing Homes, Quality Assurance, Health Care, Retrospective Studies, Severity of Illness Index, Quality Indicators, Health Care

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