Predictors of geriatric institutionalization : an exploratory comparison of semi-supportive housing and professional home health care

Abstract

This study examined two distinct types of elderly supportive care for their efficacy in meeting the overall needs of their clients and reducing the risk of institutionalization. Recipients of (a) professional home care and (b) residents of a semi-supportive housing unit were assessed utilizing the Resident Assessment Instrument for Home Care (RAI-HC), Version 2. The groups were assessed and compared for their baseline measurements on 23 indices o f functional indicators including; cognitive and physiological functioning, current levels o f Activities o f Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), psychological and social functioning, and rates of lnstitutional Risk. In addition, institutional admission and mortality rates were collected at one-year follow-up for the Semi-Supportive Housing group to identify predictor variables that preceded these two outcomes (institutionalization and mortality). Baseline measurement results revealed that that Semi-Supportive Housing group evidenced a lower risk of institutionalization despite being an older population and having more urinary and behavioral problems than did the Home Care group. The Semi-Supportive Housing group also reported less difficulty with managing their Activities of Daily Living (ADL's) in comparison to the Home Care group. Only one predictor variable (of 23) emerged as significant in relation to the actual outcome of institutionalization As such, semi-supportive housing residents triggering the Health Promotion variable displayed a reduced risk of subsequent admittance to long-term nursing home care in comparison to those residents not triggering tins variable.