Influence of pre-admission factors on quality of life and adaptation in nursing home residents with dementia: the QOL-EHPAD study protocol

Roxane Villeneuve, Céline Meillon, Valérie Bergua, Maturin Tabue-Teguo, Hélène Amieva, Roxane Villeneuve, Céline Meillon, Valérie Bergua, Maturin Tabue-Teguo, Hélène Amieva

Abstract

Background: In 2015 in France, 585,560 people were nursing home residents. A large body of studies has identified predictors of poor quality of life and poor adaptation in institution, mostly for residents without dementia. With 42 to 72% of these residents diagnosed with dementia, it is crucial to identify what factors prior to admission might have an impact on quality of life once the admission is finalized, in order to target specific domains of intervention, while the person still lives at home and after his/her admission.

Methods: QOL-EHPAD is a prospective, multi-centred, observational cohort study. At baseline, we will collect retrospective data on the life of 150 persons with dementia and their caregivers. These data will refer to the conditions of admission to a nursing home (emergency admission, involvement in the decision, admission from home or from the hospital) and to the 6 months prior to the admission of the person with dementia: sociodemographic and medical data, psychological tests, information on quality of life, satisfaction, behaviour, and nutrition. Similar data about life in the nursing home will be collected after 6 months, along with information on adaptation of the person with dementia to his/her new living environment. We will use univariate regression analyses followed by stepwise linear regression models to identify which factors pertaining to life at home are associated with quality of life and adaptation after 6 months.

Discussion: This study will provide data on the impact of institutionalization on quality of life and the determinants of a successful institutionalization in people with dementia. This could be helpful in setting up targeted interventions to prepare admission into a nursing home before the actual admission and to accompany both the caregiver and the person with dementia throughout this process.

Keywords: Adaptation; Dementia; Nursing home; Predictors; Quality of life.

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. DREES. L’accueil des personnes âgées en établissement: entre progression et diversification de l’offre - Résultats de l’enquête EHPA. 2015:2017. . Accessed 30 Oct 2017.
    1. Afram B, Stephan A, Verbeek H, Bleijlevens MHC, Suhonen R, Sutcliffe C, et al. Reasons for institutionalization of people with dementia: informal caregiver reports from 8 European countries. J Am Med Dir Assoc. 2014;15:108–116. doi: 10.1016/j.jamda.2013.09.012.
    1. Gaugler JE, Duval S, Anderson KA, Kane RL. Predicting nursing home admission in the U.S: a meta-analysis. BMC Geriatr. 2007;7:13. doi: 10.1186/1471-2318-7-13.
    1. Wergeland JN, Selbæk G, Bergh S, Soederhamn U, Kirkevold Ø. Predictors for nursing home admission and death among community-dwelling people70 years and older who receive domiciliary care. Dement Geriatr Cogn Disord EXTRA. 2015;5:320–329. doi: 10.1159/000437382.
    1. Delbès C, Gaymu J. Qui vit en institution? Gérontologie Société. 2005:13–24.
    1. Kao H-F, Stuifbergen AK. Family experiences related to the decision to institutionalize an elderly member in Taiwan: an exploratory study. Soc Sci Med. 1999;49:1115–1123. doi: 10.1016/S0277-9536(99)00211-7.
    1. INSEE . Les personnes âgées. 2005.
    1. Chao S-Y, Lan Y-H, Tso H-C, Chung C-M, Neim Y-M, Clark MJ. Predictors of psychosocial adaptation among elderly residents in long-term care settings. J Nurs Res JNR. 2008;16:149–159. doi: 10.1097/01.JNR.0000387300.22172.c6.
    1. Somme D. Participation et choix des résidents dans le processus d’entrée en institution. Doss Solidar Santé. 2003:35–47.
    1. Estrada A, Cardona D, Segura ÁM, Chavarriaga LM, Ordóñez J, Osorio JJ. Calidad de vida de los adultos mayores de Medellín [in Spanish] Bioméd. 2011;31:492–502. doi: 10.7705/biomedica.v31i4.399.
    1. Chazal J. Les pathologies démentielles (maladie d’Alzheimer et maladies apparentées) des personnes âgées vivant en établissement. Doss Solidar Santé. 2011:1–76.
    1. Brandburg GL. Making the transition to nursing home life: a framework to help older adults adapt to the long-term care environment. J Gerontol Nurs. 2007;33:50–56. doi: 10.3928/00989134-20070601-08.
    1. Hoe J, Hancock G, Livingston G, Woods B, Challis D, Orrell M. Changes in the Quality of Life of People With Dementia Living in Care Homes. Alzheimer Dis Assoc Disord. 2009;23:285–290. doi: 10.1097/WAD.0b013e318194fc1e.
    1. Selwood A, Thorgrimsen L, Orrell M. Quality of life in dementia? A one-year follow-up study. Int J Geriatr Psychiatry. 2005;20:232–237. doi: 10.1002/gps.1271.
    1. Olsen C, Pedersen I, Bergland A, Enders-Slegers MJ, Jøranson N, Calogiuri G, Ihlebæk C. Differences in quality of life in home-dwelling persons and nursing home residents with dementia – a cross-sectional study. BMC Geriatr. 2016;16(1).
    1. Missotten P, Ylieff M, Di Notte D, Paquay L, De Lepeleire J, Buntinx F, et al. Quality of life in dementia: a 2-year follow-up study. Int J Geriatr Psychiatry. 2007;22:1201–1207. doi: 10.1002/gps.1814.
    1. Missotten P, Dupuis G, Adam S. Dementia-specific quality of life instruments: a conceptual analysis. Int Psychogeriatr. 2016;28:1245–1262. doi: 10.1017/S1041610216000417.
    1. Mjørud M, Røsvik J, Rokstad AMM, Kirkevold M, Engedal K. Variables associated with change in quality of life among persons with dementia in nursing homes: a 10 months follow-up study. PLoS One. 2014;9:E115248. doi: 10.1371/journal.pone.0115248.
    1. Castro-Monteiro E, Forjaz MJ, Ayala A, Rodriguez-Blazquez C, Fernandez-Mayoralas G, Diaz-Redondo A, et al. Change and predictors of quality of life in institutionalized older adults with dementia. Qual Life Res. 2014;23:2595–2601. doi: 10.1007/s11136-014-0706-8.
    1. Wetzels RB, Zuidema SU, de Jonghe JFM, Verhey FRJ, Koopmans RTCM. Determinants of quality of life in nursing home residents with dementia. Dement Geriatr Cogn Disord. 2010;29:189–197. doi: 10.1159/000280437.
    1. Beer C, Flicker L, Horner B, Bretland N, Scherer S, Lautenschlager NT, et al. Factors associated with self and informant ratings of the quality of life of people with dementia living in care facilities: a cross sectional study. PLoSOne. 2010;5:e15621. doi: 10.1371/journal.pone.0015621.
    1. Fernández-Mayoralas G, Rojo-Pérez F, Martínez-Martín P, Prieto-Flores M-E, Rodríguez-Blázquez C, Martín-García S, et al. Active ageing and quality of life: factors associated with participation in leisure activities among institutionalized older adults, with and without dementia. Aging Ment Health. 2015;19:1031–1041. doi: 10.1080/13607863.2014.996734.
    1. Altintas E, De Benedetto G, Gallouj K. Adaptation to nursing home: the role of leisure activities in light of motivation and relatedness. Arch Gerontol Geriatr. 2017;70:8–13. doi: 10.1016/j.archger.2016.12.004.
    1. Achterberg W, Pot AM, Kerkstra A, Ribbe M. Depressive symptoms in newly admitted nursing home residents. Int J Geriatr Psychiatry. 2006;21:1156–1162. doi: 10.1002/gps.1623.
    1. Scocco P, Rapattoni M, Fantoni G. Nursing home institutionalization: a source of eustress or distress for the elderly? Int J Geriatr Psychiatry. 2006;21:281–287. doi: 10.1002/gps.1453.
    1. Raggi Alberto, Corso Barbara, Minicuci Nadia, Quintas Rui, Sattin Davide, De Torres Laura, Chatterji Somnath, Frisoni Giovanni Battista, Haro Josep Maria, Koskinen Seppo, Martinuzzi Andrea, Miret Marta, Tobiasz-Adamczyk Beata, Leonardi Matilde. Determinants of Quality of Life in Ageing Populations: Results from a Cross-Sectional Study in Finland, Poland and Spain. PLOS ONE. 2016;11(7):e0159293. doi: 10.1371/journal.pone.0159293.
    1. Brownie S, Horstmanshof L, Garbutt R. Factors that impact residents’ transition and psychological adjustment to long-term aged care: a systematic literature review. Int J Nurs Stud. 2014;51:1654–1666. doi: 10.1016/j.ijnurstu.2014.04.011.
    1. Wolak A., Novella J.-L., Guillemin F., Toussaint É., Marchand A.C., Collart M., Parent A., Morrone I., Blanchard F., Jolly D. Adaptation transculturelle et validation psychométrique du Quality of Life in Alzheimer's Disease (QoL-AD) en version française. Revue d'Épidémiologie et de Santé Publique. 2009;57:S58. doi: 10.1016/j.respe.2009.02.201.
    1. Logsdon RG, Gibbons LE, McCurry SM, Teri L. Assessing quality of life in older adults with cognitive impairment. Psychosom Med. 2002;64:510–519. doi: 10.1097/00006842-200205000-00016.
    1. Novella J-L, Dhaussy G, Wolak A, Morrone I, Drame M, Blanchard F, et al. Quality of life in dementia: state of the knowledge. Gériatrie Psychol Neuropsychiatr Vieil. 2012;10:365–372.
    1. Hoe J, Katona C, Roch B, Livingston G. Use of the QOL-AD for measuring quality of life in people with severe dementia--the LASER-AD study. Age Ageing. 2005;34:130–135. doi: 10.1093/ageing/afi030.
    1. Moniz-Cook E, Vernooij-Dassen M, Woods R, Verhey F, Chattat R, De Vugt M, et al. A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health. 2008;12:14–29. doi: 10.1080/13607860801919850.
    1. Perales J, Cosco TD, Stephan BCM, Haro JM, Brayne C. Health-related quality-of-life instruments for Alzheimer’s disease and mixed dementia. Int Psychogeriatr. 2013;25:691–706. doi: 10.1017/S1041610212002293.
    1. Castonguay G, Ferron S. Élaboration et validation d’un instrument évaluant le degré d’adaptation de la personne âgée à sa résidence. Can J Aging Rev Can Vieil. 1999;18:363–375. doi: 10.1017/S0714980800009922.
    1. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483. doi: 10.1097/00005650-199206000-00002.
    1. Ware J, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–233. doi: 10.1097/00005650-199603000-00003.
    1. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The neuropsychiatric inventory comprehensive assessment of psychopathology in dementia. Neurol. 1994;44:2308. doi: 10.1212/WNL.44.12.2308.
    1. Zarit S, Orr NK, Zarit JM. The hidden victims of Alzheimer’s disease: families under stress. New York: NYU Press; 1985.
    1. Guigoz Y, Vellas B, Garry PJ. Mini nutritional assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts Res Interv Geriatr. 1997:15–60.
    1. Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. The Gerontologist. 1970;10:20–30. doi: 10.1093/geront/10.1_Part_1.20.
    1. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–186. doi: 10.1093/geront/9.3_Part_1.179.
    1. Gosling SD, Rentfrow PJ, Swann WB., Jr A very brief measure of the big-five personality domains. J Res Personal. 2003;37:504–528. doi: 10.1016/S0092-6566(03)00046-1.
    1. Bouisson J. Routinization preferences, anxiety, and depression in an elderly French sample. J Aging Stud. 2002;16:295–302. doi: 10.1016/S0890-4065(02)00051-8.
    1. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–198. doi: 10.1016/0022-3956(75)90026-6.
    1. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401. doi: 10.1177/014662167700100306.
    1. Fuhrer R, Rouillon F. The French version of the Center for Epidemiologic Studies - Depression Scale. Psychiatr Psychobiol. 1989;4:163–166.
    1. Beerens HC, Sutcliffe C, Renom-Guiteras A, Soto ME, Suhonen R, Zabalegui A, et al. Quality of life and quality of care for people with dementia receiving long term institutional care or professional home care: the European RightTimePlaceCare Study. J Am Med Dir Assoc. 2014;15:54–61. doi: 10.1016/j.jamda.2013.09.010.
    1. RStudio Team . RStudio: integrated development for R. Inc. RStudio: Boston, MA; 2016.
    1. Lawrence V, Fossey J, Ballard C, Moniz-Cook E, Murray J. Improving quality of life for people with dementia in care homes : making psychosocial interventions work. Br J Psychiatry. 2012;201:344–351. doi: 10.1192/bjp.bp.111.101402.
    1. Mittelman MS, Haley WE, Clay OJ, Roth DL. Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology. 2006;67:1592. doi: 10.1212/01.wnl.0000242727.81172.91.

Source: PubMed

3
Suscribir