J Richardson1, M Bedard, B Weaver. 1. Research Department, St Peter's Hospital, Hamilton, Ontario, Canada. jrichard@mcmaster.ca
Abstract
PURPOSE: Chronic care and long-term care facilities have a responsibility to provide care that enables residents to attain or maintain their maximal functional capacity. This paper uses the Minimum Data Set (MDS) to examine changes in functional health. METHODS: One hundred and thirty-eight residents were assessed quarterly using the MDS over a 12 month period in a chronic care and long-term care institution. Physical functioning was conceptualized in two areas of physical limitations (e.g. bed mobility) and disability (e.g. dressing). RESULTS: Ten percent of the residents physical functioning improved. Gender, range of motion score at baseline, change in bed mobility and change in short term memory were strong independent predictors of changes in functional activity FL adjusted R2 = 0.23, F(5156) = 10.47, p<0.0001. The strongest independent predictors of change in ADL were gender, balance while standing at baseline, joint range of motion at baseline and change in depression scores, and weight loss, adjusted R2 = 0.24 , F(4157)= 13.38, p < 0.0001. CONCLUSIONS: Most residents' physical functioning showed a deterioration or remained stable. Impairments which best explained changes in functioning such as range of motion or balance in standing are modifiable and should be targeted in interventions by nursing and rehabilitation staff.
PURPOSE: Chronic care and long-term care facilities have a responsibility to provide care that enables residents to attain or maintain their maximal functional capacity. This paper uses the Minimum Data Set (MDS) to examine changes in functional health. METHODS: One hundred and thirty-eight residents were assessed quarterly using the MDS over a 12 month period in a chronic care and long-term care institution. Physical functioning was conceptualized in two areas of physical limitations (e.g. bed mobility) and disability (e.g. dressing). RESULTS: Ten percent of the residents physical functioning improved. Gender, range of motion score at baseline, change in bed mobility and change in short term memory were strong independent predictors of changes in functional activity FL adjusted R2 = 0.23, F(5156) = 10.47, p<0.0001. The strongest independent predictors of change in ADL were gender, balance while standing at baseline, joint range of motion at baseline and change in depression scores, and weight loss, adjusted R2 = 0.24 , F(4157)= 13.38, p < 0.0001. CONCLUSIONS: Most residents' physical functioning showed a deterioration or remained stable. Impairments which best explained changes in functioning such as range of motion or balance in standing are modifiable and should be targeted in interventions by nursing and rehabilitation staff.