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Nursing home admission decision-making: Working age residents' perspective

Claudia Rosu, MD, Public Policy Department, UMBC, 1000 Hilltop Circle, Baltimore, MD 21250, 410-455-1385, crosu1@umbc.edu and Nancy A Miller, PHD, Department of Public Policy, UMBC, 1000 Hilltop Circle, Baltimore, MD 21250.

There have been marked changes in the demographics of nursing homes’ residents in the last decade. The working age adults, many of them with mental health problems, are an increasing share of residents. Little is known to date about their values and preferences in long term care and this may affect the quality of care in these “total institutions”. Although quantitative inquiry is able to elicit important intervening variables, what residents have to tell us is of unique worth. The present study is a qualitative analysis that attempts to understand the “emic”, or the insider perspective on the “lived experience” of entering a nursing home, based on the fact that any individual is shaped by personal experience, and cultural and social ties. A purposive sample of 200 working age nursing home residents was selected and data were gathered using semi-structured and open-ended questions. This information was triangulated with medical history interviews and the results of a quantitative analysis. The findings of this study point out that the decision-making process to enter a nursing home is a negative experience for many younger residents. Themes like disempowerment, lack of choices, family conflict over the decision, and deficient communication with the health care provider or the social worker in charge with the process emerged. By listening to the voices of “those rarely heard” all those involved in decisions regarding nursing home care can improve the transition to nursing home life.

Learning Objectives:

Keywords: Nursing Homes, Decision-Making

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Exploring the Social Environment of Older Adults

The 132nd Annual Meeting (November 6-10, 2004) of APHA