This Article Full Text Full Text (PDF) Services Download to citation manager Citing Articles Citing Articles via HighWire PubMed PubMed Citation

The Transition From Home to Nursing Home Mortality Among People With Dementia

^a Department of Community Health Services, University of California, Los Angeles
^b Department of Sociology, University of Maryland, College Park
^c Department of Health Promotion and Gerontology, University of Texas, Medical Branch, Galveston

Carol S. Aneshensel, Department of Community Health Science, School of Public Health, Box 951772, University of California, Los Angeles, CA 90095-1772. Email: anshnsl@ucla.edu.

Objectives. This article examines the impact of nursing home admission on mortality among persons with dementia, comparing social selection and social causation explanations of excess deaths occurring immediately after relocation.

Methods. Data from a multiwave panel survey of caregivers to persons with Alzheimer's Disease are analyzed with proportional hazard models of time from illness onset to death of the care recipient and, for those admitted to a nursing home , time from admission until death .

Results. Relocation is associated with a two-fold increase in mortality risk net of health status. Social selection effects were found for poor health, advanced age, being male, and being White. Patients admitted for reasons other than poor health also experienced elevated mortality immediately following admission, which is inconsistent with a social selection interpretation. However, none of the specific indicators of stressful admission or unsatisfactory nursing home conditions are significantly related to mortality.

Discussion. These data demonstrate selection processes for postadmission mortality, but indicate that the admission of patients in poor health may not fully account for the elevation in mortality that occurs immediately following admission.

This article has been cited by other articles:

				R. K. Scherer, N. Scarmeas, J. Brandt, D. Blacker, M. S. Albert, and Y. Stern The Relation of Patient Dependence to Home Health Aide Use in Alzheimer's Disease J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2008; 63(9): 1005 - 1009. [Abstract] [Full Text] [PDF]

				J. E. Gaugler, A. M. Pot, and S. H. Zarit Long-Term Adaptation to Institutionalization in Dementia Caregivers Gerontologist, December 1, 2007; 47(6): 730 - 740. [Abstract] [Full Text] [PDF]

				D. Adamis, A. Treloar, F.-Z. Darwiche, N. Gregson, A. J. D. Macdonald, and F. C. Martin Associations of delirium with in-hospital and in 6-months mortality in elderly medical inpatients Age Ageing, November 1, 2007; 36(6): 644 - 649. [Abstract] [Full Text] [PDF]

				M. S. Mittelman, W. E. Haley, O. J. Clay, and D. L. Roth Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology, November 14, 2006; 67(9): 1592 - 1599. [Abstract] [Full Text] [PDF]

				M. J. McClendon, K. A. Smyth, and M. M. Neundorfer Long-term-care placement and survival of persons with Alzheimer's disease. J. Gerontol. B. Psychol. Sci. Soc. Sci., July 1, 2006; 61(4): P220 - P227. [Abstract] [Full Text] [PDF]

				R Portelli, D Lowe, P Irwin, M Pearson, and A. Rudd Institutionalization after stroke Clinical Rehabilitation, January 1, 2005; 19(1): 97 - 108. [Abstract] [PDF]