The Effect on Nursing Home Resident Outcomes of Creating a Household Within a Traditional Structure

OBJECTIVES: Person-centered care (PCC) is a revolutionary approach to the culture change of elder care that is being adopted by nursing home providers across the nation. One aspect of PCC is the introduction of more self-contained units or households within long term care facilities. This study aimed to evaluate the effect of households on nursing home residents' physical and psychological outcomes using the Minimum Data Set (MDS) comprehensive assessment data. DESIGN: A retrospective, longitudinal study. SETTING: Two care units in a large urban nursing home within the Western New York long term care system. PARTICIPANTS: Residents living in two units (household unit and traditional care unit) within one nursing home during January 2005 to April 2007. MEASUREMENTS: The MDS 2.0 is a standardized and comprehensive assessment tool that measures long term care facility residents' functional, medical, cognitive, and psycho-social status. The de-identified MDS 2.0 records of residents living in these units during this time period were retrieved from the New York Association of Homes and Services for the Aging. The residents' cognitive patterns, mood and behavior pattern, physical functioning, pain, fall, nutritional status, number of ulcers, medication use, and special treatment were compared. Descriptive and correlational statistics were used for data analysis. RESULTS: MDS records of 35 household-unit residents and 33 traditional-unit residents were analyzed. After adjusting for baseline differences, household-unit residents had better self- performed eating ability, daytime sleepiness, and restraint use; however, more fall incidents were reported for the household unit. CONCLUSIONS: Our findings indicate that households generated some better outcomes for residents and provide preliminary evidence to support households in nursing homes. Further research is needed to overcome design issues; however, the MDS may be useful for PCC outcomes measurement.