Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Systematic Reviews
Published in: Systematic Reviews 1/2019

Open Access 01-12-2019 | Care | Research

Factors associated with length of stay in care homes: a systematic review of international literature

Authors: Danni Collingridge Moore, Thomas J. Keegan, Lesley Dunleavy, Katherine Froggatt

Published in: Systematic Reviews | Issue 1/2019

Login to get access

Abstract

Background

A number of studies have explored factors associated with resident length of stay in care homes; however the findings of these studies have not been synthesized. The aim of this paper is to provide a systematic review of factors associated with length of stay until death and the strength of evidence supporting each of these factors.

Methodology

This is a systematic review; databases included MEDLINE, EMBASE, PsycINFO, CINAHL, Proquest, the Cochrane Library and Web of Science were searched. Observational studies, either prospective or retrospective, that explored multiple factors associated with length of stay until death in care homes were included. Studies that met the inclusion criteria were sourced, data extracted and assessed for quality. Data synthesis combined the direction and significance of association with the quality of the study, resulting in strong, moderate, weak or inconclusive evidence for each factor identified.

Results

Forty-seven studies were identified as meeting the inclusion criteria. After quality assessment, 14 studies were judged to be of a high quality, 31 of a moderate quality and 2 of a low quality. Three factors had strong evidence to support their association with shorter lengths of stay: shortness of breath, receipt of oxygen therapy and admission to a facility providing nursing care.

Conclusions

This review summarized the factors associated with length of stay. It found stronger evidence for physical functioning being associated with shorter lengths of stay than for cognitive functioning. An understanding of expected length of stay for older adults admitted to a care home is important for estimating lifetime costs and the implications of reforming funding arrangements for social care. Further research is needed to explore heterogeneity in this area.
Appendix
Available only for authorised users
Literature
1.
United Nations Department of Economic and Social Affairs Population Division. World Population Ageing 2017 - Highlights. 2017. New York: ST/ESA/SER.A/397.
2.
United Nations Department of Economic and Social Affairs Population Division. World Population Prospects: the 2017 Revision.2017.New York: ESA/P/WP/248 2017.
3.
4.
Gomes B, Calanzani N, Gysels M, Hall S, Higginson I. Heterogeneity and changes in preferences for dying at home: a systematic review. BMC Palliat Care. 2013;12:7.PubMedPubMedCentralCrossRef
5.
Houttekier D, Cohen J, Bilsen J, Addington-Hall J, Onwuteaka-Philipsen BD, Deliens L. Place of death of older persons with dementia. A study in five European countries. J Am Geriatr Soc. 2010;58(4):751–6.PubMedCrossRef
6.
Mitchell SL, Teno JM, Miller SC, Mor V. A National Study of the location of death for older persons with dementia. J Am Geriatr Soc. 2005;53(2):299–305.PubMedCrossRef
7.
Bone AE, Gomes B, Etkind SN, Verne J, Murtagh FEM, Evans CJ, et al. What is the impact of population ageing on the future provision of end-of-life care? Population-based projections of place of death. Palliat Med. 2018;32(2):329–36.PubMedCrossRef
8.
Froggatt K, Reitinger E. Palliative care in term care settings for older people. Report of an EAPC taskforce 2010–2012. European Association of Palliative Care: Milan; 2013.
9.
Luppa M, Luck T, Weyerer S, König H-H, Brähler E, Riedel-Heller S. Prediction of institutionalization in the elderly. A systematic review. Age Ageing. 2010;39(1):31–8.PubMedCrossRef
10.
Shah SM. Identifying the clinical characteristics of older people living in care homes using a novel approach in a primary care database. Age Ageing. 2010;39:617–23.PubMedCrossRef
11.
Groom L, Avery AJ, Boot D, O'Neill C, Thornhill K, Brown K, et al. The impact of nursing home patients on general practitioners’ workload. Br J Gen Pract. 2000;50(455):473–6.PubMedPubMedCentral
12.
Godden S, Pollock AM. The use of acute hospital services by elderly residents of nursing and residential care homes. Health Soc Care Community. 2001;9(6):367–74.PubMedCrossRef
13.
14.
Barclay S, Froggatt K, Crang C, Mathie E, Handley M, Iliffe S, et al. Living in uncertain times: trajectories to death in residential care homes. Br J Gen Pract. 2014;64(626):e576–e83.PubMedPubMedCentralCrossRef
15.
16.
17.
Boersch-Supan A, Brandt M, Hunkler C, Kneip T, Korbmacher J, Malter F, et al. Data resource profile: the survey of health, ageing and retirement in Europe (SHARE). Int J Epidemiol. 2013;42(4):992–1001.CrossRef
18.
Collingridge Moore D, Hanratty B. Out of sight, out of mind? A review of data available on the health of care home residents in longitudinal and nationally representative cross-sectional studies in the UK and Ireland. Age Ageing. 2013;42(6):798–803.CrossRef
19.
20.
Reitinger E, Froggatt K, Brazil K, Heimerl K, Hockley J, Kunz R, et al. Palliative care in long-term care settings for older people : findings from an EAPC taskforce. Eur J Palliat Care. 2013;20(5):251–3.
21.
Froggatt K, Edwards M, Morbey H, Payne S. Mapping palliative care systems in long term care facilties in Europe Lancaster. United Kingdom: Lancaster University; 2016.
22.
Kruse RL, Oliver DP, Mehr DR, Petroski GF, Swenson DL, Zweig SC. Using mortality risk scores for long-term prognosis of nursing home residents: caution is recommended. J Gerontol Ser A Biol Sci Med Sci. 2010;65A(11):1235–41.CrossRef
23.
Porock D, Parker-Oliver D, Petroski GF, Rantz M. The MDS mortality risk index: the evolution of a method for predicting 6-month mortality in nursing home residents. BMC Res Notes. 2010;3:200.PubMedPubMedCentralCrossRef
24.
Mitchell S, Miller S, Teno J, Kiely D, Davis R, Shaffer M. Prediction of 6-month survival of nursing home residents with advanced dementia using ADEPT vs hospice eligibility guidelines. JAMA. 2010;304(17):1929–35.PubMedPubMedCentralCrossRef
25.
Thomas JM, Cooney LM, Fried TR. Systematic review: health-related characteristics of elderly hospitalized adults and nursing home residents associated with short-term mortality. J Am Geriatr Soc. 2013;61(6):902–11.PubMedPubMedCentralCrossRef
26.
Moher D, Liberati A, Tetzlaff J, Altman D for the PRISMA group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.PubMedPubMedCentralCrossRef
27.
Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) explanation and elaboration. Epidemiology. 2007;18(6):805–35.PubMedCrossRef
28.
Engle VF, Graney MJ. Predicting outcomes of nursing-home residents - death and discharge home. J Gerontol. 1993;48(5):S269–S75.PubMedCrossRef
29.
Hedinger D, Hammig O, Bopp M, Swiss National Cohort Study G. Social determinants of duration of last nursing home stay at the end of life in Switzerland: a retrospective cohort study. BMC Geriatr. 2015;15:114.PubMedPubMedCentralCrossRef
30.
Sanderson S, Tatt LD, Higgins JPT. Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int J Epidemiol. 2007;36(3):666–76.PubMedCrossRef
31.
Qaseem A, Snow V, Shekelle P, Casey DE, Cross JT, Owens DK, et al. Evidence-based interventions to improve the palliative care of pain, dyspnea, and depression at the end of life: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;148(2):141–6.PubMedCrossRef
32.
Suominen M, Muurinen S, Routasalo P, Soini H, Suur-Uski I, Peiponen A, et al. Malnutrition and associated factors among aged residents in all nursing homes in Helsinki. Eur J Clin Nutr. 2005;59(4):578–83.PubMedCrossRef
33.
Darton R, Bäumker T, Callaghan L, Holder J, Netten A, Towers A-M. The characteristics of residents in extra care housing and care homes in England. Health Soc Care Community. 2012;20(1):87–96.PubMedCrossRef
34.
Mitchell S, Loew J, Millington-Sanders C, Dale J. Providing end-of-life care in general practice: findings of a national GP questionnaire survey. Br J Gen Pract. 2016;66(650):e647–e53.PubMedPubMedCentralCrossRef
35.
Caplan GA, Meller A, Squires B, Chan S, Willett W. Advance care planning and hospital in the nursing home. Age Ageing. 2006;35(6):581–5.PubMedCrossRef
36.
Glaser K, Grundy E, Lynch K. Transitions to supported environments in England and Wales among elderly widowed and divorced women: the changing balance between co-residence with family and institutional care. J Women Aging. 2003;15(2–3):107–26.PubMedCrossRef
37.
Chatterji S, Byles J, Cutler D. Health, functioning, and disability in older adults-present status and future implications. Lancet. 2015;385(9967):508.CrossRef
38.
Fries JF. Measuring and monitoring success in compressing morbidity. Ann Intern Med. 2003;139(5):455–9.PubMedCrossRef
39.
Xie J, Brayne C, Matthews FE. Medical Research Council. Survival times in people with dementia: analysis from population based cohort study with 14 year follow-up. Br Med J. 2008;336(7638):258–62.CrossRef
40.
41.
Bertrand RM, Fredman L, Saczynski J. Are all caregivers created equal? Stress in caregivers to adults with and without dementia. J Aging Health. 2006;18(4):534–51.PubMedCrossRef
42.
Ory MG, Hoffman RR, Yee JL, Tennstedt S, Schulz R. Prevalence and impact of caregiving: a detailed comparison between dementia and nondementia caregivers. Gerontologist. 1999;39(2):177–85.PubMedCrossRef
43.
Reilly S, Abendstern M, Hughes J, Challis D, Venables DAN, Pedersen I. Quality in long-term care homes for people with dementia: an assessment of specialist provision. Ageing Soc. 2006;26(4):649–68.CrossRef
44.
Sloane PD, Zimmerman S, Gruber-Baldini AL, Hebel JR, Magaziner J, Konrad TR. Health and functional outcomes and health care utilization of persons with dementia in residential care and assisted living facilities: comparison with nursing homes. Gerontologist. 2005;45(1):124–34.PubMedCrossRef
Metadata
Title
Factors associated with length of stay in care homes: a systematic review of international literature
Authors
Danni Collingridge Moore
Thomas J. Keegan
Lesley Dunleavy
Katherine Froggatt
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-019-0973-0

Other articles of this Issue 1/2019

Systematic Reviews 1/2019 Go to the issue

Protocol

Associations between school-based peer networks and smoking according to socioeconomic status and tobacco control context: protocol for a mixed method systematic review

Systematic review update

Evidence of past dental visits and incidence of head and neck cancers: a systematic review and meta-analysis

Protocol

Prevalence of type 2 diabetes mellitus among hepatitis C virus-infected patients: a protocol for systematic review and meta-analysis

Protocol

Non-Interventional Factors Influencing Velopharyngeal Function For Speech In Initial Cleft Palate Repair: A Systematic Review Protocol

Protocol

The association between socioeconomic status and pandemic influenza: protocol for a systematic review and meta-analysis

Protocol

Psychometric properties of the Jefferson Scale of Empathy: a COSMIN systematic review protocol