Bathing a marker for nursing home

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By Joyce Howard Price
September 5, 2006

Persistent problems with bathing increase an elderly person’s risk of long-term nursing home admission by 77 percent and are the main reason why older people need nursing care at home, a new study has found.
The study, conducted by researchers with the Dorothy Adler Geriatric Assessment Center at the Yale University School of Medicine, was published in the August issue of the Journal of Gerontology: Medical Sciences.
“Disability in bathing — the need for personal assistance to wash and dry one’s whole body — is highly prevalent in older persons and is a strong predictor of morbidity and mortality,” said Dr. Thomas Gill, professor of medicine, epidemiology and public health at Yale, who led the research.
Dr. Gill and his colleagues followed 754 persons aged 70 and older, who lived in New Haven, Conn. and were not disabled, for more than six years to determine the effect of the need for help with bathing.
Participants were followed with monthly phone calls to find out the occurrence of persistent bathing disability, defined as body-cleansing problems that existed for at least two consecutive months, and the time to the person’s first long-term admission to a nursing home, meaning a stay that lasted for at least three months.
“One-hundred-thirteen participants, or 15 percent, had a long-term nursing home admission,” the authors of the report wrote.
“At least one episode of persistent bathing disability occurred among 59 participants, or 52.2 percent, of those with a long-term nursing home admission, and [among] 210, or 32.8 percent, of those without a long-term admission,” they explained.
They concluded the occurrence of persistent bathing disability elevated the risk of long-term nursing home admission by 77 percent, but that it had no effect on the risk of a short-term nursing home admission.
Dr. Gill said that the graying of the American populace means that “identifying potentially modifiable risk factors for persistent bathing disability should be a high research priority,” since preventing and correcting such difficulties “can reduce the burden and expense of long-term care services.”
A focus of such research is expected to be on finding ways to help brittle-boned older people avoid falling in the bathtub or shower and fracturing bones, such as greater use of “shower chairs” and installing metal handlebars on tubs.
The Yale research, funded by the National Institute on Aging, is part of an ongoing study that seeks to discover how older persons manage day-to-day activities and remain independent at home

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