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Naylor MD, Hirschman KB, Hanlon AL, et al. Factors Associated With Changes in Perceived Quality of Life Among Elderly Recipients of Long-Term Services and Supports. J Am Med Dir Assoc. 2015;17(1):44-52doi: 10.1016/j.jamda.2015.07.019.
Naylor, M. D., Hirschman, K. B., Hanlon, A. L., Abbott, K. M., Bowles, K. H., Foust, J., Shah, S., & Zubritsky, C. (2016). Factors Associated With Changes in Perceived Quality of Life Among Elderly Recipients of Long-Term Services and Supports. Journal of the American Medical Directors Association, 17(1), 44-52. https://doi.org/10.1016/j.jamda.2015.07.019
Naylor, Mary D, et al. "Factors Associated With Changes in Perceived Quality of Life Among Elderly Recipients of Long-Term Services and Supports." Journal of the American Medical Directors Association vol. 17,1 (2016): 44-52. doi: https://doi.org/10.1016/j.jamda.2015.07.019
Naylor MD, Hirschman KB, Hanlon AL, Abbott KM, Bowles KH, Foust J, Shah S, Zubritsky C. Factors Associated With Changes in Perceived Quality of Life Among Elderly Recipients of Long-Term Services and Supports. J Am Med Dir Assoc. 2016 Jan;17(1):44-52. doi: 10.1016/j.jamda.2015.07.019. Epub 2015 Sep 26. PMID: 26412018; PMCID: PMC4696886.
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J Am Med Dir Assoc. 2016 Jan;17(1):44-52. doi: 10.1016/j.jamda.2015.07.019. Epub 2015 Sep 26.

Factors Associated With Changes in Perceived Quality of Life Among Elderly Recipients of Long-Term Services and Supports.

Journal of the American Medical Directors Association

Mary D Naylor, Karen B Hirschman, Alexandra L Hanlon, Katherine M Abbott, Kathryn H Bowles, Janice Foust, Shivani Shah, Cynthia Zubritsky

Affiliations

  1. NewCourtland Center for Transitions and Health; University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania. Electronic address: [email protected].
  2. NewCourtland Center for Transitions and Health; University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.
  3. Miami University, Department of Sociology and Gerontology, Scripps Research Center, Oxford, OH.
  4. College of Nursing and Health Sciences, University of Massachusetts - Boston, Boston, MA.
  5. Center for Home Care Policy and Research, Visiting Nurse Service of New York, New York, NY.
  6. University of Pennsylvania School of Medicine, Department of Psychiatry, Philadelphia, PA.

PMID: 26412018 PMCID: PMC4696886 DOI: 10.1016/j.jamda.2015.07.019

Abstract

OBJECTIVES: Advance knowledge about changes in multiple dimensions of health related quality of life (HRQoL) among older adults receiving long-term services and supports (LTSS) over time and across settings.

DESIGN: A prospective, observational, longitudinal cohort design.

SETTING: Nursing homes (NHs), assisted living facilities (ALFs), community.

PARTICIPANTS: A total of 470 older adults who were first-time recipients of LTSS.

MEASUREMENT: Single-item quality-of-life measure assessed every 3 months over 2 years. HRQoL domains of emotional status, functional status, and social support were measured using standardized instruments.

RESULTS: Multivariable mixed effects model with time varying covariates revealed that quality-of-life ratings decreased over time (P < .001). Quality-of-life ratings were higher among enrollees with fewer depressive symptoms (P < .001), higher general physical function (P < .001), enhanced emotional well-being (P < .001), and greater social support (P = .004). Ratings also were higher among those with increased deficits in activities of daily living (P = .02). Ratings were highest among enrollees who received LTSS from ALFs, followed by NHs, then home and community-based services (H&CBS), but only findings between ALFs and H&CBS were statistically significant (P < .001). Finally, ratings tended to decrease over time among enrollees with greater cognitive impairment and increase over time among enrollees with less cognitive impairment (P < .001).

CONCLUSIONS: Findings advance knowledge regarding what is arguably the most important outcome of elderly LTSS recipients: quality of life. Understanding associations between multiple HRQoL domains and quality of life over time and directly from LTSS recipients represents a critical step in enhancing care processes and outcomes of this vulnerable population.

Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Keywords: Long-term care; assisted living; home- and community-based services; nursing home; quality of life

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