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Care Lacking for Nursing Home Residents With Diabetes


June 28, 2016

A recent study found that nursing home (NH) residents with diabetes were hospitalized and received rehabilitation or clinically complex care more often than those without diabetes, and neither group received the recommended frequency of preventative procedures. The findings were published online in the Journal of Post-Acute and Long-Term Care Medicine (JAMDA).

Between 2009 and 2011, the Services and Health for Elderly in Long TERm care (SHELTER) project conducted a 12-month prospective cohort study to assess 4037 NH residents 60 years old and above residing in 59 NHs in seven European countries and Israel. The international residential assessment instrument (InterRAI) tool for long-term care facilities was used to assess care needs. The researchers identified differences between NH residents with diabetes and without diabetes as well as factors determining use of services and care provided to both groups.

Residents with diabetes were hospitalized more often than those without diabetes (18.2% vs 14.3%) and required more rehabilitation (23.8% vs 18.2%) or clinically complex care (15.9% vs 13.7%). They also more frequently received a repositioning program (26.8% vs 22.7%), wound care (15.1% vs 9.8%), and some preventive services such as yearly eye examination (41.0% vs 35.9%), pneumococcal vaccination (33.5% vs 26.6%), mammography in women (12.1% vs 7.4%), and colonoscopy (5.6% vs 3.6%).

Yet, rates of certain services (mammography, colonoscopy, hearing and dental examinations) were very low in both study cohorts, with the exception of annual influenza vaccination (82.1%) and yearly blood pressure checkup (95.0%). Interestingly, diabetes enhanced the odds of receiving mammography [odds ratio (OR) 1.55, 95% confidence interval [CI] 1.15–2.09, P = .004) and eye examination (OR 1.21, 95% CI 1.03–1.42; P = .018).

Researchers Katarzyna Szczerbińska, MD, PhD (Jagiellonian University Medical College, Kraków, Poland), and colleagues concluded that residents with diabetes receive clinically complex diabetes care more frequently. But, overall, the recommended frequency of preventative procedures is not met in diabetic and non-diabetic residents. —Amanda Del Signore

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