Elderly in Nursing Homes Risk Faster Decline

By Jan Battles, The Sunday Times

November 30, 2008 

Ireland

People in nursing homes have worse memories, lower attention spans and poorer dexterity than the elderly in the community, according to a university study. 

The abilities and psychological wellbeing of 50 residents in 17 nursing homes were compared with 50 similar people in the community. The participants did not suffer from any physical or mental illnesses or have difficulty communicating.

“The people we were dealing with theoretically could live in the community but because of the lack of support structures they ended up moving into a nursing home,” said Kieran Walsh of the National University of Ireland Galway, who carried out the research with Thomas Waldmaan of the University of Limerick.

Carmel Magee, in her late seventies, lives at home in Ringsend and is secretary of the local active-retirement group. She agrees that the right sort of support is vital. “At our group we can relate to one another’s problems. I get companionship and you’re doing things. 

“There was one woman I knew who was quite healthy mentally who had to go into a nursing home. She had nobody to talk to besides the doctors and nurses and they didn’t have time, naturally. The other patients were more advanced and had Alzheimer’s or stroke. Slowly she just deteriorated.” 

Among the activities Magee engages in are bowling, musical evenings and putting on variety shows for those in nursing homes. “My family say we have a better social life than they have,” she said.

Nursing-home residents performed worse in tests with just six exceptions, when the score was the same as community-based people. Those participants were in nursing homes with more services, affording greater independence. More residents had low-dependency levels allowing more interaction. Some still drove into town. 

The study, in the academic journal Aging and Mental Health, does not prove that the nursing home was the cause of the poorer performance. But Walsh said: “If you are going into a nursing home and you are in these environments where stimulation isn’t very prevalent, or the environmental structures aren’t there, then your abilities will decline.” 

Losing autonomy by becoming institutionalised alongside high-dependency residents, and no longer carrying out everyday tasks may lead to deterioration, said Walsh. 

In 2002, almost 21,000 elderly people lived in long-stay care facilities in Ireland, about 2,000 of whom had low-dependency levels. In many countries care is categorised to cater for residents of low, medium, high or maximum dependency. In Ireland it is typical to find a wide range of older adults, varying in their abilities and afflictions, in a single facility. 

Gerard Scully of Age Action Ireland said: “If the community services were in place it would be better if older people who are low-level dependent were to live in the community for as long as possible. The sad fact is once you go into a nursing home you’re in an institution. Even if you go in as a low-dependency, autonomous person very quickly, within six months or so, you become an institutionalised resident, losing abilities.”  

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