ABSTRACT
On the basis of an account of the mortality and changes in the need for care over a 2-year period among independent persons and patients requiring care in De Gamles By, Copenhagen, an assessment is made of the movements of patients and the need for care in a model of a geriatric institution. This model includes both purpose-built residential apartments for independent persons and places for dependent patients requiring nursing care. It is shown that the accommodation for the latter patients rapidly becomes occupied by the independent persons from the residential apartments who subsequently need nursing care. Thus, the places in the nursing section are blocked for the admittance of dependent persons living in the community outside. This situation arises when there are equal numbers of both types of accomodation. Where the number of residential apartments is greater than the number of places in the nursing section the care function must be transferred to the residential apartments, and this is regarded as impracticable.
Subject(s)
Geriatric Nursing , Homes for the Aged , Aged , Denmark , Health Services Needs and Demand , Humans , Residence CharacteristicsABSTRACT
Based on an account of the need for nursing care in the entire patient population in De Gamles By, Copenhagen, on January 15, 1967, and again on January 15, 1969, it is shown that the need for care varies considerably, despite a policy of admitting only independent persons. The consequences of this variability for the size of the nursing staff required are discussed, together with some aspects of admittance policy.
Subject(s)
Geriatric Nursing , Health Planning , Health Services Needs and Demand , Aged , Denmark , Female , Humans , MaleABSTRACT
With the aim of demonstrating prognostics as regards death in a geriatric population, the mortality among 1 486 patients (516 men and 970 women) in De Gamles By, Copenhagen, was observed over a 2-year period. The mortality curves for the groups examined were found to be rectilinear in logarithmic form and could therefore be described with sufficient certainty by one value, viz. the probability of death in any one year. The probability of death was just over 20% and was the same for both sexes. Of the parameters examined, particularly high mortality was found where there was urinary incontinence, severe mental abnormality, a great need for nursing, and poor physical mobility (especially inability to walk). On the other hand, there was no particular relationship with age. Where the degree of the handicapping factors was severe, there was generally greater mortality among the men than among the women, but this was not so in the less severe cases. The length of stay in the institution had no effect on the mortality. The results of the present study are in good agreement with previous findings reported from New York (7).
Subject(s)
Geriatrics , Mortality , Aged , Female , Geriatric Nursing , Humans , Immobilization , Male , Mental Disorders , Probability , Prognosis , Urinary IncontinenceABSTRACT
On the basis of a study from De Gamles By, Copenhagen, concerning the mortality and changes in the patients' need for nursing care over a 2-year period, calculation is made of the time-related changes in the care status, using a special model for homes for elderly persons. This model is based on a policy that only independent persons are received into such homes and that they remain there until they die. It is found that the need for care becomes stabilized after a period of 5-6 years and remains at a level corresponding to about 45% independent, 36% slightly dependent, and 17% heavily dependent patients (the "minimum need for care"). Using the model, a few examples are given to illustrate the changes which would arise in the need for care in De Gamles By if, on the basis of the primary care status on January 15, 1969, (A) only independent patients were admitted, and (B) the current admittance policy was continued.
Subject(s)
Geriatric Nursing , Homes for the Aged , Aged , Female , Humans , Male , Models, Theoretical , MortalityABSTRACT
The prospects of survival and changes in function (need for care) are evaluated after a two-year period for the 1486 persons resident in the geriatric institution "De Gamles By", Copenhagen, on January 15, 1967. It is shown that the logarithm of the survival percentages is approximately a linear function of the time. The prospect of survival is slightly better for the females than for the males because of a significantly higher mortality among the dependent men than among the dependent women. There is no difference as regards sex in the mortality rate for the independent patients (25%). The prospect of survival is poorest in the heavily dependent patients, regardless of sex. Only 5% of the patients were discharged to their homes or transferred to a hospital or some other institution. There was an improvement in the care status, regardless of sex, in 4%, the condition was unchanged in 61%, and there was deterioration in 35% of the 870 patients who survived the two-year period. On the basis of the prospects of surviving whilst waiting for admittance, the saving in institutional places is discussed. The increased need for more accomodation in geriatric institutions is emphasized in order to reduce the unfortunate consequences of the time spent in waiting for admission.
Subject(s)
Mortality , Nursing Homes , Age Factors , Aged , Chronic Disease , Denmark , Female , Follow-Up Studies , Humans , Male , Prognosis , Prospective Studies , Sex FactorsABSTRACT
Two cross-sectional studies, carried out at an interval of exactly 2 years at a geriatric institution accomodating about 1400 residents, show an increase in the age of the patients and in the need for care after the 2 years. An analysis of the conditions shows that the changes are due to the surviving patients becoming older and in need of more care, without adequate compensation for this trend having been taken into account when admitting new patients. The admittance and staff aspects connected with these changes are discussed.
