Study: Half of SNF residents end up in emergency room, regardless of cognitive status

Nearly half of long-stay nursing home residents will require transfer to an emergency department over the course of a year, regardless of their cognitive status, according to a recent study.

Researchers at the Indiana University Center for Aging Research and the Regenstrief Institute examined records of more than 4,000 nursing home residents with stays of 90 or more consecutive days. While nearly half of all residents required transfer to an emergency room, only one-third of those were subsequently admitted to the hospital.

The results also showed that long-stay residents with dementia spent an average of 258 days in a skilled nursing facility before an emergency room visit; residents with early to moderate cognitive impairment had a 250-day average and those with no dementia stayed an average of 202 days.

While cognitive ability had little impact on the likelihood or time of emergency room transfer, researchers noted that age, race, number of chronic conditions, “do not resuscitate” status and number of hospitalizations in the year prior to the study did influence emergency transfers, researchers noted.

"We — physicians, nursing home staff and all who are concerned with older adults who live in long-term care facilities — should be thinking about why individuals with advanced dementia, for whom comfort-oriented care is often more in line with preferences indicated by family members, have ED utilization patterns similar to those patients with early to moderate dementia and even those with no dementia,” said lead researcher Michael LaMantia, M.D., MPH.

Study results were published online in JAMDA ahead of print publication.