Shot of a senior woman in a wheelchair looking sad, depressed at a nursing home

It often can be difficult to determine when a person with dementia may need to go to a nursing home or receive that level of care. A new study created models to help people determine when older adults living with dementia will require nursing home-level care.

The results can give people and their loved ones evidence-backed data if it comes time to make that decision. The study was published on Dec. 4 in JAMA Internal Medicine.

The team evaluated data from two groups spanning 1998 to 2019. It covered 3,327 people over the age of 65 who likely had dementia. Of them the mean age was 82.4 years old, and 70% were female.

The team defined the need for nursing home-level care as depending on others for three or more activities of daily living (ADL), having two or more ADL dependencies and wandering, or needing help to eat. Predictors for needing care included age, baseline ADL status, instrumental ADL dependencies, and an individual’s driving status. One model included body mass index and history of falls; another added how well people could recall a date, their sex, and if they experienced incontinence. 

At the end of the follow-up period (that varied depending on the group of data used), 63.3% of the people needed nursing home-level care. 

When the researchers tested the models to see how well they predicted who would need the level of care provided in a nursing home, the team found they worked well to tell which people needed the care. 

“These models may be used to enhance conversations with patients and families about future planning by giving estimates of when an individual with dementia may need high-level care, whether provided in a nursing home or at home. Predicting need for nursing home-level of care rather than nursing home admission provides a standardized metric applicable across cultural and socioeconomic backgrounds,” the authors wrote.