A groundbreaking study led by the University of California, Irvine, has determined that simply increasing the number of staff in nursing homes is not enough to address the disparities in care quality and health outcomes between facilities with varying levels of residents with dementia. According to the research recently published in the journal Health Services Research, other factors such as specialised training, designing environments that are easy to navigate, and maintaining consistent staff are equally vital for catering to the needs of this demographic.
The study reveals that while higher staffing levels generally enhance patient outcomes across the board, notable differences persist between facilities with high and low proportions of dementia residents, regardless of staffing levels. The effects of staffing on care quality varied depending on the percentage of residents with dementia. They covered a range of outcomes from daily living activities like bathing, dressing, and eating independently to the frequency of emergency room visits and pressure sores.
Dana Mukamel, a professor of medicine at UCI and the study’s lead author, emphasised the objective of analysing how staffing hours correlated with care quality and comparing health outcomes in nursing homes with different densities of dementia populations. The findings indicated that while increased hours of registered nurses and certified nurse assistants per resident day tended to improve outcomes for both groups, adding more staff members was unlikely to be the sole solution.
The study underlined the complexity of dementia care, noting that over 40 per cent of nursing home residents in the United States are estimated to suffer from Alzheimer’s disease, related dementia, or cognitive impairments. These conditions complicate communication, requiring staff to be trained in specialised techniques to recognise non-verbal cues and understand diverse forms of self-expression.
This research involved regression analyses of a national sample of nursing homes from 2017 to 2019, utilising various datasets, including Medicare claims and data from the Centers for Medicare and Medicaid Services’ Payroll-Based Journal. The analysis controlled for resident and facility characteristics, employing separate linear models to predict six long-term facility-level outcomes.
Mukamel highlighted the necessity of increasing staffing and integrating specialised training, ensuring a secure environment, and maintaining staff consistency to manage the complexities associated with dementia effectively. She called for further research to identify specific areas for improvement in both high- and low-dementia facilities, aiming to enhance the overall quality of care.
More information: Dana B. Mukamel et al, Dementia, nurse staffing, and health outcomes in nursing homes, Health Services Research. DOI: 10.1111/1475-6773.14270
Journal information: Health Services Research Provided by University of California – Irvine
