Health, functional, psychological and nutritional status of cognitively impaired long-term care residents in Poland.

Purpose: To find if there are differences in health, functional, nutritional and psychological status among residents with cognitive impairment (CI) depending on where they stay, in nursing homes (NH) or residential homes (RH), and depending on the level of CI. To find factors increasing the probability that the resident with CI stays in the NH compared to RH.

Design: A cross-sectional survey of a country-representative sample of 23 LTCIs randomly selected from all six regions in Poland was conducted in 2015-2016. We included 455 residents with CI: 214 recruited from 11 NHs and 241 from 12 RHs. Data were collected using the InterRAI-LTCF tool. The descriptive analysis and logistic regression models were used.

Results: The NH residents more frequently had worse functional and nutritional status, and psychotic symptoms than RH ones, while they did not differ significantly in health status, frequency of behavioral problems and aggression. More advanced CI was associated with higher presence of functional disability (ADL, bowel and bladder incontinence), nutritional decline (BMI, swallowing problems, aspiration, pressure ulcers) and psychological problems (aggression, resistance to care, agitation, hallucinations and delusions). Nevertheless, the level of CI severity did not increase the chance to stay in NH compared to RH, but ADL dependency did (OR 1.52, 95% CI 1.31-1.76).

Conclusion: The level of CI is significantly associated with physical, psychological and nutritional functioning of residents and thus may have an impact on care needs. Therefore, it is very important to use CI assessments while referring to NH or RH, to ensure that patients with CI are placed in an appropriate facility, where they may receive optimal care.