Bathing Disability in Elderly Strong Predictor of Long-Term Admission to Nursing Homes

Researchers at Yale School of Medicine have found that persistent bathing disability among the elderly can increase the risk of long-term nursing home admission by 77 percent, but interventions aimed at prevention and remediation could reduce the need for these long-term care services.

The results are published in the August issue of Gerontology: Medical Sciences. Disability in bathing—the need for personal assistance to wash and dry one’s whole body—is highly prevalent in older persons and is a strong predictor of morbidity and mortality. It is also the primary reason why older persons receive nursing aide assistance in the home.

Thomas Gill, M.D., professor of medicine and epidemiology and public health at Yale School of Medicine and colleagues conducted a longitudinal study of 754 community-living residents of New Haven aged 70 and older. These participants were non-disabled in four essential activities of daily living. They were followed with monthly telephone interviews for over six years to determine the occurrence of persistent (present for at least two consecutive months) disability in bathing and the time to the first long-term nursing home admission, defined as longer than three months.

Gill and his co-authors found that 15 percent of study participants had a long-term nursing home admission. At least one episode of persistent bathing disability occurred among 52.2 percent of participants with a long-term nursing home admission and 32.8 percent without a long-term admission. The occurrence of persistent bathing disability increased the risk of long-term nursing home admission by 77 percent. This elevation in risk accounted for several other factors including the occurrence of persistent disability in other essential activities of daily living, and was not observed for short-term nursing home admissions.

“The results show that the occurrence of persistent bathing disability is strongly associated with the risk of long-term nursing home admissions,” said Gill, who is the recipient of a MERIT award from the National Institute on Aging. “Interventions directed at the prevention and remediation of bathing disability have the potential to reduce the burden and expense of long-term care services. Identifying potentially modifiable risk factors for bathing disability should be a high research priority.”

The results are part of the ongoing Yale Precipitating Events Project (PEP), which seeks to better understand how older persons manage day-to-day activities and remain independent at home. Titled “Epidemiology of Disability and Recovery in Older Persons,” the PEP study includes 754 participants age 70 or older from the Greater New Haven area.

Other authors on the study include Yale researchers Heather G. Allore and Ling Han.

The research was supported by grants from the National Institute on Aging.

Citation: J. Gerontol. Med. Sci., Vol. 61A, No. 8 (August, 2006)