+AA
Fr
Back
Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

The evidence is unclear about whether it is better for older adults to receive long-term care through home and community-based services or in a nursing home

Wysocki A, Butler M, Kane RL et al. Long-term care for older adults: A review of home and community-based services versus institutional care Agency for Healthcare and Quality (US). 2012;Report no 12 (3):EHC134-EF.

 

Review question

What are the benefits and harms of long-term care provided through home and community-based services compared to institutions such as nursing homes, for adults age 60 and older who need long-term care?

 

Background

Long-term care refers to a range of services designed to provide assistance over longer periods of time to help those suffering from chronic illness or physical or mental disability.

 

The type, frequency and intensity of long-term care services varies, with some people needing assistance for a few hours each week and others needing full-time support.

 

Long-term care includes institutional settings such as nursing homes as well as care provided outside of institutions, which are generally referred to as home and community-based services.

 

How the review was done

The review aimed to identify studies conducted from 1995-2012 that compared home and community-based care to nursing homes, for those aged 60 and over.

 

42 eligible articles were identified that presented results from 32 studies.

 

The review was funded by the Agency for Healthcare Research and Quality.

 

What the researchers found

There is low-strength evidence that changes in physical function, cognition and mental health do not differ significantly between home and community-based services and nursing home residents.

 

There is low-strength evidence that mortality does not differ between residents receiving long-term care through home and community-based services and nursing home residents.

 

Low-strength evidence suggests that those who receive care in a nursing home are less likely to experience episodes of pain, shortness of breath, and use anti-anxiety medication, but are more likely to require a feeding tube or oxygen therapy, and more likely to develop pneumonia, or a pressure ulcer.

 

Conclusion

There is no strong evidence to suggest that health outcomes differ among older adults receiving long-term care in a nursing home compared to those who receive long-term care through home and community-based services.

 

The results are also mixed with respect to different rates of harms associated with long-term care provided through home and community-based services compared to nursing homes.

 




Related Web Resources

  • Alzheimer's Disease: Do Ginkgo products help?

    Informed Health Online
    Gingko supplements (240 mg per day) may help reduce symptoms of Alzheimer's disease and enable you to perform daily tasks better. Be aware that gingko could interact with other medications, so talk to your doctor before taking any supplements.
  • High blood sugar can increase cognitive decline

    Berkeley Wellness
    New research shows that if you have high blood sugar, you might be more at risk for cognitive decline as you age. Whether or not you have diabetes, it is important to keep your blood sugar under control.
  • Statins

    Cognitive Vitality
    Research has shown that taking statins later in life will not prevent Alzheimer’s or dementia. Statins are used to manage cholesterol. Cholesterol management may lower your risk for getting Alzheimer’s disease as you get older.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Register
Want the latest in aging research? Sign up for our email alerts.
Subscribe
© 2012 - 2017 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use