Prevention of Functional Decline by Reframing the Role of Nursing Homes?

Clarisse Laffon de Mazières; John E Morley; Cari Levy; Fabien Agenes; Mario Barbagallo; Matteo Cesari; Philipe De Souto Barreto; Lorenzo Maria Donini; Jaime Fitten; Alain Franco; Mikel Izquierdo; Rosalie A Kane; Finbarr C Martin; Graziano Onder; Joseph Ouslander; Kaisu Pitkälä; Debra Saliba; Alan Sinclair; Leocadio Rodriguez Manas; Bruno Vellas; Yves Rolland

doi:10.1016/j.jamda.2016.11.019

Prevention of Functional Decline by Reframing the Role of Nursing Homes?

J Am Med Dir Assoc. 2017 Feb 1;18(2):105-110. doi: 10.1016/j.jamda.2016.11.019.

Authors

Clarisse Laffon de Mazières¹, John E Morley², Cari Levy³, Fabien Agenes⁴, Mario Barbagallo⁵, Matteo Cesari⁶, Philipe De Souto Barreto⁶, Lorenzo Maria Donini⁷, Jaime Fitten⁸, Alain Franco⁹, Mikel Izquierdo¹⁰, Rosalie A Kane¹¹, Finbarr C Martin¹², Graziano Onder¹³, Joseph Ouslander¹⁴, Kaisu Pitkälä¹⁵, Debra Saliba¹⁶, Alan Sinclair¹⁷, Leocadio Rodriguez Manas¹⁸, Bruno Vellas⁶, Yves Rolland⁶

Affiliations

¹ Department of Geriatric Medicine, Gérontopôle, Toulouse University Hospital (CHU de Toulouse), Toulouse, France; Inserm UMR 1027, Toulouse, France. Electronic address: laffondemazieres.c@chu-toulouse.fr.
² Division of Geriatric Medicine, Saint Louis University School of Medicine, St Louis, MO; Division of Endocrinology, Saint Louis University School of Medicine, St Louis, MO.
³ Denver-Seattle Center of Innovation at the Denver VA Medical Center, Denver, CO; Division of Health Care Policy and Research, University of Colorado School of Medicine, Aurora, CO.
⁴ Office for Science and Technology, French Consulate in Los Angeles, Embassy of France in the United States, Los Angeles, CA, USA.
⁵ Geriatric Unit, University of Palermo, Palermo, Italy.
⁶ Department of Geriatric Medicine, Gérontopôle, Toulouse University Hospital (CHU de Toulouse), Toulouse, France; Inserm UMR 1027, Toulouse, France.
⁷ Sapienza University of Rome, Rome, Italy.
⁸ Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA; Geriatric Psychiatry, Greater Los Angeles VA, Sepulveda Campus, Los Angeles, CA.
⁹ University of Nice-Sophia Antipolis, Nice, France.
¹⁰ Department of Health Sciences, Public University of Navarre, Navarra, Pamplona, Spain.
¹¹ Center on Aging, Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
¹² King's College London, London, UK.
¹³ Department of Geriatrics, Centro Medicina Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
¹⁴ Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL; Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL.
¹⁵ University of Helsinki, Department of General Practice and Primary Health Care, Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland.
¹⁶ UCLA/JH Borun Center for Gerontological Research, University of California, Los Angeles, CA; Los Angeles Veterans Administration Geriatrics Research Education and Clinical Center, Los Angeles, CA.
¹⁷ Foundation for Diabetes Research in Older People, Diabetes Frail, Medici Medical Practice, Luton, UK.
¹⁸ Department of Geriatrics, Hospital Universitario de Getafe and School of Health Sciences, Universidad Europea de Madrid, Getafe, Spain.

PMID: 28126135
DOI: 10.1016/j.jamda.2016.11.019

Abstract

Institutionalization is generally a consequence of functional decline driven by physical limitations, cognitive impairments, and/or loss of social supports. At this stage, intervention to reverse functional losses is often too late. To be more effective, geriatric medicine must evolve to intervene at an earlier stage of the disability process. Could nursing homes (NHs) transform from settings in which many residents dwell to settings in which the NH residents and those living in neighboring communities benefit from staff expertise to enhance quality of life and maintain or slow functional decline? A task force of clinical researchers met in Toulouse on December 2, 2015, to address some of these challenges: how to prevent or slow functional decline and disabilities for NH residents and how NHs may promote the prevention of functional decline in community-dwelling frail elderly. The present article reports the main results of the Task Force discussions to generate a new paradigm.

Keywords: Nursing home; frailty; functional decline; prevention.

MeSH terms

Activities of Daily Living
Aged
Cognitive Dysfunction / prevention & control*
Frail Elderly*
Humans
Nursing Homes*
United States