Rachel Fleishman, Fernando Potel, Dror Walk, Jenny Mandelson, Gad Mizrahi, Fanny Yuz and Miriam Bar‐Giora
In Israel, institution staff classify residents’ functional status as part of the routine governmental surveillance of institutions for semi‐independent and frail elderly…
Abstract
In Israel, institution staff classify residents’ functional status as part of the routine governmental surveillance of institutions for semi‐independent and frail elderly. However, owing to a lack of clarity and specificity in the regulation which defines functional status categories, nurse surveyors, who conduct the routine surveillance of institutions, have begun to make their own estimates of functional status. Data were collected and compared on the functional status classification of 78 per cent of the elderly residents by institution staff and nurse surveyors. Data analysis showed that the poorer the functional status, the less congruity between the classifications. This has practical consequences for estimating the number and type of staff needed. It was found that the waste of resources and discrepancies caused by reclassification of the elderly by the nurse surveyors may be avoided by using more specific and precise definitions as suggested in this article.
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Rachel Fleishman, Gabriella Heilbrun, Jenny Mandelson and Vicky Shirazi
This article describes actual UI prevalence and quality of care at Israeli LTC institutions for the elderly. The analysis is based on current regulatory data on 14,406 residents…
Abstract
This article describes actual UI prevalence and quality of care at Israeli LTC institutions for the elderly. The analysis is based on current regulatory data on 14,406 residents at 196 residential homes, and 8,278 patients at 159 hospitals for the chronically ill. It includes a calculation of summary indices of quality, the percentage of institutions with deficient items and of those showing change, and a description of functional status profiles. Multiple regression explains the deficiency rate variance through independent institutional variables. There is a higher prevalence of severe functional impairment and full incontinence at hospitals for the chronically ill than at residential homes. There were higher rates of deficiencies and lower rates of corrections for structural items than for process items at both. A major improvement occurred for process items (50‐100 per cent). Regarding outcomes, 34 percent of the residents with UI during the first assessment were continent two years later.