Mobility Decline Prevention
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Modules - Mobility Decline Prevention
The Effects of Staffing on In-Bed Times of Nursing Home Residents
Barbara M. Bates-Jensen, John F. Schnelle, Cathy A. Alessi, Nahla R. Al-Samarrai, and Lené Levy-Storms, 2004, in Journal of the American Geriatrics Society; 52:931-938.
Many nursing home residents spend a potentially unhealthful amount of time in bed, between 15 and 18 hours a day, sometimes more. Why? A low staffing level is the strongest predictor of excessive in-bed times, followed by impairments in residents' functional ability, according to this study. The study also found that the more time residents spent in bed during the day, the more they slept during the day, the more socially isolated they were, and the less they ate. (See also our press release on this study.)
The study compared nursing homes with low staffing levels-less than 3.4 staff hours per resident per day-to facilities with some of the industry's highest staffing levels-more than 3.7 staff hours per resident per day. Residents in lower-staffed homes were observed in bed an estimated average of 5 hours a day, between 7 a.m. and 7 p.m., versus an estimated average of 3 daytime hours for residents in the high-staffed homes. Given that many residents are put to bed by 7 p.m.-a finding from previous Borun Center research-residents in low-staffed homes could be spending as much as an average of 17 hours a day in bed.
Eight hundred and eighty-two long-stay residents in 34 nursing homes throughout southern California participated. The authors interviewed residents, observed them at hourly intervals on one day to estimate in-bed time and measure social engagement, monitored mealtimes, and conducted physical performance evaluations to assess residents' ability to stand and bear weight.
The authors point out that letting residents with physical impairments linger in bed could accelerate their decline. And the fact that residents with similar physical disabilities were observed out of bed more frequently in the high-staffed homes suggests in-bed times can be improved.
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