Grant: Travel Awards - Institute Community Support

More than 200,000 older Canadians currently reside in publicly subsidized nursing homes because they require constant care and are no longer able to live independently. Most of these residents need help doing activities of daily living, such as getting dressed, using the toilet or feeding themselves. Research shows that older adults who are more disabled in activities of daily living report lower quality of life; a majority would rather abstain from life-saving treatment than lose their ability to do these activities. Most nursing home residents become significantly more disabled in activities of daily living over the 2-3 years they spend in nursing homes prior to their death. Little is known about why this is happening or what should be done differently to reduce the burden of disability in this vulnerable population. This study seeks to improve our understanding of this phenomenon. We describe which chronic diseases and geriatric syndromes are the most strongly associated with high disability in a sample of 77,165 nursing home residents from 614 Ontario nursing homes. We test whether these relationships are different for male versus female residents and residents of different ages. We also study whether peoples' high disability levels are more attributable to their individual ailments versus features of the nursing homes in which they live. Understanding what chronic diseases and geriatric syndromes are associated with disability is critical to guide targeted interventions to reduce its burden in nursing home residents. Clarifying the relationship between nursing home features and resident disability is important to guide health policies that hold nursing homes accountable for resident outcomes. By 2041 approximately 320,000 Canadian seniors will call nursing homes "home." This study is a critical step in understanding how to reduce activity of daily living disability in this population.