Journal List > J Korean Acad Nurs > v.39(5) > 1002578

TOOLS
Kim, Jung, and Lee: Cognitive Impairment, Behavioral Problems, and Mental Health in Institutionalized Korean Elders -An Eligibility Issue for Care Settings-
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2009; 39(5): 741-750.

Published online: 31 October 2009

DOI: https://doi.org/10.4040/jkan.2009.39.5.741

Cognitive Impairment, Behavioral Problems, and Mental Health in Institutionalized Korean Elders -An Eligibility Issue for Care Settings-

Hyun-Sil Kim1, Young-Mi Jung2, Hung-Sa Lee2

1Professor, Department of Nursing, Daegu Haany University, Daegu, Korea.

2Assistant Professor, Department of Nursing, Daegu Haany University, Daegu, Korea.

Address reprint requests to: Kim, Hyun-Sil. Department of Nursing, Daegu Haany University, 165 Sang-dong, Suseong-gu, Daegu 706-060, Korea. Tel: 82-53-770-2282, Fax: 82-53-770-2286, hskim@dhu.ac.kr

Received 5 January 2009       Revised 12 January 2009       Accepted 22 September 2009

Copyright © 2009 Korean Society of Nursing Science

Abstract

Purpose

The purpose of this study was to identify the prevalence of cognitive impairment, behavioral problems, and the state of mental health for elderly Korean people who have been institutionalized.

Methods

A cross-sectional, nation-wide survey was performed using an anonymous questionnaire. The participants in this study were 2,521 institutionalized elderly Korean people. A proportional stratified random sampling method was employed.

Results

1) Elders admitted to subacute hospitals and long term care (LTC) facilities showed a higher level of cognitive impairment compared to elders admitted to acute care hospitals. 2) Elders confined in LTC facilities showed a higher level of behavioral problems compared to elders in acute or subacute hospitals. 3) Elders admitted to subacute hospitals and LTC facilities showed more serious mental health problems, such as depression or suicidal ideation, compared to elders in acute care hospitals.

Conclusion

The results of this study indicate that the severity of cognitive-behavioral or mental health problems do not match well with type of care setting. Therefore, health personnel working with elderly people should be provided guidance on detection and management of cognitive-behavioral and mental health problems. The necessity of a decision support system for eligibility and placement in long-term care is also discussed.

Keywords: Cognitive impairment, Behavioral problem, Mental health, Institutionalized elderly

Figures and Tables

Table 1
Demographic Characteristics of the Participants (N=2,521)
jkan-39-741-i001

hosp.=hospital; LTC=long term care; DM=diabetes mellitus.

Table 2
Comparison of Cognitive Function by Care Settings (N=2,521)
jkan-39-741-i002

hosp.=hospital; LTC=long term care.

Table 3
Comparison of Behavioral Problems by Care Settings (N=2,521)
jkan-39-741-i003

hosp.=hospital; LTC=long term care.

Table 4
Comparison of Mental Health Conditions by Care Settings (N=2,521)
jkan-39-741-i004

hosp.=hospital; LTC=long term care.

Table 5
Differences in Cognitive Function, Behavioral Problems, & Mental Health by Care Settings
jkan-39-741-i005

LTC=long term care.

References

1. Brodaty H, Peters K, Boyce P, Hickie I, Parker G, Mitchell P, et al. Age and depression. Journal of Affective Disorders. 1991. 23:137–149.
2. Chu SK, Yoo JH, Lee CY. The effects of a cognitive behavior program on cognition, depression, and activities of daily living in elderly with cognitive impairment. Journal of Korean Academy of Nursing. 2007. 37:1049–1060.
3. Doble SE, Fisher AG. The dimensionality and validity of the older Americans resources and services (OARS) activities of daily living (ADL) scale. Journal of Outcome Measurement. 1998. 2:4–24.
4. Fox P, Maslow K, Zhang X. Long-term care eligibility criteria for people with Alzheimer's disease. Health care and Financing Review. 1999. 20:67–85.
8. Hambletone RK, Robin F, Xing D. Tinsley H, Brown S, editors. Item Response Models for the analysis of educational and psychological test data. Handbook of applied multivariate statistics and mathematic modeling. 2000. San Diego, CA: Academic Press;553–585.
8. Hirdes JP, Tjam EY, Fries BE. . Eligibility for community, hospital and institutional services in Canada: A preliminary study of case managers in seven provinces. 2001. Toronto: National Evaluation of the Cost-Effectiveness of Home Care, Canada, Department of Health Studies & Gerontology, University of Waterloo, Canadian Collaborating Centre -inter RAI, Province Centre, Toronto, St.Mary's Hospital, Kitchener, Institute of Gerontology, University of Michigan, Ann Arbor, Ann Arbor VA Medical Centre.
7. Ito H, Miyamoto Y. Impact of long-term care insurance on institutional dementia care in Japan. Health Policy. 2003. 64:325–333.
8. Ito H, Tachimori H, Miyamoto Y, Morimura Y. Are the care levels of people with dementia correctly assessed for eligibility of the Japanese long-term care insurance? International Journal of Geriatric Psychiatry. 2001. 16:1–7.
9. Kim B, Hong S. A psychometric revision of the Asian values scale using the Rasch model. Measurement and Evaluation in Counseling and Development. 2004. 37:15–27.
10. Kim HS, Hwang JY, Jung YM, Lee HS, Park YE, Cho YH, et al. A Study on eligibility and placement for the elderly in the Korea longterm care insurance. 2008. Seoul: National Health Insurance Corporation, Daegu Haany University, & Korea Health Industry Development Institute.
11. Kim JS, Jung JS. The effects of a folk play program on cognition, ADL, and problematic behavior in the elderly with dementia. Journal of Korean Academy of Nursing. 2005. 35:1163–1173.
12. Kim KA. Development of an assessment tool of problematic behaviors for institutionalized old people with dementia. 2003. Seoul: Seoul National University;Unpublished doctoral dissertation.
13. Korea Alzheimer's Association. Suicide in the elderly. 2008. 12. 30. Retrieved December 30, 2008. from http://www.alzza.or.kr/sub/dementia/sub_01.asp.
14. Lenze EJ, Mulsant BH, Shear MK, Alexopoulos GS, Frank E, Reynolds CF II. Comorbidity of depression and anxiety disorders in later life. Depression and Anxiety. 2001. 14(2):86–93.
15. Mazure CM, Maciejewski PK. A model of risk for major depression: Effects of life stress and cognitive style vary by age. Depression and Anxiety. 2003. 17:26–33.
16. Mental Health Foundation. Mental health problems. 2009. 01. 20. Retrieved March 16, 2009. from http://www.mentalhealth.org.uk.
17. Min SG, Go KB, Kim KH, Kim BH, Kim I, Kim HS, et al. Modern psychiatry. 1998. 3rd ed.Seoul: Iljogak.
18. Ministry of Health and Welfare & National Health Insurance Corporation. Manual for long term care eligibility system & service provision. 2007. 05. Seoul: Author.
19. Morris J, Murphy K, Nonemaker S. Long term care Resident Assessment Instrument user's manual for version 2.0. U.S. 1995. Retrieved December 30, 2008. from http://chfs.ky.gov/NR/rdonlyres/C3215FE3-A99B-4C41-878C-A2AC8CB4BF26/0/1775a.pdf.
20. Ownby RL, Harwood DG, Barker WW, Duara R. Predictors of anxiety in patients with Alzheimer's disease. Depression and Anxiety. 2000. 11:38–42.
21. Parashos IA, Stamouli S, Rogakou E, Theodotou R, Nikas I, Mougias A, et al. Recognition of depressive symptoms in the elderly: What can help the patient and the doctor. Depression and Anxiety. 2002. 15:111–116.
22. Rovner BW, Broadhead J, Spencer M, Carson K, Folstein MF. Depression and Alzheimer's disease. American Journal of Psychiatry. 1989. 146:350–353.
23. van Campen C, van Gameren E. Eligibility for long-term care in the Netherlands: Development of a decision support system. Health & Social Care in the Community. 2005. 13:287–296.
24. Weeks JW, Heimberg RG. Evaluation of the psychometric properties of the Beck Depression Inventory in a non-elderly adult sample of patients with generalized anxiety disorder. Depression and Anxiety. 2005. 22:41–44.
25. Won JS, Kim KH. Evaluation of cognitive functions, depression, life satisfaction among the elderly receiving visiting nursing services. Journal of Korean Academy of Nursing. 2008. 38:1–10.
TOOLS
Similar articles