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Article
Longitudinal investigation of wandering behavior in Department of Veterans Affairs nursing home care units
International Journal of Geriatric Psychiatry (2009)
  • Bellinda B. King-Kallimanis
  • Lawrence Schonfeld
  • Victor A. Molinari
  • Donna Algase
  • Lisa M. Brown
  • William D. Kearns, University of South Florida
Abstract

We explored the extent of and factors associated with male residents who change wandering status post nursing home admission. Longitudinal design with secondary data analyses. Admissions over a 4-year period were examined using repeat assessments with the Minimum Data Set (MDS) to formulate a model understanding the development of wandering behavior. One hundred thirty-four Veterans Administration (VA) nursing homes throughout the United States, with 6673 residents admitted to VA nursing homes between October 2000 and October 2004. MDS variables (cognitive impairment, mood, behavior problems, activities of daily living and wandering) included ratings recorded at residents' admission to the nursing home and a minimum of two other time points at quarterly intervals. The majority (86%) of the sample were classified as non-wanderers at admission and most of these (94%) remained non-wanderers until discharge or the end of the study. Fifty-one per cent of the wanderers changed status to non-wanderers with 6% of these residents fluctuating in status more than two times. Admission variables associated with an increased risk of changing status from non-wandering to wandering included older age, greater cognitive impairment, more socially inappropriate behavior, resisting care, easier distractibility, and needing less help with personal hygiene. Requiring assistance with locomotion and having three or more medical comorbidities were associated with a decreased chance of changing from non-wandering to wandering status. A resident's change from non-wandering to wandering status may reflect an undetected medical event that affects cognition, but spares mobility.

Keywords
  • activities of daily living,
  • cognition disorders,
  • longitudinal studies,
  • mood disorders,
  • multivariate analysis,
  • nursing homes,
  • Psychiatric Status Rating Scales,
  • risk factors,
  • veterans,
  • wandering behavior
Publication Date
2009
Citation Information
Bellinda B. King-Kallimanis, Lawrence Schonfeld, Victor A. Molinari, Donna Algase, et al.. "Longitudinal investigation of wandering behavior in Department of Veterans Affairs nursing home care units" International Journal of Geriatric Psychiatry Vol. 25 Iss. 2 (2009)
Available at: http://works.bepress.com/lawrence_schonfeld/6/