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Caregivers' reasons for nursing home placement: clues for improving discussions with families prior to the transition
Buhr GT, Kuchibhatla M, Clipp EC.. The Gerontologist, 2006-02-01
Topic: Risk, prevention and care in population studies
Purpose This study identifies the relative importance of reasons for institutionalization endorsed by caregivers of patients with dementia; examines the relationship between caregivers' reasons for institutionalization and indicators of caregiver and patient physical and emotional functioning measured in the prior year; and compares, on these indicators, caregivers who institutionalized their care recipients with caregivers who did not. Design and methods Participants were 2,200 caregivers from the National Longitudinal Caregiver Study, including 580 who institutionalized their care recipient during the 3-year interval. Caregivers' reason(s) for institutionalization were examined and correlated with indicators of caregiver and patient physical and emotional functioning. These indicators were used in a proportional hazards model to determine independent predictors. Results Caregivers' reasons for placement included (a) the need for more skilled care (65%); (b) the caregivers' health (49%); (c) the patients' dementia-related behaviors (46%); and (d) the need for more assistance (23%). Each of these reasons was significantly associated with indicators in the prior year's survey. This study uniquely demonstrates that caregiving task demand and a single-item measure of caregiver life satisfaction significantly predict placement. Implications These findings emphasize that caregivers' reasons have valid underpinnings and that institutionalization of dementia patients results from caregiver and patient factors evident in the year prior to placement. In routine office visits, caregivers should be systematically screened; accounts of low life satisfaction, dementia problem behaviors, or high task demand should cue clinicians that discussions of nursing home placement would be timely and appropriate.
Key findings
- Results Caregivers' reasons for placement included (a) the need for more skilled care (65%); (b) the caregivers' health (49%); (c) the patients' dementia-related behaviors (46%); and (d) the need for more assistance (23%).
- Each of these reasons was significantly associated with indicators in the prior year's survey.
- This study uniquely demonstrates that caregiving task demand and a single-item measure of caregiver life satisfaction significantly predict placement.
- Implications These findings emphasize that caregivers' reasons have valid underpinnings and that institutionalization of dementia patients results from caregiver and patient factors evident in the year prior to placement.
Why it matters
This study of 2,200 caregivers found that the main reasons for nursing home placement included need for more skilled care, the caregiver's health, the patient's dementia-related behaviors, and need for more assistance. It is about reasons for institutionalization and does not test any treatment or cure for dementia.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 54/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Gerontologist) |
| Journal's citation record | 2 / 4 | The Gerontologist: journal h-index 238 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2006 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 259 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 11.8 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 5 / 6 | Cited 33.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 14 other studies in this library |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Elizabeth Colerick Clipp: h-index 49 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Duke University: institution h-index 1,541 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 16452284) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 54 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Buhr, G. T., Kuchibhatla, M., & Clipp, E. C. (2006). Caregivers' reasons for nursing home placement: clues for improving discussions with families prior to the transition. The Gerontologist. https://doi.org/10.1093/geront/46.1.52
Vancouver
Buhr GT, Kuchibhatla M, Clipp EC. Caregivers' reasons for nursing home placement: clues for improving discussions with families prior to the transition. The Gerontologist. 2006. doi:10.1093/geront/46.1.52. PMID: 16452284.
BibTeX
@article{buhr2006-16452284,
author = {Buhr, G. T. and Kuchibhatla, M. and Clipp, E. C.},
title = {{Caregivers' reasons for nursing home placement: clues for improving discussions with families prior to the transition}},
journal = {The Gerontologist},
year = {2006},
doi = {10.1093/geront/46.1.52},
pmid = {16452284},
url = {https://doi.org/10.1093/geront/46.1.52}
}
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