Appropriate Placement of the Chronically Ill and Aged

Abstract

A thorough medical, nursing, and social evaluation is essential for the appropriate placement of chronically ill and aging persons for whom institutional care, usually a nursing home, is being considered. Experience with 332 patients is described, all referred for consideration for placement in nursing homes. As a result of this comprehensive evaluation, 22% were enabled to remain at home, and only 35% were found to need nursing homes. Despite chronic illness, half of the patients did not have a regular physician, and more than half required further medical study or treatment before a long-term decision could be made. By independent follow-up assessment, 84% of these 332 patients were appropriately placed for their needs—an improvement of more than 20% over the degree of appropriateness of long-term care found in this community in other studies.