Diverse Care Trajectories for Dual-Eligible Nursing Home Residents with Dementia

Strategic Insights -

As researchers from Purdue University have found, nursing home residents with dementia exhibit a range of care trajectories, from early mortality to sustained community living. A study of 9,853 dual-eligible older adults admitted to Minnesota nursing homes between 2015 and 2020 identified four distinct trajectories, each with unique characteristics and outcomes. The findings underscore the need for individualized care planning and system-level strategies to meet the complex needs of these residents.

Key Takeaways:

  • Four distinct care trajectories were identified among dual-eligible nursing home residents with dementia, each with unique characteristics and outcomes.
  • Trajectory 1, characterized by early mortality and high nursing home utilization, was associated with the shortest survival time and highest hospitalization rates.
  • Trajectory 2, marked by steady return to long-term care, had longer survival times but frequent hospitalizations in years 2 and 3.
  • Trajectory 3, characterized by transitional care and multiple moves, had better survival times and longer community stays but increased nursing home use over time.
  • Trajectory 4, with short stay and return to community, had the best outcomes, with longest survival times, minimal nursing home readmissions, and few hospitalizations.
  • Care trajectories among dual-eligible nursing home residents were significantly associated with baseline differences in cognitive function, physical dependency, and sociodemographic characteristics.
  • Individualized care planning and system-level strategies are needed to meet the complex, evolving needs of these residents.
  • The study highlights the importance of accounting for the diverse needs and trajectories of nursing home residents with dementia in developing effective care strategies.

Statistics:

  • 38% of residents remained in nursing homes until death.
  • 29% sustained community living.
  • 33% experienced frequent transitions between nursing home care and community stays.
  • 9853 older adults were included in the study.
  • The study followed participants for up to 60 months.

Sources:

  • Care Trajectories for a Cohort of First-Time Nursing Home Admissions: A 5-Year Longitudinal Study in Minnesota. Journal of the American Medical Directors Association, 2025:105885.
  • Dongjuan Xu, School of Nursing, Purdue University, West Lafayette, IN, United States.
  • Emily Garcia and Greg Arling, researchers, Purdue University.
  • Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA.