COGNITIVE IMPAIRMENT AND PROBLEM BEHAVIORS AS RISK-FACTORS FOR INSTITUTIONALIZATION

Data from the 1982 and 1984 National Long-Term Care Surveys are used t o develop a predictive model for nursing home institutionalization tha t includes cognitive functioning and problem behaviors in addition to more commonly studied indicators such as disability. As expected, cogn itive impairment is a risk factor for institutionalization, controllin g for other characteristics such as age, living arrangement, and use o f paid inhome care. Four problem behaviors were investigated, but only one, Wanders/Gets Lost, contributed to the model. Among cognitively i mpaired persons, those who wander/get lost had a twofold risk of insti tutionalization. The findings suggest the need to differentiate among difficult or problem behaviors and to further investigate those that a rouse concerns about safety and require extensive supervision as risk factors for institutionalization.