LOW-CARE CASES IN LONG-TERM-CARE SETTINGS - VARIATION AMONG NATIONS

Method: residents of long-term care settings without major activity of daily Living (ADL) deficits are often referred to as 'low-care cases' and are deemed inappropriately placed in an institution. We compare t he prevalence and characteristics of this population in Denmark, Icela nd, Italy, Japan, Sweden and the USA, using the Resident Assessment In strument Minimum Data Set. Results: among the six nations, the percent age of low-care cases ranged from 27 to 52% using a broad definition o f no physical assistance required in late-loss ADLs (bed mobility, toi leting, transfer and eating). With a more narrow definition which addi tionally excludes those falling into the Resource Utilization Groups, version III categories of rehabilitation, clinically complex, impaired cognition and behaviour problems, the percentages seen range from 9 t o 35%. Finally, 2-14% meet the most restrictive definition, which furt her excluded residents requiring any supervision in late-loss ADLs, wi th any deficits in early-loss ADLs (dressing or grooming) or needing m edical and psychiatric supervision. Conclusion: although long-term car e settings differ, making comparison by country difficult, the use of the same standard assessment form makes it possible to compare the man y reasons for institutionalization.