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Long-term care settings not appropriate for adults with TBI

Long-term care settings, such as nursing homes, may not be appropriate for the rehabilitation of patients with traumatic brain injuries, according to data from a recent cross-sectional study.

“Developing interventions that satisfy the long-term or lifelong physical, cognitive and behavioral needs of people with TBI requires a complete understanding of their multidimensional characteristics. These clinical and behavioral complexities require health policies advocating for tailored and more attentive care for people with TBI,” Angela Colantonio, PhD, senior scientist at the Toronto Rehabilitation Institute, and colleagues wrote.

To access the demographic, clinical and functional characteristics as well as mood, behavior, treatment and medication of patients with TBI (n = 10,878), researchers used existing data from Resident Assessment Instrument (RAI) national Canadian databases from 1996 to 2011. RAI databases consisted of data from four different care settings, including home care, mental health, nursing home and complex continuing care facilities.

Results demonstrated that in mental health care settings, patients with TBI were younger, and more likely to be male. Nursing home and home care patients with TBI had the highest psychotropic drug use in relation to other conditions, according to researchers.

Compared with patients without TBI in all four care settings (n = 993,867), TBI patients had worse cognitive function, with roughly 80% of patients in home care and 93% in nursing homes and complex care units having some degree of cognitive deficit. Over one-third of patients with TBI in nursing homes and complex continuing care had communication difficulties.

“Improving the health of people with TBI requires moving beyond generalized care intervention methods and focusing more on training caregivers to provide their needs across care settings. Further evaluation of the impact of providing care services on outcomes would strengthen the case for developing appropriate and efficacious care strategies,” Colantonio and colleagues wrote.

Disclosure: The researchers report no relevant financial disclosures.