Abstract:
Background the proportion of older adults living in residential aged care has steadily decreased over the last two decades due to many factors including introduction of compulsory pre-admission assessments, increased community care, and more retirement villages, encouraging only those with the highest dependency to be admitted. this study examines residents' dependency changes over 20 years in Auckland, New Zealand. Sampling Methods All people residing in aged care facilities in the Auckland region in 1988, 1993, 1998, and 2008 were assessed using the same 23-item functional ability survey. there were 7,516 residents assessed in 1988 (99% response rate), 6,972 in 1993 (85% response), 5,056 in 1998 (65% response), and 6,828 in 2008 (89% response). Analyses for 1993, 1998 and 2008 surveys were weighted to accommodate nonresponse. A composite dependency score with five ordinal levels from ‘apparently independent’ to ‘highly dependent’ was derived from mobility, activities of daily living ability, continence and cognitive function items. results All functional indicators demonstrated significantly increased dependency over the 20- year period (p<0.0001). However, in years between 1998 and 2008 surveys there were significant increases in dependency for toileting, urinary and faecal continence, mobility, dressing and orientation, but no significant changes in memory, orientation to place, disturbing behaviours, wandering and need for night care. the proportion of ‘apparently independent’ residents decreased from 18% in 1988 to 9% (1993), 5% (1998), and 4% in 2008, whilst those ‘highly dependent’ increased from 16% in 1988, to 18% (1993), 19% (1998) to 21% in 2008. Conclusion Dependency of aged care residents has increased significantly between 1988 and 2008. the population of older people will increase dramatically in the future including the population of those with dementia signalling a likely continued rise in aged care resident dependency.