Dementia patients who have the same nurse for all of their home health care visits are a third less likely to be readmitted to the hospital, a new study finds.
"While continuity of nursing care may benefit every home health care patient, it may be particularly critical for people with dementia," said study co-author Chenjuan Ma. "Having the same person delivering care can increase familiarity, instill trust, and reduce confusion for patients and their families."
For many dementia patients, home health care begins after they've been discharged from the hospital.
"Nurses play a pivotal role in providing home health care," said Ma, an assistant professor at NYU Rory Meyers College of Nursing, in New York City. "As the population ages and older adults choose to 'age in place' as long as possible, the demand for home health care for people with dementia is expected to grow rapidly."
For the study, Ma and colleagues analyzed data on nearly 24,000 older adults with dementia who received home health care after hospitalization. About one in four had to be readmitted to the hospital. The three most common reasons for rehospitalization were infections, respiratory problems and heart disease.
There were wide variations in the continuity of nursing staff looking after the patients. While 26% received all their visits from one nurse, 8% had a different nurse see them each time.
The more hours of care a patient received each week, the lower their continuity of care, the study found.
Perhaps "it is hard to achieve continuity of care when a patient requires more care," Ma said in a college news release.
After controlling for other factors, the researchers concluded that patients with high continuity of nursing care were 30% to 33% less likely to be rehospitalized than those with low or moderate continuity of care.
The study was published June 23 in the journal Medical Care.
In 2018, more than 5 million Medicare beneficiaries in the United States received home health care, including 1.2 million with Alzheimer's disease and related dementias. These older Americans often have multiple chronic illnesses, take several medications and need help performing everyday tasks.