Person-centred care (PCC) in residential care facilities (RCFs) is valuable but creates challenges for care professionals balancing involvement and a partnership approach for residents while considering the health and safety outcomes of all residents. This review evaluates what is known about the substance use and misuse of residents living in RCFs and what is important to study in future research to enhance PCC, especially in cases in which residents wish to choose unhealthy behaviours. A scoping review was conducted and exclusion criteria were set. The included papers were assessed on methodological quality using the Mixed Methods Appraisal Tool and the results were qualitatively analysed. The included papers consisted of studies regarding alcohol, tobacco and illicit drugs. The results showed that care professionals are involved in facilitating and regulating alcohol and tobacco. The focus of the included papers is on alcohol and tobacco. Five of the 16 papers assessed the residents’ perspective. This review highlights the importance of incorporating the perspectives of residents, care professionals and the organisation to enhance PCC and enable residents to make shared and well-informed decisions in dialogue with care professionals. Future research should also assess the distinction between substance use and misuse, and how this affects implementing PCC in RCFs.

In this cross-sectional study, we examined the relationship between resident level of care in the nursing home and colonization with resistant gram-negative bacteria. Residential-care residents were more likely to be colonized with resistant gram-negative bacteria than were postacute care residents (odds ratio, 2.3; 95% confidence interval, 1.40–3.80; P < .001).

Little research has focussed on nursing home residents with a history including a non-dementia related chronic mental illness (HCMI) that manifested before placement in a nursing home. Data from the 1993 Minimum Data Set for Nursing Home Resident Assessment and Care Screening (MDS) on over 70,000 residents in Kansas, Maine, Mississippi, and South Dakota were used to investigate differences in characteristics and care between these residents and more traditional residents. HCMI residents were more likely to be under 65 years of age, male, Medicaid recipients, less functionally impaired, to exhibit higher levels of problem behaviours, and to receive psychoactive medications and psychological therapy, though therapy prevalence rates were low. These data may indicate that appropriate care for HCMI residents is a concern.

This paper describes a new measure, the Worry Questionnaire for Nursing Home Residents (WQNHR), designed to assess the frequency of specific worries. It was administered to 67 residents. Psychometric evaluation showed an average item-to-total correlation of 0.20 (range = 0.15 to 0.58), an internal consistency estimate of 0.79, and a test-re-test reliability coefficient of 0.80. The WQNHR showed good convergent validity with other measures of worry obtained from residents, good discriminant validity with measures of health, but poor discriminant validity with self-ratings of depression. Psychometric results also indicated that the WQNHR performed better for residents with higher cognitive functioning. In addition, a collateral form (WQNHR-C) was administered to family or friends; however, it was not significantly correlated with the WQNHR. Overall, the WQNHR is a promising screening instrument for assessing worry in nursing home residents.

Objective: To determine correlates of hoarding behavior in frail elderly persons. Methods: Information about nursing home residents (n = 408) and community-dwelling senior day-care participants (n = 177) was gathered through interviews with family and professional caregivers, medical chart review, and physician examinations, and included the following areas of assessment: hoarding behavior, demographic and health information, level of cognitive functioning, activities of daily living (ADL) performance, depressed affect, social functioning, manifestations of agitated behaviors, and previous stressful life experiences. Results: We found that 15% of the nursing home residents and 25% of the community-dwelling senior day-care participants manifested hoarding behavior at a rate of several times a week or higher. For nursing home residents, hoarding behavior was significantly related to a larger appetite, taking fewer medications, higher social functioning, comparatively less ADL impairment, and manifestations of physically nonaggressive agitated behaviors. For senior day-care participants, hoarding behavior was significantly associated with being female, a larger appetite, comparatively less gait impairment, fewer medical diagnoses, more involvement in activities, a positive diagnosis of dementia, hallucinations, the delusion of infidelity, and manifestations of three syndromes of agitated behaviors. Conclusion: While hoarding behavior in our samples presents differently from compulsive hoarding described in the literature, we obtained robust findings that show that despite differences in living conditions, the elderly persons who manifested hoarding behavior were those with relatively fewer health and functional disabilities. In addition, those who exhibited hoarding behavior also manifested agitated behaviors. We suggest that future researchers develop alternative measures of hoarding behavior so as to further clarify the phenomenon of hoarding behavior in the elderly.