Hospital discharge into nursing home care: Psychological reactions and contributing factors

Two groups of older people were investigated within a hospital setting, a 'care' group (N = 32) to be discharged into nursing home care and a 'home' group (N = 20) discharged to their own home. The groups completed a series of standardized assessments and a semi-structured interview. The factors which most significantly predicted going into 'care' were lower levels of emotional support, being without a spouse and older, and having a lower level of functional ability. Compared to community norms, both groups demonstrated higher scores on the Hospital Anxiety and Depression Scale and lower scores on the Philadelphia Geriatric Centre Morale Scale. There was some evidence to suggest that the 'care' group was more clinically depressed and had lower morale. Interview data were categorized into six types of acceptance of the decision to go into care. These were associated with whether or not a person themselves initiated the idea to go into care and level of emotional support received. Descriptive data regarding the most frequent concerns associated with discharge into nursing home care were also obtained. Overall, the results were discussed with respect to the factors relating to the decision to enter care and how this acceptance might be facilitated.