Screening Tests for Nursing Home Patients

Abstract

Approximately 1.5 million individuals are cared for in more than 18 000 nursing homes in the United States. The number is expected to double in the next ten to 20 years. Admission to a nursing home is a wrenching change for any patient, a change often made more devastating by an interruption in the continuity of medical care. It is uncommon for the patient's previous physician to follow the patient into the nursing home. Furthermore, a well-organized summary of past medical care does not often accompany the patient to the nursing home. Finally, in many nursing homes the initial evaluation by the new physician is often brief. As Golodetz1 has pointed out, the examination often fails to focus on the chief problems of functioning in the elderly: it does not include a detailed evaluation of the musculoskeletal system or assessment of cognition, the functioning of the special senses, or