Adaptive competence impairment and cognitive deficits in acutely ill schizophrenia patients residing in nursing homes.

OBJECTIVES

The loss of long-term inpatient psychiatric hospital beds over the years has caused schizophrenia patients of all ages to be increasingly placed in nursing home environments that were traditionally reserved for elderly patients. Consequently, many nongeriatric patients with chronic schizophrenia are now residing in nursing home settings. The objective of this article is to determine whether many of these nongeriatric patients are placed in nursing homes because of chronicity of illness and severity of impairment, or because of the limited alternative viable housing options.

DESIGN

Multiple and stepwise regressions examined predictors of cognitive ability, adaptive competence, social skills and inpatient social and adaptive functioning, and clinical symptomatology.

SETTING

Inpatient psychiatric unit in a general hospital.

PARTICIPANTS

Fifty acutely ill geriatric and nongeriatric patients with schizophrenia who reside in nursing homes.

MEASUREMENTS: Participants' clinical symptoms, cognitive ability, adaptive functioning, social skills, and inpatient social and adaptive functioning were assessed.

RESULTS

Findings revealed that patients' cognitive impairment and age of admission to the nursing home, irrespective of patients' current age, were predictors of impaired adaptive competence.

CONCLUSIONS

Examination of cognitive and adaptive deficits with assessment of symptom severity, independent of patients' current age, may aide in the determination of appropriate residential placements for individuals with schizophrenia.