[Consideration of mental symptoms and physical disabilities in deciding upon placement in a residential home versus a nursing home].

This study analysed 235 applications of elderly people for residential home and nursing home care. The applications were submitted to a Dutch municipal care allocation board. Based on the 1994 registration data from this board the impact of physical restrictions and mental problems on the care allocation for residential or nursing homes and connected care was studied. Physical complaints were measured with an adl and an hdl scale (Activities of Daily Living and Household Activities of Daily Living), mental problems were assessed by means of the Reality, Orientation and Restlessness Scales. Persons with an admission allocation for a nursing home (both psychogeriatric and somatic) had the highest scores on all scales; persons allocated to the residential home and related care had significantly lower scores. Above-mentioned scales have been combined into care level categories. Fifty seven persons, however, appeared not to have any physical or mental problems despite a care allocation to the residential home or related care. Contextual problems (housing, social contacts, endurance-capacity of relatives and friends) were particularly decisive in this case. Moderately severe problems, both physical and mental, generally resulted in an allocation to the residential home or related care. Serious problems usually result in allocation to the somatic or the psychogeriatric nursing home. Combined serious problems (75%) tended to result in an allocation to the psychogeriatric nursing home. This study is preliminary to the development of a care allocating instrument.