Twenty-year trends in dependency in residential aged care in Auckland, New Zealand: a descriptive study

Abstract

Objective: To describe changes in aged care residents' dependency over a 20-year period.

Design: All residents in 1988, 1993, 1998, and 2008 were assessed using the same 23-item functional ability survey.

Setting: Residential aged care facilities in Auckland, New Zealand.

Participants: In 1988 there were 7516 participants (99% response rate), 6972 in 1993 (85% response rate), 5056 in 1998 (65% response rate), and 6828 in 2008 (89% response rate). Data were weighted to accommodate variation in response.

Measurements: A composite dependency score with 5 ordinal levels was derived from a census-type survey reporting mobility, activities of daily living ability, continence, and cognitive function.

Results: The proportion of "apparently independent" residents decreased from 18% in 1988 to 9% in 1993, 5% in 1998, and 4% in 2008, whereas those "highly dependent" increased from 16% in 1988, to 18% in 1993, 19% in 1998, to 21% in 2008. All functional indicators demonstrated increased dependency over the 20-year period (P < .0001). However, between 1998 and 2008 there were significant increases in dependency for continence, mobility, self-care, and orientation, but no significant changes in memory and behavior.

Conclusion: The increased dependency over 20 years directly affects care requirements for this population.