Influence of pre-admission factors on quality of life and adaptation in nursing home residents with dementia: the QOL-EHPAD study protocol

BACKGROUND: In 2015 in France, 585,560 people were nursing home residents. A large body of studies has identified predictors of poor quality of life and poor adaptation in institution, mostly for residents without dementia. With 42 to 72% of these residents diagnosed with dementia, it is crucial to identify what factors prior to admission might have an impact on quality of life once the admission is finalized, in order to target specific domains of intervention, while the person still lives at home and after his/her admission. METHODS: QOL-EHPAD is a prospective, multi-centred, observational cohort study. At baseline, we will collect retrospective data on the life of 150 persons with dementia and their caregivers. These data will refer to the conditions of admission to a nursing home (emergency admission, involvement in the decision, admission from home or from the hospital) and to the 6 months prior to the admission of the person with dementia: sociodemographic and medical data, psychological tests, information on quality of life, satisfaction, behaviour, and nutrition. Similar data about life in the nursing home will be collected after 6 months, along with information on adaptation of the person with dementia to his/her new living environment. We will use univariate regression analyses followed by stepwise linear regression models to identify which factors pertaining to life at home are associated with quality of life and adaptation after 6 months. DISCUSSION: This study will provide data on the impact of institutionalization on quality of life and the determinants of a successful institutionalization in people with dementia. This could be helpful in setting up targeted interventions to prepare admission into a nursing home before the actual admission and to accompany both the caregiver and the person with dementia throughout this process.