Diabetes in Residential Care Facilities: United States, 2010

A lthough national data show that 25% of nursing home residents and 31% of home health patients have diabetes (1,2), little is known about diabetes among older adults living in residential care facilities (RCFs). The 2010 National Survey of Residential Care Facilities (3) provides nationally representative data on this population. Resident information, including demographics, health conditions, and physical and cog-nitive functioning was collected from respondents who were most knowledgeable about sampled residents. Respondents included facility directors, registered nurses, licensed practical nurses, and personal care aides. Analyses were conducted using SUDAAN 10.0 software to account for the strata, cluster, and weight variables that define the complex sampling approach in the National Survey of Residential Care Facilities. Of the 733,000 individuals in RCFs, 17% had diabetes. Diabetic residents were more likely to be admitted following a short stay in a hospital, nursing home, or rehabilitation facility. Although 53.8% of all residents were $85 years old, the oldest-old were significantly less common among diabetic residents compared with residents without diabetes (40.6 vs. 56.5%). Diabetic residents were more likely to be male (38.2 vs. 28.8%) and less likely to be white (85.7 vs. 92.1%). Diabetic residents were less likely to have attended college (36.3 vs. 41.6%) and more likely to have received support from Medicaid in the past 30 days (29.2 vs. 16.9%). Diabetic residents had a significantly higher mean number of comorbid conditions than residents without diabetes (3.2 vs. 2.9). Congestive heart failure, chronic obstructive pulmonary disease, coronary heart disease, hypertension, re-nal disease, and stroke were all more common among diabetic residents. Although diabetic residents were more likely to have had emergency department visits (39.0 vs. 33.7%) and overnight hospital admissions (27.8 vs. 23.0%) in the past year, they were less likely to have experienced an injurious fall during this period (12.7 vs. 15.4%). However, they were more likely to use walking aids (58.2 vs. 54.4%) and less likely to exercise (44.2 vs. 49.4%). Diabetic residents were more likely to receive dietary support (61.7 vs. 24.2%), assistance with medications (89.3 vs. 85.5%), skilled nursing (16.0 vs. 11.9%), health monitoring (81.6 vs. 73.8%), and medical transportation (63.0 vs. 58.1%) services. RCFs are a fast-growing sector of the senior housing market that can support older adults as their needs increase and become more complex. The primary reason that older adults choose RCFs is that they offer services that help maintain independence. We demonstrate that 17% …