Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 2 , Pages 244-250, February 2008

Characterizing Wandering Behaviors in Persons With Traumatic Brain Injury Residing in Veterans Health Administration Nursing Homes

  • Heather G. Belanger, PhD

      Affiliations

    • Department of Mental Health & Behavioral Science, James A. Haley Veterans Administration Medical Center, Tampa, FL
    • Defense and Veterans Brain Injury Center, Washington, DC
    • Psychology Department, University of South Florida, Tampa, FL
    • Corresponding Author InformationReprint requests to Heather G. Belanger, PhD, PM&R-117, 13000 Bruce B. Downs, Tampa, FL 33612
    • ,
  • Bellinda King-Kallimanis, MS

      Affiliations

    • Department of Aging and Mental Health, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL
    • ,
  • Audrey L. Nelson, PhD, RN

      Affiliations

    • The Patient Safety Center of Inquiry, James A. Haley Veterans Administration Medical Center, College of Nursing, University of South Florida, Tampa, FL.
    • ,
  • Lawrence Schonfeld, PhD

      Affiliations

    • Department of Aging and Mental Health, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL
    • ,
  • Steven G. Scott, DO

      Affiliations

    • Department of Physical Medicine & Rehabilitation, James A. Haley Veterans Administration Medical Center, Tampa, FL
    • Defense and Veterans Brain Injury Center, Washington, DC
    • ,
  • Rodney D. Vanderploeg, PhD

      Affiliations

    • Department of Mental Health & Behavioral Science, James A. Haley Veterans Administration Medical Center, Tampa, FL
    • Defense and Veterans Brain Injury Center, Washington, DC
    • Psychology Department, University of South Florida, Tampa, FL

Abstract 

Belanger HG, King-Kallimanis B, Nelson AL, Schonfeld L, Scott SG, Vanderploeg RD. Characterizing wandering behaviors in persons with traumatic brain injury residing in Veterans Health Administration nursing homes.

Objective

To examine the prevalence and correlates of wandering in persons with traumatic brain injury (TBI) in nursing homes (NHs).

Design

Using a cross-sectional design, logistic regression modeling was used to analyze a national database.

Setting

One hundred thirty-four NH facilities operated by the Veterans Health Administration.

Participants

NH residents (N=625) with TBI as well as a sample (n=164) drawn from a larger dataset of NH residents without TBI using 1:K matching on age.

Interventions

Not applicable.

Main Outcome Measure

Wandering.

Results

Wanderers with and without TBI did not differ significantly overall. The prevalence of wandering among patients with TBI was 14%, compared with 6.5% of the general nursing home population. The results of the multivariate logistic regression suggested that wandering was associated with poor memory, poor decision making, behavior problems, independence in locomotion and ambulation, and dependence in activities of daily living related to basic hygiene.

Conclusions

Wandering is relatively common in NH residents with TBI. As expected, it is associated with cognitive, social, and physical impairments. Further research with a larger sample should examine those with comorbid dementia and/or psychiatric diagnoses.

Key Words: Brain injuries, Nursing homes, Rehabilitation

 

 Supported by the Department of Veterans Affairs, Veterans Health Administration; the Defense and Veterans Brain Injury Center (grant no MDA 905-03-2-0003); and the Patient Safety Center of Inquiry, James A. Haley Veterans’ Hospital.No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(07)01655-3

doi:10.1016/j.apmr.2007.08.145

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 2 , Pages 244-250, February 2008

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