People with dementia receiving home health care visits are less likely to be readmitted to the hospital when there is consistency in nursing staff, according to a new study.

Home health care — in which health providers, primarily nurses, visit patients’ homes to deliver care — has become a leading source of home- and community-based services caring for people living with dementia. These individuals often have multiple chronic conditions, take several medications, and need assistance with activities of daily living. In 2018, more than 5 million Medicare beneficiaries received home health care, including 1.2 million with Alzheimer’s disease and related dementias.

«Nurses play a pivotal role in providing home health care,» said Chenjuan Ma, PhD, MSN, assistant professor at NYU Meyers and the study’s lead author. «As the population ages and older adults choose to ‘age in place’ as long as possible, the demand for home health care for people with dementia is expected to grow rapidly.»

For most patients, their home health care often begins after being discharged from the hospital. Given that hospital readmissions are a significant quality, safety, and financial issue in healthcare, Ma and her colleagues wanted to understand if having continuity of care, or the same nurse coming to each home visit, could help prevent patients from being readmitted.

Using multiple years of data from a large, not-for-profit home health agency, the researchers studied 23,886 older adults with dementia who received home health care following a hospitalization. They measured continuity of care based on the number of nurses and visits during home health care, with a higher score indicating better continuity of care.

Approximately one in four (24 percent) of the older adults with dementia in the study were rehospitalized from home health care. Infections, respiratory problems, and heart disease were the three most common reasons for being readmitted to the hospital.

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