Positions of Influence in the Nursing Home Admission Decision

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Abstract
Decisions leading to nursing home admissions have substantial personal and policy consequences, but little research has focused on who is influential in the decision process. We sought to determine which of various social positions were viewed as being very influential in the decision to admit and what factors were associated with perceived level of influence of certain social positions. We examined data from telephone interviews with a sample of 145 responsible parties of first-time, recently admitted nursing home residents in Virginia. Family influence on institutional decision making appears to follow a hierarchical pattern similar to that for preadmission family caregiving. Nursing home residents were infrequently very influential parties to the decision. Health care professionals, especially physicians, were frequently described by sponsors as very influential to the decision process. There is some evidence of a cluster of influence among health professionals and clergy, with the physician occupying a central position in this cluster.