Residents’ involvement in the admission process in long-term care settings in France: Results of the “EHPA 2000” survey

In order to identify the factors influencing residents’ involvement in the decision-making process prior to admission to a long-term care setting, we analyzed results of a national survey of residents of long-term care settings in France. We interviewed 3538 residents in 584 long-term care settings. Only 38.1% of residents said they had taken part in the admission process. Risk factors for non-involvement were the care level of the long-term care settings (odds ratio = OR = 8.11 [5.63–11.68] and 2.73 [2.26–3.30], respectively, for long-term care units and retirements homes as compared to residential homes), lack of autonomy (dressing/washing) (OR = 1.95 [1.66–2.30] versus autonomous), inability to answer questions on income (OR = 2.16 [1.83–2.56]), age under 80 (OR = 1.29 [1.04–1.61]) versus >90 years old patients, and being married (OR = 1.60 [1.13–2.26]). Resident involvement in the decision-making process influenced subsequent feelings about institutional life. Older adults said that they were frequently not involved in the decision-making process prior to admission to a long-term care setting. This was particularly true for the high-care level long-term care settings, where organizational factors might intervene and for vulnerable elders for whom loss of autonomy could be lived as a loss of citizenship.