The European Union recently announced funding for a large multi-national study aimed to validate the interRAI LTCF instrument as a methodology to assess the provision of care in nursing homes in Europe.

Services and Health for Elderly in Long TERm care (SHELTER)

The European Union, through the 7th Framework programme, has recently funded a the study SHELTER (Services and Health for Elderly in Long TERm care. The project leader is interRAI collaborator Professor Roberto Bernabei. The SHELTER study is aimed to validate the MDS assessment instrument for long term care residents (MDS-LTCF or interRAI LTCF) as a methodology to assess the provision of care in NH in Europe. To make this instrument applicable to a large European population, this study will assess:

a. linguistic validity of the instrument in different translations
b. face validity of items included in the translated versions of the instrument
c. test-retest and inter-rater reliability of each item
In addition, the SHELTER study proposes to implement and apply on al large scale the MDS LTCF, leading to the creation of a database that will allow the unprecedented opportunity to:
d. measure residents outcomes and identify predictors of outcomes
e. develop eligibility criteria and resource utilization groupings
f. monitor services delivery and analyse quality measures

After this process will be completed the MDS LTCF could be used on a large scale as a common and standardised assessment instrument for NH residents in Europe, allowing to compare characteristics of NH residents in different countries, to assess quality of care, resources utilisation and patients outcomes.
NH residents in the study will be assessed using an MDS-like assessment instrument specifically designed (MDS-LTCF). Data on both “structural” and “organisational” characteristics of each NH will also be collected with a specifically designed form, the European Nursing Home Services (EU-NHS). All the information collected will contribute to the creation of a previously not available European database on NH (Shelter database).

The study will be performed in 8 countries, including:
- Italy;
- Czech Republic;
- Germany;
- Finland;
- France;
- Israel;
- The Netherlands;
- United Kingdom.

Each country will contribute a sample of 500 individuals from several NHs. The representativeness of the study sample from each country will be checked against the available national statistics on nursing home residents.
The enrolment of participants will span over 3 months. Participants in the study will include individuals residing in NH at the beginning of the study. Resident’s assessment will be performed at baseline, at 6 and 12 months. In addition, a sample of 100 residents from each country will be used to calculate test-retest and inter-rater reliability. Participants will be followed for a 1 year period. There will be no established exclusion criteria. Researchers in each participating country will anyway seek the approval by the competent ethical committee and patients, caregivers or family members will be asked to give an informed consent.