Predictors of institutionalization for people with dementia living at home with a carer

✍ Scribed by Tony Hope; Janet Keene; Kathy Gedling; Christopher G. Fairburn; Robin Jacoby

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 140 KB
• Volume: 13
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/(sici)1099-1166(1998100)13:10<682::aid-gps847>3.0.co;2-y

✦ Synopsis

Objective:

This article examines the relationships between behaviour, psychological functioning, the caring environment and subsequent institutionalization in patients with dementia living at home with a carer.

Design:

Longitudinal study of behaviour in dementia, with a nested case-control study to investigate predictors of institutionalization.

Setting:

Subjects with dementia, known to service, living at home with a carer. all lived in oxfordshire, uk.

Participants:

100 people with dementia (alzheimer's disease and/or vascular dementia) who were living at home with a carer at the start of the study.

Measures:

At 4-monthly intervals, the carers were interviewed and the subjects with dementia were assessed cognitively. subjects' behaviour and psychological functioning were assessed using the present behavioural examination.

Results:

The characteristics which best predicted institutionalization 1 year later were: excessive night-time activity; immobility or difficulty in walking; incontinence; being away from a carer for more than 16 hours a week; and being cared for by a female. aggressive behaviour was not associated with an increased chance of entry into an institution 1 year later, although it was more prevalent 4 months before entering an institution.

Conclusions:

Both behaviour and psychological functioning and the caring environment can help in predicting which patients with dementia currently living at home will enter an institution 1 year later. these predictors are not the same as those which are the immediate cause of institutionalization.