All 224 consecutive new patients who were admitted in 1982 through 1985 to the day care department of a skilled-care psychogeriatric nursing home were followed longitudinally until death. Dementia was diagnosed in 95.1% of the 133 women and 91 men. Their mean age at admission was 78.7 years (SD = 7.4). Every 12 months after their initial attendance the patients' status was recorded and coded as living in the community, institutionalized or dead. At one year after initial attendance 99 (44.20/,) patients still resided in the community, 94 (42.0%) were admitted to a nursing home or (psychiatric) hospital and 31 (13.8%) had died. At five years only nine (4.0%) patients resided in the community, 65 (29.0%) were in long-term institutional care and 150 (67.0%) had died. Age, gender, socioeconomic status or living alone did not contribute to first-year outcome, but severity of cognitive impairment was associated with an increased risk of becoming institutionalized. Using logistic regression analysis, a model of three variables, living at home, needing help from caregiving children, and high ratings of dependency, assigned 61.4%) of 176 subjects correctly as institutionalized versus residing in the community.
KEY woms-Day hospital, predictors of institutionalization, dementia, survival, behaviour ratings, psychometric variables, sociodemographic variables, caregiving.
Psychogeriatric day care has a relatively short history in The Netherlands. Only in 1977 did the Dutch government decide that nursing homes which provide skilled nursing care and round-theclock custodial care to elderly people were allowed to deliver day care too. In 1979 only 150 places were available for psychogeriatric day care in this country. Now, governmental planning norms allow 75 places for psychogeriatric day care for 100 000 inhabitants of 65 years or older. In 1990 there were 1483 places for psychogeriatric day care, serving the Dutch elderly population of 1.91 million (Centraal Bureau voor de Statistiek (CBS), 1991; SIG Informatiecentrum voor de Gezondheidszorg (SIG), 1991).
The three main objectives of day care are to enhance the patient's physical, cognitive and social abilities, to help the caregivers in looking after the Some of the findings in this article were originally presented at the 2nd European Congress of Gerontology, Madrid, September 11-14, 1991.