Predictors of institutionalization for people with dementia living athome with a carer
T. Hope
Bok Engelsk 1998
| Utgitt | 1998
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| Omfang | Side 682- 690
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| Opplysninger | Objective. This article examines the relationships between behaviour,psychological functioning, the caring environment and subsequentinstitutionalization in patients with dementia living at home with acarer.Design. Longitudinal study of behaviour in dementia, with a nestedcase-control study to investigate predictors ofinstitutionalization.Setting. Subjects with dementia, known to service, living at homewith a carer. All lived in Oxfordshire, UK.Participants. 100 people with dementia (Alzheimer's disease and/orvascular dementia) who were living at home with a carer at the startof the study.Measures. At 4-monthly intervals, the carers were interviewed and thesubjects with dementia were assessed cognitively. Subjects' behaviourand psychological functioning were assessed using the PresentBehavioural Examination.Results. The characteristics which best predictedinstitutionalization 1 year later were: excessive night-timeactivity; immobility or difficulty in walking incontinence; beingaway from a carer for more than 16 hours a week; and being cared forby a female. Aggressive behaviour was not associated with anincreased chance of entry into an institution 1 year later, althoughit was more prevalent 4 months before entering an institution.Conclusions. Both behaviour and psychological functioning and thecaring environment can help in predicting which patients withdementia currently living at home will enter an institution 1 yearlater. These predictors are not the same as those which are theimmediate cause of institutionalization. (C) 1998 John Wiley & Sons.
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