title: Reasons of informal caregivers for institutionalizing dementia patients previously living at home: the Pixel study.
abstract: BACKGROUND
  Study of the problems and requirements of the main caregiver providing home care for dementia patients that have resulted in the patient being institutionalised.
  
  
  OBJECTIVE
  To determine the reasons for placing the dementia patient in an institution.
  
  
  METHODS
  Self-administered questionnaire of 48 questions on the patient and caregiver, including a list of complaints, given to the main caregiver. Medical questionnaire on the patient filled in by the geriatrician.
  
  
  RESULTS
  Data were collected from 109 questionnaires concerning 75 females with dementia (84.7 +/- 6.7 years) and 34 demented males (80.8 +/- 7.4 years). In two-thirds of cases the main caregiver was a female, aged 61.1 +/- 12.1 years. Cognitive disorders were not the main reasons for institutionalizing patients. The most frequent caregiver complaint at the time of institutionalisation was incontinence, followed by withdrawal. The caregiver's main problem resulting in institutionalisation was dependence, with behavioural disorders in second place. A treatment with anticholinesterase for dementia was associated with a live-in career being provided for 20 months longer than in the case of patients not receiving this treatment. Statistical analysis revealed 6 groups of separate caregiver-patient situations. On the one hand there were those patients who appeared to be easy for the caregiver to cope with: those with no problems, docile patients and passive patients not opposing care. In these cases the caregiver was most often young and male, or not directly related to the patient. On the other hand there were 3 other groups: patients with inappropriate motor behaviours, violent/agitated patients and unmotivated patients who opposed care. These patients lived with an elderly caregiver who had been looking after the patient for several years.
  
  
  CONCLUSIONS
  Caregivers' requirements are for help with coping with and preventing dependence. The caregiver suffers terribly from a lack of relief, particularly when young.
  
  
  CONCLUSIONS
  It is necessary to change the focus of home care for dementia patients towards preventing loss of autonomy and its consequences and to allow for periods of relief for home caregivers.
authors.affiliation: Poitiers University Hospital, Poitiers, France. thomasphil@interpc.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Thomas
authors.forename: Pierre
authors.initials: P
authors.lastname: Ingrand
authors.forename: Fabrice
authors.initials: F
authors.lastname: Lalloue
authors.forename: Cyril
authors.initials: C
authors.lastname: Hazif-Thomas
authors.forename: Rémy
authors.initials: R
authors.lastname: Billon
authors.forename: François
authors.initials: F
authors.lastname: Viéban
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Clément
mesh_terms: D000223:Adaptation, Psychological; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology; D003704:Dementia / Q000150:complications / Q000188:drug therapy / Q000451:nursing*; D003858:Dependency, Psychological; D005260:Female; D006801:Humans; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000209:etiology