An attempt to determine the benefits of a 'home-for-life' principle in residential care for people with dementia and behavioural problems: a comparative cohort study.
It is not clear whether moving individuals with dementia and behavioural problems as part of a rehabilitation and relocation ('intermediate care', IC) nursing home model worsens behaviour, compared with a 'home for life' philosophy. We studied this in contiguous services with the same formal admission criteria but different models of subsequent care. 37 patients admitted to 'homes for life' and 24 to IC homes were followed up for 1 year using the BEHAVE-AD. Scores were lower at baseline in the IC group. Both groups deteriorated over the year, although more in IC patients (trend), and those actually moving home were worse after the move. Use of neuroleptic medication increased significantly in the IC group. Our results confirm previous studies of the disruptive effects of re-location for patients with severe dementia but do not suggest major differences between the two models of care.
Macdonald
Alastair
A
Joint Division of Psychological Medicine, Guy's, King's and St. Thomas' Medical Schools and Institute of Psychiatry, King's College, London, UK. alstair.macdonald@kcl.ac.uk
Philpot
Michael
M
Briggs
Catherine
C
D000368:Aged; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000534:rehabilitation; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales; D012112:Residential Facilities; D013997:Time Factors; D016896:Treatment Outcome