title: [The end of home care or the end at home?].
abstract: The decision to refer a demented patient to a nursing home is not always an easy one. The family physician has an active role to play: asking timely questions, helping families to prevent what can be prevented; giving proper advice on how and when to make arrangements for private or public accommodation; giving adequate support to the patient and his/her family before and after entering a nursing home. Some difficult situations can occur: family members may disagree on the necessity for the patient to be sent to a nursing home, or the patient may refuse to leave home. Here as well, the physician can play an essential role: his knowledge of the patient's family and personal history, his communication skills and his capacity to assess the patient's ability to consent are key factors in making a smooth transition. Occasionally, the patient's family decides to keep the patient at home until the end. The success of such a venture is highly dependent on the following elements: thorough understanding of the patient's condition and of its possible complications, a readily available and reliable support network, good teamwork, medical follow-up and full-time on-call system.
authors.affiliation: Service de gériatrie de l'Hôpital Laval, Québec.
authors.forename: Guy
authors.initials: G
authors.lastname: Béland
mesh_terms: D003704:Dementia / Q000628:therapy*; D005190:Family; D006699:Home Care Services; D006801:Humans; D007326:Institutionalization; D017149:Private Sector; D017150:Public Sector