title: Long-term-care placement and survival of persons with Alzheimer's disease.
abstract: Although long-term-care (LTC) placement may shorten the survival of persons with Alzheimer's disease, studies have not examined whether the timing of placement matters. A sample of 258 persons with Alzheimer's disease and their family caregivers was used in a Cox survival model that included care-recipient impairments, caregiver characteristics, and LTC placement as covariates. Placement was associated with shortened survival, but the later the placement, the smaller the impact of placement on survival time. In an elaboration on prior work, the increased risk of death associated with wishfulness-intrapsychic caregiver coping was found to occur independently of LTC placement. This is the first study to link delayed LTC with a reduced risk of death in Alzheimer's disease. Interventions to assist family caregivers in the home are indeed appropriate; nevertheless, these findings may help long-term caregivers accept eventual institutionalization for their care recipients when care at home threatens their own health.
authors.affiliation: University Memory and Aging Center, Case Western Reserve University and University Hospitals of Cleveland, 12200 Fairhill Road, Cleveland, OH 44120, USA. mjm18@cwru.edu
authors.forename: McKee J
authors.initials: MJ
authors.lastname: McClendon
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Smyth
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Neundorfer
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003710:Demography; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D008134:Long-Term Care / Q000706:statistics & numerical data*; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*