title: Efficacy of a geriatrics team intervention for residents in dementia-specific assisted living facilities: effect on unanticipated transitions.
abstract: OBJECTIVE
  To determine whether a multidisciplinary team intervention minimizes unanticipated transitions from assisted living for persons with dementia.
  
  
  METHODS
  Randomized trial.
  
  
  METHODS
  Two dementia-specific assisted living facilities in Connecticut owned and managed by the same corporation.
  
  
  METHODS
  One hundred older adults with dementia who relocated to assisted living.
  
  
  METHODS
  Four systematic multidisciplinary assessments by a geriatrician, geriatrics advanced practice nurse, physical therapist, dietitian, and social worker during the first 9 months of relocation to assisted living.
  
  
  METHODS
  Permanent relocation to a nursing facility, emergency department (ED) visits, hospitalization, and death.
  
  
  RESULTS
  Fifty-five residents experienced any unanticipated transition out of assisted living, on average 84 +/- 74 days after relocation; falls were the primary reason for transition. The intervention reduced the risk of any unanticipated transitions (13%), permanent relocation to a nursing facility (11%), ED visits (12%), hospitalization (45%), and death (63%), but the results did not meet statistical significance. In secondary analysis, more men experienced any unanticipated transition (P<.001), hospitalization (P<.001), or death (P<.001) than women.
  
  
  CONCLUSIONS
  Although an untargeted multidisciplinary intervention did not significantly reduce the risk of transitions for individuals with dementia relocating to assisted living in this small sample, trends for decreasing hospitalization and death were found. The data further suggest that those at risk for falls and men may benefit from targeted clinical interventions to prevent unanticipated transitions, especially during the first 3 months after relocation.
authors.affiliation: Baystate Medical Center/Tufts University School of Medicine, Springfield, Massachusetts, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Bellantonio
authors.forename: Anne M
authors.initials: AM
authors.lastname: Kenny
authors.forename: Richard H
authors.initials: RH
authors.lastname: Fortinsky
authors.forename: Alison
authors.initials: A
authors.lastname: Kleppinger
authors.forename: Julie
authors.initials: J
authors.lastname: Robison
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gruman
authors.forename: Martin
authors.initials: M
authors.lastname: Kulldorff
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Trella
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration*; D006760:Hospitalization; D006801:Humans; D008297:Male; D009735:Nursing Homes; D010348:Patient Care Team / Q000458:organization & administration*; D010360:Patient Transfer; D016896:Treatment Outcome