Efficacy of a geriatrics team intervention for residents in dementia-specific assisted living facilities: effect on unanticipated transitions.
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.
Bellantonio
Sandra
S
Baystate Medical Center/Tufts University School of Medicine, Springfield, Massachusetts, USA.
Kenny
Anne M
AM
Fortinsky
Richard H
RH
Kleppinger
Alison
A
Robison
Julie
J
Gruman
Cynthia
C
Kulldorff
Martin
M
Trella
Patricia M
PM
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