title: Understanding care of people with dementia in Spain: cohabitation arrangements, rotation and rejection to long term care institution.
abstract: BACKGROUND
  Most people with dementia in Spain live at home with their families. Current changes in the family structure are transforming the care of people with dementia through new cohabitation arrangenments and rotation practices.
  
  
  OBJECTIVE
  To describe the cohabitation arrangements of families of people with dementia in Spain and to understand the caregivers' characteristics related to rotation and the rejection of long term care institutions.
  
  
  METHODS
  A cross sectional study -NEDICES study- was conducted using both quantitative and qualitative methodologies.150 caregivers of people with dementia from two communities from Madrid, Spain, were surveyed using a questionnaire designed to describe cohabitation arrangements and care. Qualitative methods included: 13 caregivers participating in focus groups, and 3 caregivers in Semi Structured Interviews aimed to understand rotation practices and rejection to long term care institution.
  
  
  RESULTS
  Characteristics related with rotation were: sex of persons with dementia, widowhood, socio-economic status, caregiver relationship and burden of the caregiver. The qualitative study showed that the use of the rotation was related to normative behaviors and with obligation feelings, along with a change in the role of women in the current Spanish family. The use of long term care institutions was related to geographical distance of the family.
  
  
  CONCLUSIONS
  The results of this study suggest that rotation has appeared in Spain as a new mechanism of care for people with dementia, and its related to the rejection of long term care institutions.
authors.affiliation: Universidad de Salamanca, Departamento de Sociología y Comunicación, Facultad de Ciencias Sociales, Salamanca, Spain. jrivera@usal.es
authors.forename: Jesús
authors.initials: J
authors.lastname: Rivera
authors.forename: Felix
authors.initials: F
authors.lastname: Bermejo
authors.forename: Manuel
authors.initials: M
authors.lastname: Franco
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Morales-González
authors.forename: Julian
authors.initials: J
authors.lastname: Benito-León
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000534:rehabilitation*; D005190:Family / Q000523:psychology*; D005260:Female; D006701:Home Nursing / Q000458:organization & administration* / Q000523:psychology; D006801:Humans; D007326:Institutionalization; D008134:Long-Term Care / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012111:Residence Characteristics; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult