[Study of discharge support in dementia cases].
OBJECTIVE
The goal of this study was to clarify how the post-discharge support by a full time psychiatric social worker (PSW) in a dementia ward affected the discharge status of dementia patients.


METHODS
Patients who were discharged from a dementia ward were examined for hospitalization, post-discharge status, nutrition methods, treatment drugs, and relationship with discharge support performed by the PSW.


RESULTS
A total of 192 cases met the requirements for this examination, and approximately half (94, 49.0%) of these patients had Alzheimer disease. Fifty-two patients (32.3%) moved to home care. Forty-five patients visited our hospital for treatment, while 17 visited other medical institutions for treatment. Thirty-four patients (17.7%) moved to other medical institutions, and the remaining 96 patients (50.0%) entered other institutions. About half of these patients entered insurance care facilities for the elderly, and the number of entered cases decreased in the order of special elderly nursing homes, paid homes for the elderly, and group homes. The highest mean support frequency per case was more than 50 occasions and 800 minutes for a paid home for the elderly. This support decreased in the order of special elderly nursing homes, insurance care facilities, and group homes. Cases treated at other medical institutions had the shortest hospitalization, but these cases had a greater mean support frequency than the cases treated at our hospital. The lowest mean support frequency was for oral meal intake while the highest mean support frequency was for nourishment by gastrostomy, with a significant difference between both (P<0.01). Only for cases that entered insurance care facilities for the elderly was there significantly more support frequency for cases that took donepezil hydrochloride than cases that took other drugs (P<0.03).


CONCLUSIONS
After discharge from a dementia ward, the PSW spent a significant amount of time on discharge support, and this discharge support was indispensable. Hospitalization at a medical institution or admission to facilities was associated with a higher degree of discharge support than home care. Furthermore, patients who were hospitalized at a long-term medical treatment institution, or those who entered an insurance care facility for the elderly, needed frequent support for drug administration.
Shioji
Naoko
N
Department of Regional Alliances, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University Faculty of Medicine.
Aiba
Miyoji
M
Tsuda
Hiroshi
H
Isonuma
Hiroshi
H
D000359:Aftercare / Q000379:methods*; D000368:Aged; D003704:Dementia / Q000628:therapy*; D006801:Humans; D009735:Nursing Homes / Q000706:statistics & numerical data; D010351:Patient Discharge; D012949:Social Work, Psychiatric