title: Priority for elderly persons with behavioral and psychological symptoms of dementia on waiting lists for placement in nursing homes in Japan: do nursing homes change priorities based on their own guidelines?
abstract: OBJECTIVE
  In Japan, individuals seeking to be placed in nursing homes under the public long term care insurance program are subject to long waiting lists. Applicants are evaluated according to their needs for nursing home placement and assigned to homes based on their relative priority. The aim of the present study was to examine differences between the admission guidelines used by nursing homes and their attitudes regarding the priority for admitting elderly persons with behavioral and psychological symptoms of dementia (BPSD) from their waiting lists.
  
  
  METHODS
  This study was conducted using a cross-sectional study design.
  
  
  METHODS
  Two hundred and eight different facilities provided sets of completed questionnaires and copies of their placement guidelines.
  
  
  METHODS
  The managing director or social worker at each facility provided self-reports of whether they would increase the priority of applicants with BPSD and whether they would admit applicants who require treatment for BPSD. Each facility's placement guidelines were also collected.
  
  
  RESULTS
  Most evaluation guidelines (65.9%) considered an applicant's BPSD as a condition that required nursing home placement; however, only 16.8% of the respondents actually increased the placement priority of applicants with BPSD. Some respondents refused to admit applicants who require treatment for BPSD but did not explicitly state in their guidelines that the priority of applicants with BPSD would be reduced because of the facility's inability to address BPSD.
  
  
  CONCLUSIONS
  The present study revealed differences between nursing homes' official guidelines and their attitudes toward the priority of admitting elderly persons with BPSD from their waiting lists. Future studies should explore the factors that influence the placement of individuals with BPSD into nursing homes.
authors.affiliation: Institute for Health Economics and Policy, Tokyo, Japan. mnakanishi-tky@umin.ac.jp
authors.forename: Miharu
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Keiko
authors.initials: K
authors.lastname: Hattori
authors.forename: Taeko
authors.initials: T
authors.lastname: Nakashima
authors.forename: Kanae
authors.initials: K
authors.lastname: Sawamura
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003704:Dementia / Q000503:physiopathology*; D004608:Eligibility Determination; D006801:Humans; D007564:Japan; D001523:Mental Disorders; D009735:Nursing Homes; D010343:Patient Admission; D011795:Surveys and Questionnaires; D014850:Waiting Lists