How spouses evaluate Nursing Home Placement of their demented partner: a study about the end of perseverance time.
OBJECTIVE
This study was about the final decision by spouses to have their demented partner placed in a nursing home. The central question was whether the admission took place in the right time in their point of view.


METHODS
Fourteen partners of persons with dementia evaluated the nursing home placement. They were interviewed at home using a semi-structured questionnaire. Grounded theory was used to explore the process of decision-making. In addition to the interviews, quantitative data were used from a 2-year follow-up study.


RESULTS
Results underline that the placement decision had to be made in phases over time. The first decision is about placement of the relative on a waiting list, and the second decision is about the actual placement in a nursing home once a place becomes available. This second and final decision often had to be taken under time pressure to avoid a place in the nursing home being left empty. If they had been given more time and space to reconsider their admission decision, most partners said they could have had continued providing homecare longer. During the investigation, the following classification in timeliness of the admission emerged: Placement was at the right time, too early, too late or out of control.


CONCLUSIONS
Spouses indicated they could have kept on giving care for a longer period of time if they had been given more time and space to make their final decision about the admission of their partner. It may be helpful for informal and formal carers to focus on perseverance time in considering placement or prolonged support at home. Placement at an appropriate time may lead to a higher degree of well-being of informal carers before and especially after the admission.
Julius Centre for Health Sciences and Primary Care, Utrecht MC, Utrecht, The Netherlands.
Henk
H
Kraijo
Rob
R
de Leeuw
Guus
G
Schrijvers
D003704:Dementia / Q000451:nursing*; D006801:Humans; D009735:Nursing Homes; D010343:Patient Admission; D018454:Spouses / Q000523:psychology*
admission; dementia; informal carer; nursing home placement; perseverance time; spouses