title: ["As Good as it Gets at Home" - Reasons for Institutionalisation in Dementia].
abstract: OBJECTIVE
  What are the reasons for institutionalising community-dwelling persons with dementia?
  
  
  METHODS
  A written survey of family caregivers and general practitioners was undertaken.
  
  
  RESULTS
  Within 2 years 47 of 351 people with dementia (13%) were institutionalised. The person with dementia was involved in the decision in only 1/3 of the cases. The 3 most common reasons were: ensuring the best possible care, high expenditure of care-giving time at home, deterioration of the health of the care-receiver.
  
  
  CONCLUSIONS
  From the ethical point of view the exclusion of the persons with dementia from the decision-making with regard to institutionalisation has to be examined critically. The often given reason of ensuring the best possible care through institutionalisation could be counteracted by the improvement of community-based care.
authors.affiliation: Zentrum für Medizinische Versorgungsforschung, Psychiatrische Universitätsklinik Erlangen, Erlangen.
authors.forename: H
authors.initials: H
authors.lastname: Grau
authors.affiliation: Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Carl Gustav Carus Dresden, Dresden.
authors.forename: H
authors.initials: H
authors.lastname: Berth
authors.affiliation: Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, (IQWiG), Köln.
authors.forename: J
authors.initials: J
authors.lastname: Lauterberg
authors.affiliation: Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München, Neuherberg.
authors.forename: R
authors.initials: R
authors.lastname: Holle
authors.affiliation: Zentrum für Medizinische Versorgungsforschung, Psychiatrische Universitätsklinik Erlangen, Erlangen.
authors.forename: E
authors.initials: E
authors.lastname: Gräßel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000941:ethics / Q000706:statistics & numerical data; D000066491:Clinical Decision-Making / Q000941:ethics* / Q000379:methods*; D003704:Dementia / Q000453:epidemiology* / Q000451:nursing*; D005260:Female; D058005:General Practitioners / Q000941:ethics / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000941:ethics / Q000706:statistics & numerical data*; D014600:Utilization Review