title: [Geriatric psychiatric home counseling for people with dementia and anosognosia : Results of a model project].
abstract: BACKGROUND
  Lack of awareness of an illness (anosognosia) is a common symptom in dementia and has a significant impact on the course of the disease. It is associated with dysfunctional interaction with caregivers. Due to unawareness patients are not able to accept diagnostic procedures or medical treatment and refuse any kind of support. Thus, they are not integrated into psychosocial networks and medical support. This has a significant impact on patient-centered care in a domestic environment. In this article a model project with home visits to patients with dementia and anosognosia is described.
  
  
  METHODS
  A total of 55 home visits were carried out. The aim of this project was the integration into the existing healthcare services in order to safeguard the domestic environment. These visits focused on advice and information for the patients and their caregivers initiating the visits. Sociodemographic data of the patient cohort and the satisfaction of the caregiving relatives and general practitioners are presented.
  
  
  RESULTS
  Subjects with dementia were found to be in advanced stages of the disease, caring situations were complex and required assistance. Caregivers showed a substantial burden in accordance with previous reports.
  
  
  CONCLUSIONS
  New strategies are required to cope with anosognosia in patients with dementia and their caregivers. Even single home visits seem to be sufficient to initiate support for subjects with dementia and their relatives.
authors.affiliation: Institutsambulanz Gerontopsychiatrie, LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Mooren Str. 5, Gebäude 14.99, 40225, Düsseldorf, Deutschland. sandra.verhuelsdonk@lvr.de.
authors.forename: Sandra
authors.initials: S
authors.lastname: Verhülsdonk
authors.affiliation: Institutsambulanz Gerontopsychiatrie, LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Mooren Str. 5, Gebäude 14.99, 40225, Düsseldorf, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Supprian
authors.affiliation: Institutsambulanz Gerontopsychiatrie, LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Mooren Str. 5, Gebäude 14.99, 40225, Düsseldorf, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Höft
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000377:Agnosia / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000193:education / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D037001:Directive Counseling / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D005852:Geriatric Psychiatry / Q000379:methods / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: Ambulatory care; Counseling; Geriatric psychiatry; Networks; Neuropsychological tests