title: Admission into a Nursing Home. Delay or prevention with the use of a complete support network?
abstract: BACKGROUND
  Becoming older in Germany often leads to admission into a nursing home.
  
  
  OBJECTIVE
  The aim of this study was to investigate if a complete support network (CSN) can contribute to preventing admission into a nursing home. Organizational and financial prerequisites of a CSN were documented.
  
  
  METHODS
  In this study 32 patients with psychiatric disorders diagnosed according to the International Classification of Diseases 10 (ICD 10, 16 as F00 dementia in Alzheimer disease and 16 as F31-33 bipolar affective disorder, depressive episode and recurrent depressive disorder) were observed over a period of 2 years. The intervention consisted of participation in a defined CSN, which was developed by the Alexian Research Centre in Krefeld (ARCK). A cooperation of all persons and institutions involved in the care of elderly patients with psychiatric disorders was initiated. An individualized help plan was compiled for each patient. The primary outcome was admittance to a nursing home or remaining at home. The duration of staying at home was measured in days. User satisfaction was assessed with a 5‑step Likert scale questionnaire. The steering process and the financial efforts necessary to run the CSN were descriptively evaluated.
  
  
  RESULTS
  At the end of the observation period 28 out of 32 patients were not admitted to a nursing home. During the observational period one patient dropped out, one died and two were admitted to a nursing home. User satisfaction achieved a median score of 5 (very satisfied). No additional funding was necessary to run the CSN.
  
  
  CONCLUSIONS
  The CSN can prevent admission to a nursing home without needing additional funding and the whole process can be guided by the patient.
authors.affiliation: Department of Psychiatry, University of Duesseldorf, Duesseldorf, Germany. R.Ihl@alexianer.de.|Alexian Research Center, Dießemer Bruch 81, 47805, Krefeld, Germany. R.Ihl@alexianer.de.
authors.forename: Ralf
authors.initials: R
authors.lastname: Ihl
authors.affiliation: Alexian Research Center, Dießemer Bruch 81, 47805, Krefeld, Germany.
authors.forename: Nadine
authors.initials: N
authors.lastname: Cujai
authors.affiliation: Alexian Research Center, Dießemer Bruch 81, 47805, Krefeld, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Krah
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis / Q000451:nursing*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006699:Home Care Services / Q000706:statistics & numerical data*; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D000072858:Psychosocial Support Systems; D012944:Social Support; D016896:Treatment Outcome
keywords: Dementia; Depression; Nursing home admission; Prevention; Service structures