title: Characteristics of double care demanding patients in a mental health care setting and a nursing home setting: results from the SpeCIMeN study.
abstract: BACKGROUND
  Older patients suffering from a combination of psychiatric disorders and physical illnesses and/or dementia are called Double Care Demanding patients (DCDs). Special wards for DCDs within Dutch nursing homes (NHs) and mental health care institutions (MHCIs) offer a unique opportunity to obtain insight into the characteristics and needs of this challenging population.
  
  
  METHODS
  This observational cross-sectional study collected data from 163 DCDs admitted to either a NH or a MHCI providing specialized care for DCDs. Similarities and differences between both DCD groups are described.
  
  
  RESULTS
  Neuropsychiatric symptoms were highly prevalent in all DCDs but significantly more in MHCI-DCDs. Cognitive disorders were far more present in NH-DCDs, while MHCI-DCDs often suffered from multiple psychiatric disorders. The severity of comorbidities and care dependency were equally high among all DCDs. NH-DCDs expressed more satisfaction in overall quality of life.
  
  
  CONCLUSIONS
  The institutionalized elderly DCD population is very heterogeneous. Specific care arrangements are necessary because the severity of a patient's physical illness and the level of functional impairment seem to be equally important as the patient's behavioural, psychiatric and social problems. Further research should assess the adequacy of the setting assignment and the professional skills needed to provide adequate care for elderly DCDs.
authors.affiliation: a Department of Family Medicine/Elderly Care Medicine and Department Health Services Research, School for Public Health and Primary Care (CAPHRI) , Maastricht University , Maastricht , The Netherlands.|c Department of Elderly , Mondriaan Mental Health Care , Heerlen , The Netherlands.
authors.forename: Janine
authors.initials: J
authors.lastname: Collet
authors.affiliation: b Department of Psychiatry and Psychology, School of Mental Health and Neuroscience , Maastricht University Medical Centre+, Alzheimer Centre Limburg , Maastricht , The Netherlands.
authors.forename: Marjolein E
authors.initials: ME
authors.lastname: de Vugt
authors.affiliation: b Department of Psychiatry and Psychology, School of Mental Health and Neuroscience , Maastricht University Medical Centre+, Alzheimer Centre Limburg , Maastricht , The Netherlands.
authors.forename: Frans R J
authors.identifier: http://orcid.org/0000-0002-8307-8406
authors.initials: FRJ
authors.lastname: Verhey
authors.affiliation: c Department of Elderly , Mondriaan Mental Health Care , Heerlen , The Netherlands.
authors.forename: Noud J J A
authors.initials: NJJA
authors.lastname: Engelen
authors.affiliation: a Department of Family Medicine/Elderly Care Medicine and Department Health Services Research, School for Public Health and Primary Care (CAPHRI) , Maastricht University , Maastricht , The Netherlands.
authors.forename: Jos M G A
authors.initials: JMGA
authors.lastname: Schols
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000451:nursing*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003704:Dementia / Q000451:nursing*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000451:nursing*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009426:Netherlands; D009735:Nursing Homes / Q000706:statistics & numerical data*
keywords: Geriatric psychiatry; double care demanding patients; integrated care; nursing home