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Predictors of institutionalization for people with dementia living at home with a carer
Author(s) -
Hope Tony,
Keene Janet,
Gedling Kathy,
Fairburn Christopher G.,
Jacoby Robin
Publication year - 1998
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/(sici)1099-1166(1998100)13:10<682::aid-gps847>3.0.co;2-y
Subject(s) - institutionalisation , dementia , activities of daily living , psychology , gerontology , institution , medicine , disease , psychiatry , pathology , political science , law
Objective . This article examines the relationships between behaviour, psychological functioning, the caring environment and subsequent institutionalization in patients with dementia living at home with a carer. Design . Longitudinal study of behaviour in dementia, with a nested case‐control study to investigate predictors of institutionalization. Setting . Subjects with dementia, known to service, living at home with a carer. All lived in Oxfordshire, UK. Participants . 100 people with dementia (Alzheimer's disease and/or vascular dementia) who were living at home with a carer at the start of the study. Measures . At 4‐monthly intervals, the carers were interviewed and the subjects with dementia were assessed cognitively. Subjects' behaviour and psychological functioning were assessed using the Present Behavioural Examination. Results . The characteristics which best predicted institutionalization 1 year later were: excessive night‐time activity; immobility or difficulty in walking; incontinence; being away from a carer for more than 16 hours a week; and being cared for by a female. Aggressive behaviour was not associated with an increased chance of entry into an institution 1 year later, although it was more prevalent 4 months before entering an institution. Conclusions . Both behaviour and psychological functioning and the caring environment can help in predicting which patients with dementia currently living at home will enter an institution 1 year later. These predictors are not the same as those which are the immediate cause of institutionalization. Copyright© 1998 John Wiley & Sons, Ltd.