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P3‐408: A french innovative department dedicated to Alzheimer's disease patients
Author(s) -
Rebillat AnneSophie,
Jean Coralie,
VolpeGillot Lisette
Publication year - 2011
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2011.05.1851
Subject(s) - medicine , dementia , geriatrics , delirium , emergency department , psychiatry , mood , donepezil , disease , pathology
Background: Innovative units dedicated to Alzheimer’s disease patients are recently emerging in France. Methods: Our Neuro-Psycho-Geriatrics Department opened in November 2009. It is part of a larger geriatric structure in Bellan teaching hospital, Paris, and has significant connections with several medical facilities (memory clinics, geriatrics departments, emergency units, nursing homes, family physicians). This implements a strong network. Results: Bed capacity is 14. In 2010, 308 patients (182 women and 126 men) were hospitalized with an average age of 83. 14 young patients were in the 45-65 range. Average length of stay was 14.1 days. Admission criterion is impaired cognitive function (diagnosed or undiagnosed dementia, mostly Alzheimer’s disease) with acute delirium or psycho-behavioral symptoms. Non admission criteria are decompensation of a psychiatric disorder and bedridden state. As examples of psycho-behavioral symptoms, we can mention: ambulation, aggressiveness, delusion, sleep disturbances, emotional distress, hallucinations, yelling. Management of these troubles includes identification of the causes (infection, metabolic perturbation, epilepsy, mood disorder, side effects of prescription medication), drug and non-drug treatment strategies. To this, layout and environment of the department have been adapted to make it as safe and stress-relieving as possible. A multidisciplinary team is in charge of the patients and involves medical specialists (neurologist, geriatrician and psychiatrist), psychologists, therapists (psychomotor, occupational, speech and language therapists), nursing supervisor, nurses, orderlies, hospital cleaners, social worker and secretary. All staff have been trained specifically in dementia care, families support and education.Conclusions:One of the objectives of this specific care management is to see the patients returning home and to delay nursing home entry. In 2010,60% of our patients could return home, 21% were transferred to rehabilitation units, 14% did enter nursing homes, and 5% died.