Patient and Caregiver Characteristics and Nursing Home Placement in Patients With Dementia

Abstract

OGNITIVE IMPAIRMENT, ESPEcially severe impairment or dementia, is one of the primary indications for nursing home placement. As many as 90% of patients with dementia reportedly become institutionalized before death. 1 However, most patients with dementia continue to live in the community until family caregivers are no longer able to care for them. 2 The decision to place a patient with dementia in long-term care is complex and is based on patient and caregiver characteristics and the sociocultural context of patient and caregiver. Yet most studies that have assessed the predictors of nursing home placement have focused primarily on the characteristics of either the patient, such as dementia severity or difficult behaviors, 1,[3][4][5][6][7][8] or the caregiver, such as subjective burden or health status, 9,10 and few studies have comprehensively investigated how both caregiver and patient characteristics influence nursing home placement. In addition, most studies that have investigated predictors of nursing home placement of Author Affiliations are listed at the end of this article.

Everyday functioning in relation to cognitive functioning and neuroimaging in community-dwelling Hispanic and Non-Hispanic older adults

“…In the SALSA study (Haan et al, 2003), overall dementia prevalence estimates for Hispanics were quite similar to those reported for Caucasian populations, but low education was a risk factor for dementia, as it has been in many other studies. Second, members of ethnic minorities are more likely to care for their elderly family members at home rather than place them in a nursing home (Salive et al, 1993;Yaffe et al, 2002). Hence the higher rate of cognitive and reported functional impairment in the community-dwelling Hispanics in this study may reflect more impaired Hispanic individuals being cared for at home.…”

ACNP White Paper: Update on Use of Antipsychotic Drugs in Elderly Persons with Dementia

“…One reported association of caregiver distress is early patient institutionalization. In a large prospective study, both caregiver burden and behavioral symptoms were independently associated with nursing home placement of persons with dementia (Yaffe et al, 2002). Forty-six percent of caregivers in another study reported behavioral problems as a reason for the decision to place persons with dementia outside the home, and caregiver stress was higher among persons opting for nursing home placement (Buhr et al, 2006).…”

Aspectos clínicos da demência senil em instituições asilares

“…Esposas ou fi lhas, em núcleos familiares com dois ou três componentes, muitas vezes sob alta carga física, fi nanceira e emocional, são as pessoas que usualmente assistem a idosos em seus domicílios. O asilamento, nessas condições, torna-se a única alternativa possível em muitos casos (Severson et al, 1994;Rubenstein et al, 1988;Chaimowicz e Greco, 1999;Garrido e Almeida, 1999;Costa et al, 2000;Magaziner et al, 2000;Smith et al, 2001;Yaffe et al, 2002;Gaugler et al Gaugler et al Gaugler ., 2003).…”

“…Encontram-se, assim, percentuais signifi cativos de dementados residindo em instituições asilares, ocupando entre 30% a 80% do total de seus leitos (Macera et al, 1991;Severson et al, 1994 ;Rabins, 1997;Magaziner et al, 2000;Smith et al, 2000;Smith et al, 2001;Yaffe et al, 2002;Bharucha et al, 2004). Justifi case, assim, rever criticamente os principais problemas e complicações clínicas desses pacientes durante internações em asilos.…”