Predictors of Time to Discharge in Patients Hospitalized for Behavioral and Psychological Symptoms of Dementia

Kitamura, Tatsuru; Kitamura, Masaru; Hino, Shoryoku; Kurata, Kouichi

doi:10.1159/000350028

Cited by 8 publications

(14 citation statements)

References 32 publications

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“…Overactivity included non‐aggressive behaviour that required monitoring, such as aimless wandering, trying to reach a different place, restlessness, or repetitive actions and/or mannerisms. Apathy/depression included serious apathetic or depressive behaviour, such as severe loss of appetite, refusal to eat, refusal to take medication, or suicidal tendencies …”

Section: Methodsmentioning

confidence: 99%

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Predictors of home discharge among patients hospitalized for behavioural and psychological symptoms of dementia

et al. 2015

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Background The Japanese government recently announced the ‘Five‐Year Plan for Promotion of Measures Against Dementia (Orange Plan)’ to promote people with dementia living in their communities. To achieve this, it is imperative that patients hospitalized with behavioural and psychological symptoms of dementia (BPSD) are helped to return to their own homes. The aim of the present study was to identify predictors of home discharge among patients hospitalized for BPSD. Methods A single‐centre chart review study was conducted on consecutive patients hospitalized from home between April 2006 and March 2011 for the treatment of BPSD. The frequency of discharge back to home was examined in relation to a patient's active behavioural problems and demographics at the time of admission. Diagnoses of dementia were made on the basis of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies. Results In all, 391 patients were enrolled in the study. Of these patients, 163 (42%) returned home. Multiple logistic regression analysis identified high Mini‐Mental State Examination and Nishimura‐style senile activities of daily living scores as significant independent predictors of home discharge. In contrast, living alone and manifestation of aggressiveness at the time of admission were negatively associated with home discharge. Conclusions Few patients hospitalized for BPSD are discharged home, and this number is affected by a patient's clinical and demographic characteristics at the time of admission. These findings should be considered in designing and implementing optimal management and care strategies for patients with BPSD.

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Section: Methodsmentioning

confidence: 99%

“…13 Previously, we demonstrated that patients' clinical and environmental characteristics at the time of admission are closely associated with time to discharge. 14 In the present study, we examined the frequency of HD in relation to patient profiles at the time of admission and determined factors that could be used to predict HD.…”

Section: Introductionmentioning

confidence: 99%

Predictors of home discharge among patients hospitalized for behavioural and psychological symptoms of dementia

et al. 2015

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“…Previous studies have shown the effectiveness of treatment of BPSD at hospital (Bellelli et al, 1998; Colombo et al, 2007; Kitamura, Kitamura, Hino, & Kurata, 2013; Rouch et al, 2017; Sugiyama et al, 2013; Taniguchi et al, 2013). However, there are some issues associated with the treatment in hospital.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the prolonged hospitalization is one of the issues in Japan. Many patients still stayed at hospital even after improvement of BPSD (Kitamura et al, 2013; Taniguchi et al, 2013). Various factors have been identified as the predictors of the prolonged hospitalization.…”

Section: Introductionmentioning

confidence: 99%

“…Various factors have been identified as the predictors of the prolonged hospitalization. Lower MMSE score (Kitamura et al, 2013), male gender (Kitamura et al, 2013), female gender (Ono et al, 2010), combative behavior (Kitamura et al, 2013), and smaller pensions (Sugiyama et al, 2013) have been identified as patient factors. Moreover, years of experience of doctors in treating dementia (Sugiyama et al, 2013) was also involved in the prolonged hospitalization.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of treatment in wards for patients with dementia and issues associated with this treatment: A prospective analysis

Taniguchi¹,

Matsuoka

Hikawa³

et al. 2017

Dementia

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In order to optimize the treatment in wards for patients with dementia, we investigated predictors of the length of stay in the ward for patients with dementia. A prospective analysis of 72 patients with dementia was conducted in two wards for patients with dementia. Severity of dementia was assessed by the Clinical Dementia Rating, basic activities of daily living were evaluated using the Physical Self-Maintenance Scale, and severity of behavioral and psychological symptoms of dementia and caregiver distress were determined with the Nursing Home version of the Neuropsychiatric Inventory. Stepwise regression analysis was used to identify predictors of the length of stay. Fewer patients were discharged to home compared to those discharged to institutions or transferred to a different hospital or ward. The mean length of stay was 92.0 days. Clinical Dementia Rating and total distress scale score on the Nursing Home version of the Neuropsychiatric Inventory were significant independent predictors of the length of stay. The total Nursing Home version of the Neuropsychiatric Inventory score and total distress scale score on the Nursing Home version of the Neuropsychiatric Inventory were significantly improved through treatment. Our results suggest that treatment in the wards for patients with dementia is effective for improvement of behavioral and psychological symptoms of dementia. However, some patients could not be discharged to their home despite improvement of behavioral and psychological symptoms of dementia, and this may be related to caregiver burden at admission.

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Einfluss der Demenz auf Verweildauer und Erlöse im Akutkrankenhaus

Motzek¹,

Junge²,

Marquardt³

2016

Z Gerontol Geriat

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Predictors of Time to Discharge in Patients Hospitalized for Behavioral and Psychological Symptoms of Dementia

Cited by 8 publications

References 32 publications

Predictors of home discharge among patients hospitalized for behavioural and psychological symptoms of dementia

Predictors of home discharge among patients hospitalized for behavioural and psychological symptoms of dementia

Effectiveness of treatment in wards for patients with dementia and issues associated with this treatment: A prospective analysis

Einfluss der Demenz auf Verweildauer und Erlöse im Akutkrankenhaus

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