The association between physical dependency and the presence of neuropsychiatric symptoms, with the admission of people with dementia to a long-term care institution: A prospective observational cohort study☆
Section snippets
Background
Dementia is a progressive neurological disorder that affects memory, thinking, language, judgment and behavior. It involves a high degree of physical dependency and represents a major challenge for society and health services (Gallese and Stobbione, 2013). Caring for older people with dementia is a complicated matter for family members, some of whom experience high levels of subjective burden and stress, social isolation and changes in patterns of family roles (Zhang et al., 2013). Thence,
Aim
The aim of the study was to investigate the association between physical dependency and the presence of neuropsychiatric symptoms in the admission of people with dementia to a long-term care institution (LTCI).
Study design
This prospective observational cohort study is part of the RightTimePlaceCare project (grant agreement 242153), which was conducted in 8 European countries: England, Estonia, Finland, France, Germany, the Netherlands, Spain and Sweden (Verbeek et al., 2012).
Population and sample
The population of interest was recently institutionalized people with dementia and people with dementia living at home but at risk of institutionalization (i.e., on the margins of admission to LTCI). A health care professional (e.g.,
Results
A total of 1065 dyads was included in the study and consisted of those who had completed baseline and follow-up measurements. From the overall sample, 116 people with dementia were institutionalized during the 3-month follow-up period (LTCI) while 949 participants remained at home (HC) despite still being at risk of institutionalization. From the sociodemographic characteristics recorded, age, income and living alone were variables with statistically significant differences when comparing
Discussion
This study investigated the association between specific categories of physical dependency, and behavioral disturbances, with the admission of people with dementia to a LTCI. The study was conducted from a European perspective, so differences between countries cannot be seen in the general analysis. Multiple reasons, mainly associated with people with dementia, contribute to their institutionalization, such as neuropsychiatric symptoms (behavioral disturbances) and care dependency (Afram et
Conclusion
This study builds on current international evidence supporting the association between specific categories of physical dependency and the presence of neuropsychiatric symptoms with the admission of people with dementia to a long-term care institution. The study results demonstrate the importance of considering the dependency of the people suffering from dementia in specific activities of daily living to identify the factors behind the final decision to their admission into a LTCI, as well as
Conflict of interest
No conflict of interest is declared.
Funding
This research was funded by a grant from the European Commission within the 7th Framework Program (Project 242153).
Ethical approval
Each country obtained ethical approval from a country-specific legal authority for research on human beings (for instance, an ethical committee specialized in medical or nursing science) to conduct the study in accordance with the national standards and regulations in participating countries. The specific names of each committee are as follows (with reference numbers if appropriate in brackets): Ethics Review Committee on Human Research of the University of Tartu (196/T-3), Ethical Committee of
Acknowledgments
The authors thank Belchin Adriyanov for all his help with the statistical analysis, and Carme Alvira, Marta Farré and Susana Miguel for all their help during the study development. The authors also thank Stephen Kelly for all his help with language revision and implication.
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This paper was submitted as an entry for the European Academy of Nursing Science's Rosemary Crow award, sponsored by the International Journal of Nursing Studies. The award is open to current doctoral students or recent graduates of the academy's programme.
- 1
The RightTimePlaceCare Consortium is disclosed in Appendix 1.