Older people with dementia cared for mostly at home

The findings challenge the widely held belief that most dementia patients eventually move into and die in nursing homes, said Dr. Christopher Callahan, of the Indiana University School of Medicine and the Regenstrief Institute in Indianapolis, and colleagues.

The researchers followed about 1,500 dementia patients and found that 74 percent of those who went to a nursing home after being hospitalized didn't remain. About one-quarter returned to the hospital in less than a month, but many others returned home.

Dementia patients did not move straight from home to hospital to nursing home, as the researchers expected. Instead, dementia patients moved back and forth between settings, which can make managing patient care even more complex and add stress for family caregivers.

The researchers also found that the majority of care for dementia patients is provided by families.

The study appears Friday in the Journal of the American Geriatrics Society.

"Our study is the first to track movement of individuals with dementia until death regardless of whether the cause of death was ... dementia or another condition," Callahan said in a journal news release. "A better understanding of the relationships between sites of care for older adults with dementia is fundamental to building better models of care for these vulnerable elders."

The findings challenge beliefs "regarding the permanence of nursing-home care for persons with dementia," Dr. Robert Kane, of the School of Public Health at the University of Minnesota in Minneapolis, and Dr. Joseph Ouslander, of the Charles E. Schmidt College of Medicine at Florida Atlantic University in Boca Raton, wrote in an accompanying editorial.

"More research is needed to understand how this impacts the quality of care for dementia patients and how we can improve care transitions and management for dementia patients and their families," they noted.

More information: The American Academy of Family Physicians has more about dementia.

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