Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-23T13:51:04.718Z Has data issue: false hasContentIssue false
  • English
  • Français

Risk factors related to the admission of people with dementia into a long-term care institution in Spain: an explorative study

Published online by Cambridge University Press:  28 September 2016

ESTER RISCO ,
ESTHER CABRERA ,
M. CARME ALVIRA ,
MARTA FARRÉ ,
SUSANA MIGUEL  and
ADELAIDA ZABALEGUI
ESTER RISCO*
Affiliation:
Department of Nursing, Hospital Clínic de Barcelona, Barcelona, Spain.
ESTHER CABRERA
Affiliation:
School of Health Sciences TecnoCampus, Pompeu Fabra University, Mataró, Spain.
M. CARME ALVIRA
Affiliation:
Department of Nursing, CAP Comte Borrell, Barcelona, Spain.
MARTA FARRÉ
Affiliation:
Department of Nursing, Hospital Clínic de Barcelona, Barcelona, Spain.
SUSANA MIGUEL
Affiliation:
School of Health Sciences Gimbernat i Tomàs Cerdà, Barcelona, Spain.
ADELAIDA ZABALEGUI
Affiliation:
Department of Nursing Management, Barcelona, Spain.
*
Address for correspondence: Ester Risco, Department of Nursing, Hospital Clínic de Barcelona, Villarroel 170, 08036 Barcelona, Spain E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Risk factors associated with admission of people with dementia to long-term care institutions need to be identified to support health-care professionals in dementia care at home. An explorative study, combining quantitative and qualitative data collection methods, was performed in people with dementia in Spain. The sample, consisting of people with dementia receiving formal care from health-care professionals but at risk of institutionalisation, and their informal care-givers; and people with dementia recently admitted to a long-term care institution, and their informal care-givers, was interviewed between November 2010 and April 2012. Perceived reasons for admission were determined through an open-ended question put to both groups. Presumed risk factors were collected with validated questionnaires and analysed using bivariate analysis. A total of 287 people with dementia and informal care-givers were studied. Reasons given by the institutionalised group were mostly related to the level of dependency of the person with dementia. People recently admitted to a long-term care institution had more cognitive impairment, a greater degree of dependency and poorer quality of life than those still living at home. Home-care services in Spain need to develop or improve interventions based on the risk factors identified in this study: informal care-giver profile, high cognitive impairment, high level of dependency and the poor quality of life of the person with dementia.

Keywords

dementiahome carelong-term care institutionalisationinformal care-giver
Type
Articles
Information
Ageing & Society , Volume 38 , Issue 1 , January 2018 , pp. 192 - 211
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Afram, B., Stephan, A., Verbeek, H., Bleijlevens, M. H. C., Suhonen, R., Sutcliffe, C., Raamat, K., Cabrera, E., Soto, M. E., Hallberg, I. R., Meyer, G., Hamers, J. P. H., on behalf of the RightTimePlaceCare Consortium 2014. Reasons for the institutionalisation of people with dementia: informal caregiver reports from eight European countries. Journal of the American Medical Directors Association, 15, 2, 108–11.Google Scholar
Afram, B., Verbeek, H., Bleijlevens, M. H. C., Challis, D., Leino-Kilpi, H., Karlsson, S., Soto, M. E., Renom-Guiteras, A., Saks, K., Zabalegui, A., Hamers, J. P. H. and the RightTimePlaceCare Consortium. 2014. Predicting institutional long-term care admission in dementia: a mixed-methods study of informal caregivers’ reports. Journal of Advanced Nursing, 71, 6, 1351–62.CrossRefGoogle ScholarPubMed
Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. 1988. Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 3, 271–84.Google Scholar
Arber, S. and Ginn, J. 1990. The meaning of informal care: gender and the contribution of elderly people. Ageing & Society, 10, 4, 429–54.CrossRefGoogle Scholar
Beerens, H. C., Sutcliffe, C., Renom-Guiteras, A., Soto, M. E., Suhonen, R., Zabalegui, A., Bökberg, C., Saks, K., Hamers, J. P and on behalf of the RightTimePlaceCare Consortium 2014. Quality of life and quality of care for people with dementia receiving long term institutional care or professional home care: the European RightTimePlaceCare study. Journal of the American Medical Directors Association, 15, 1, 54–61.Google Scholar
Brandt, M., Haberkern, K. and Szydlik, M. 2009. Intergenerational help and care in Europe. European Sociological Review, 25, 5, 585–601.Google Scholar
Brazier, J., Jones, N. and Kind, P. 1993. Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Quality of Life Research, 2, 3, 169–80.CrossRefGoogle ScholarPubMed
Brodaty, H. and Donkin, M. 2009. Family caregivers of people with dementia. Clinical Neuroscience, 11, 2, 217–28.Google Scholar
Castro-Monteiro, E., Forjaz, M. J., Ayala, A., Rodriguez-Blazquez, C., Fernandez-Mayoralas, G., Diaz-Redondo, A. and Martinez-Martin, P. 2014. Change and predictors of quality of life in institutionalized older adults with dementia. Quality of Life Research, 23, 9, 2595–601.Google Scholar
Crellin, N. E., Orrell, M., McDermott, O. and Charlesworth, G. 2014. Self-efficacy and health-related quality of life in family carers of people with dementia: a systematic review. Aging Mental Health, 18, 8, 954–69.CrossRefGoogle ScholarPubMed
Creswell, J. W. and Miller, D. L. 2000. Determining validity in qualitative inquiry. Theory into Practice, 39, 3, 124–31.CrossRefGoogle Scholar
Daatland, S. O. and Herlofson, K. 2003. ‘Lost solidarity’ or ‘changed solidarity’: a comparative European view of normative family solidarity. Ageing & Society, 23, 5, 174–82.Google Scholar
Folstein, M. F., Folstein, S. E. and McHug, P. R. 2001. Mini-Mental State Examination: Clinical Guide. Psychological Assessment Resources, Odessa, Florida.Google Scholar
Garcés, J., Carretero, S., Ródenas, F. and Vivancos, M. 2010. The care of the informal caregiver burden by the Spanish public system of social welfare: a review. Archives of Gerontology and Geriatrics, 50, 3, 250–3.Google Scholar
Gaugler, J. E. 2009. Caregiving contexts: cultural, familial, and societal implications – edited by Maximiliane E. Szinovacz and Adam Davey. Journal of Marriage and Family, 71, 1, 205–7.Google Scholar
Geldmacher, D. S. and Kerwin, D. R. 2013. Practical diagnosis and management of dementia due to Alzheimer's disease in the primary care setting: an evidence-based approach. The Primary Care Companion for CNS Disorders, 15, 4.Google Scholar
Gerdner, L. A., Buckwalter, K. C. and Reed, D. 2002. Impact of a psychoeducational intervention on caregiver response to behavioural problems. Nursing Research, 51, 6, 363–74.Google Scholar
Gitlin, L. N., Winter, L., Dennis, M. P., Hodgson, N. and Hauck, W. W. 2010. Targeting and managing behavioral symptoms in individuals with dementia: a randomized trial of a nonpharmacological intervention. Journal of American Geriatric Society, 58, 8, 1465–74.Google Scholar
Goldberg, D. P. and Hillier, V. F. 1979. A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 1, 139–45.Google Scholar
Hallberg, I. R., Cabrera, E., Jolley, D., Raamat, K., Renom-Guiteras, A., Verbeek, H., Soto, M., Stolt, M. and Karlsson, S. 2014. Professional care providers in dementia care in eight European countries; their training and involvement in early dementia stage and in home care. Dementia (London) [Epub ahead of print]Google Scholar
Hsieh, H. F. and Shannon, S. E. 2005. Three approaches to qualitative content analysis. Qualitative Health Research, 15, 9, 1277–88.Google Scholar
Karlsson, S., Bleijlevens, M., Roe, B., Saks, K., Martin, M. S., Stephan, A., Suhonen, R., Zabalegui, A., Hallberg, I. R. and RightTimeCarePlace Consortium 2015. Dementia care in European countries, from the perspective of people with dementia and their caregivers. Journal of Advanced Nursing, 71, 6, 1405–16.Google Scholar
Katz, S., Ford, A. B., Jackson, B. A. and Jaffe, M. W. 1963. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. Journal of the American Medical Association, 21, 185, 914–9.Google Scholar
Kaufer, M. D., Cummings, M. D., Ketche, M. E., Smith, V., MacMillan, A., Shelley, T., Lopez, O. and DeKosky, M. D. 2000. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. Journal of Neuropsychiatry and Clinical Neuroscience, 12, 2, 233–9.Google Scholar
Knapp, M., Iemmi, V. and Romeo, R. 2013. Dementia care costs and outcomes: a systematic review. International Journal of Geriatric Psychiatry, 28, 6, 551–61.CrossRefGoogle ScholarPubMed
Law, L. L., Barnett, F., Yau, M. K. and Gray, M. A. 2014. Effects of combined cognitive and exercise interventions on cognition in older adults with and without cognitive impairment: a systematic review. Ageing Research Reviews, 15, 61–75.Google Scholar
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. 2002. Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine, 64, 3, 510–9.CrossRefGoogle ScholarPubMed
Luppa, M., Luck, T., Brähler, E., König, H. H. and Riedel-Heller, S. G. 2008. Prediction of institutionalisation in dementia. A systematic review. Dementia Geriatric Cognitive Disorders, 26, 1, 65–78.Google Scholar
Mazzei, F., Gillan, R. and Cloutier, D. 2013. Exploring the influence of environment on the spatial behavior of older adults in a purpose-built acute care dementia unit. American Journal of Alzheimer's Disease & Other Dementias, 29, 4, 311–9.Google Scholar
Meleis, A. I., Sawyer, L. M., Im, E. O., Hilfinger Messias, D. K. and Schumacher, K. 2000. Experiencing transitions: an emerging middle-range theory. Advanced Nursing Science, 23, 1, 12–28.Google Scholar
Mielke, M. M., Vemuri, P. and Rocca, W. A. 2014. Clinical epidemiology of Alzheimer's disease: assessing sex and gender differences. Journal of Clinical Epidemiology, 8, 6, 37–48.Google Scholar
Misiak, B., Cialkowska-Kuzminska, M., Frydecka, D., Chladzinska-Kiejna, S. and Kiejna, A. 2013. European studies on the prevalence of dementia in the older people: time for a step towards a methodological consensus. International Journal of Geriatric Psychiatry, 28, 12, 1211–21.Google Scholar
Molloy, D. W. and Clarnette, R. 1999. Standardized Mini-Mental State Examination: A User's Guide. New Grange Press, Troy, New York.Google Scholar
Odenheimer, G., Borson, S., Sanders, A. E., Swain-Eng, R. J., Kyomen, H. H., Tierney, S., Gitlin, L., Forciea, M. A., Absher, J., Shega, J. and Johnson, J. 2014. Quality improvement in neurology: dementia management quality measures. Journal of American Geriatric Society, 62, 3, 558–61.CrossRefGoogle ScholarPubMed
Popping, R. 1984. Traces of agreement. On some agreement indices for open-ended questions. Quality and Quantity, 18, 2, 147–58.Google Scholar
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W. and Ferri, C. P. 2013. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers & Dementia, 9, 1, 63–75.Google Scholar
Risco, E., Cabrera, E., Farré, M., Alvira, C., Miguel, S. and Zabalegui, A. 2015. Perspectives about health care provision in dementia care in Spain: a qualitative study using focus-group methodology. American Journal of Alzheimers Diseases and Other Dementias, 31, 3, 223–30.CrossRefGoogle Scholar
Robinson, K. M., Buckwalter, K. and Reed, D. 2013. Differences between dementia caregivers who are users and nonusers of community services. Public Health Nursing, 30, 6, 501–10.CrossRefGoogle ScholarPubMed
Rodriguez-Martin, B., Martinez-Andres, M., Cervera-Monteagudo, B., Notario-Pacheco, B. and Martínez Vizcaino, V. 2014. Preconception about institutionalization at public nursing homes in Spain: views of residents and family members. Ageing & Society, 34, 4, 547–68.Google Scholar
Rogero-García, J. and Rosenberg, M. W. 2011. Paid and unpaid support received by coresident informal caregivers attending to community-dwelling older adults in Spain. European Journal of Ageing, 8, 2, 95–107.Google Scholar
Rongve, A., Vossius, C., Nore, S., Testad, I. and Aarsland, D. 2014. Time until nursing home admission in people with mild dementia: comparison of dementia with Lewy bodies and Alzheimer's dementia. International Journal of Geriatric Psychiatry, 29, 4, 392–8.Google Scholar
Tam-Tham, H., Cepoiu-Martin, M., Ronksley, P. E., Maxwell, C. J. and Hemmelgarn, B. R. 2013. Dementia case management and risk of long-term care placement: a systematic review and meta-analysis. International Journal of Geriatric Psychiatry, 28, 9, 889–902.Google Scholar
Verbeek, H., Meyer, G., Leino-Kilpi, H., Zabalegui, A., Hallberg, I. R., Saks, K., Soto, M. E., Challis, D., Sauerland, D., Hamers, J. P. and RightTimePlaceCare Consortium 2012. A European study investigating patterns of transition from home care towards institutional dementia care: the protocol of a RightTimePlaceCare study. BMC Public Health, 23, 12, 68.Google Scholar
Wimo, A., Ballard, C., Brayne, C., Gauthier, S., Handels, R. and Jones, R. W. 2014. Health economic evaluation of treatments for Alzheimer's disease: impact of new diagnostic criteria. Public Health, 30, 6, 501–10.Google Scholar
Wübker, A., Zwakhalen, S. M. G., Challis, D., Karlsson, S., Zabalegui, A., Soto, M., Saks, K. and Sauerland, D. 2014. Costs of care for people with dementia just before and after nursing home placement: primary data from 8 European countries. European Journal of Health Economics, 16, 7, 689–707.Google Scholar
Zabalegui, A., Bover, A., Rodriquez, E., Cabrera, E., Diaz, M., Gallart, A., González, A., Gual, P., Izquierdo, M. D., López, L., Pulpón, A. M. and Ramírez, A. 2008. Informal caregiving: perceived needs. Nursing Science Quarterly, 21, 2, 166–72.Google Scholar
Zabalegui, A., Hamers, J. P. H., Karlsson, S., Leino-Kilpi, H., Renom-Guiteras, A., Saks, K., Soto, M., Sutcliffe, C. and Cabrera, E. 2014. Best practices interventions to improve quality of care of people with dementia living at home. Patient Education and Counselling, 95, 2, 175–84.CrossRefGoogle ScholarPubMed
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. 1980. Relatives of the impaired elderly: correlates of feelings and burden. Gerontologist, 20, 6, 649–55.Google Scholar