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Dependency and Community Care in Presenile Alzheimer's Disease

Published online by Cambridge University Press:  02 January 2018

Andrew J. Newens ,
Donald P. Forster  and
David W. K. Kay
Andrew J. Newens*
Affiliation:
Centre for Health Services Research, University of Newcastle upon Tyne
Donald P. Forster
Affiliation:
School of Health Care Sciences, University of Newcastle upon Tyne
David W. K. Kay
Affiliation:
MRC Neurochemical Pathology Unit, Newcastle General Hospital, Newcastle upon Tyne
*
Dr Newens, University of Newcastle upon Tyne, Centre for Health Services Research, 21 Claremont Road, Newcastle upon Tyne NE2 4AA
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Extract

Background

In a study of patients with presenile dementia of Alzheimer type (PDAT), we aimed to investigate functional dependency in relation to the time since diagnosis and place of residence. Use of community and support services and the time between diagnosis and entry to permanent residential care were also studied.

Method

Interviews with 109 cases of PDAT (diagnosed before age 65) and their carers.

Results

The need for assistance in activities of daily living (ADL) was progressive with time from diagnosis. Five years after diagnosis, 57% of patients remained at home, 20% of whom required some assistance in each of six areas of ADL. The need for assistance in each ADL category was significantly greater for cases in permanent residential care than for those at home. There were no significant differences between the Mini-Mental State Examination (MMSE) scores of patients at home and those of patients in permanent care. Incontinence and the relationship of the carer to the patient were the strongest predictors of permanent residential care. Respite care had been offered in 63% of cases; 71% of these offers had been accepted.

Conclusions

Patients with PDAT who have a living relative are cared for at home for a considerable period of time despite severe cognitive impairment and loss of independence measured by ADL. The reports of carers suggest there is scope for improvement in supportive services to meet this community need.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 6 , June 1995 , pp. 777 - 782
Copyright
Copyright © Royal College of Psychiatrists, 1995 

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