ABSTRACT
This report addresses the discharge disposition following inpatient psychiatric treatment for advanced dementia. The total population included 685 305 Medicare fee-for-service decedents with advanced cognitive and functional impairment, with a mean age of 85.9 years who had resided in a nursing home. In the last 90 days of life, 1027 (0.15%) persons received inpatient psychiatry treatment just prior to the place of care where the individual died. Discharge dispositions included 132 (12.9%) persons to a medical hospital, 728 (70.9%) to nursing home without hospice services, 73 (7.1%) to hospice services in a nursing home, 32 (3.1%) to home without hospice services, and 16 (1.6%) to hospice services at home. Overall, the rate of referral to hospice services for advanced dementia was relatively low.
Subject(s)
Dementia/nursing , Hospice Care/statistics & numerical data , Nursing Homes/statistics & numerical data , Patient Discharge/statistics & numerical data , Referral and Consultation/statistics & numerical data , Aged , Aged, 80 and over , Female , Humans , Male , United StatesABSTRACT
OBJECTIVES: To determine if family caregivers of hospitalized individuals with dementia exhibit greater depression severity than caregivers of outpatients. METHODS: Caregivers were recruited during care recipient treatment. Measures assessed depression, stress, burden, and grief. RESULTS: Forty-one caregivers of a hospitalized patient and 44 caregivers of an outpatient (total N = 85) were recruited. The groups did not differ except caregivers of hospitalized patients were younger and less likely to reside with the care recipient. Regarding depression, 63.4% of caregivers of a hospitalized patient and 43.2% of caregivers of an outpatient scored within the clinical depressive symptoms range. Independent sample t-tests showed that caregivers of a hospitalized patient had greater severity of depression, burden, and grief. Caregiving for a hospitalized person remained a significant predictor of greater depression severity in regression models. CONCLUSIONS: Family caregiving for a person hospitalized for psychiatric treatment of dementia is a risk factor for depression.