The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study
Abstract Background Day care services offer meaningful activities, a safe environment for attendees and respite for family caregivers while being expected to delay the need for nursing home (NH) admission. However, previous research has shown inconsistent results regarding postponement of NH admissi...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3686-5 |
| _version_ | 1828891848330969088 |
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| author | Anne Marie Mork Rokstad Knut Engedal Øyvind Kirkevold Jūratė Šaltytė Benth Geir Selbæk |
| author_facet | Anne Marie Mork Rokstad Knut Engedal Øyvind Kirkevold Jūratė Šaltytė Benth Geir Selbæk |
| author_sort | Anne Marie Mork Rokstad |
| collection | DOAJ |
| description | Abstract Background Day care services offer meaningful activities, a safe environment for attendees and respite for family caregivers while being expected to delay the need for nursing home (NH) admission. However, previous research has shown inconsistent results regarding postponement of NH admission. The objective of the study was to explore the influence of a day care programme designed for home-dwelling people with dementia on NH admission. Method A quasi-experimental trial explored the proportion of patients permanently admitted to nursing homes after 24 months as the main outcome by comparing a group of day care attendees (DG) and a group of participants without day care (CG). In all, 257 participants were included (181 in DG and 76 in CG). A logistic regression model was developed with NH admission as the outcome. Participant group (DG or CG) was the main predictor, baseline patient and family caregiver characteristics and interactions were used as covariates. Results The mean age of participants was 81.5 (SD 6.4), 65% were women and 53% lived alone. The mean MMSE score was 20.4 (SD 3.5). In all, 128 (50%) of the participants were admitted to a nursing home by the 24-month follow-up, 63 participants (25%) completed the follow-up assessment and 66 (26%) dropped out due to death (8%) and other reasons (18%). In the logistic unadjusted regression model for NH admission after 24 months, participant group (DG or CG) was not found to be a significant predictor of NH admission. The results from the adjusted model revealed that the participant group was associated with NH admission through the interactions with age, living conditions, affective symptoms, sleep symptoms and practical functioning, showing a higher probability for NH admission in DG compared to CG. Conclusion The study reveals no evidence to confirm that day care services designed for people with dementia postpone the need for NH admission. Admission to nursing homes seems to be based on a complex mix of personal and functional characteristics both in the person with dementia and the family caregivers. The findings should be considered in accordance with the limitation of inadequate power and the high drop-out rate. Trial registration The study is registered in Clinical Trials (NCT01943071). |
| first_indexed | 2024-12-13T13:25:20Z |
| format | Article |
| id | doaj.art-9731569c56b74251a1f29f868d9c286f |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-13T13:25:20Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-9731569c56b74251a1f29f868d9c286f2022-12-21T23:44:19ZengBMCBMC Health Services Research1472-69632018-11-0118111110.1186/s12913-018-3686-5The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled studyAnne Marie Mork Rokstad0Knut Engedal1Øyvind Kirkevold2Jūratė Šaltytė Benth3Geir Selbæk4Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital TrustNorwegian National Advisory Unit on Ageing and Health, Vestfold Hospital TrustNorwegian National Advisory Unit on Ageing and Health, Vestfold Hospital TrustInstitute of Clinical Medicine, Campus Ahus, University of OsloNorwegian National Advisory Unit on Ageing and Health, Vestfold Hospital TrustAbstract Background Day care services offer meaningful activities, a safe environment for attendees and respite for family caregivers while being expected to delay the need for nursing home (NH) admission. However, previous research has shown inconsistent results regarding postponement of NH admission. The objective of the study was to explore the influence of a day care programme designed for home-dwelling people with dementia on NH admission. Method A quasi-experimental trial explored the proportion of patients permanently admitted to nursing homes after 24 months as the main outcome by comparing a group of day care attendees (DG) and a group of participants without day care (CG). In all, 257 participants were included (181 in DG and 76 in CG). A logistic regression model was developed with NH admission as the outcome. Participant group (DG or CG) was the main predictor, baseline patient and family caregiver characteristics and interactions were used as covariates. Results The mean age of participants was 81.5 (SD 6.4), 65% were women and 53% lived alone. The mean MMSE score was 20.4 (SD 3.5). In all, 128 (50%) of the participants were admitted to a nursing home by the 24-month follow-up, 63 participants (25%) completed the follow-up assessment and 66 (26%) dropped out due to death (8%) and other reasons (18%). In the logistic unadjusted regression model for NH admission after 24 months, participant group (DG or CG) was not found to be a significant predictor of NH admission. The results from the adjusted model revealed that the participant group was associated with NH admission through the interactions with age, living conditions, affective symptoms, sleep symptoms and practical functioning, showing a higher probability for NH admission in DG compared to CG. Conclusion The study reveals no evidence to confirm that day care services designed for people with dementia postpone the need for NH admission. Admission to nursing homes seems to be based on a complex mix of personal and functional characteristics both in the person with dementia and the family caregivers. The findings should be considered in accordance with the limitation of inadequate power and the high drop-out rate. Trial registration The study is registered in Clinical Trials (NCT01943071).http://link.springer.com/article/10.1186/s12913-018-3686-5DementiaDay careNursing home admission |
| spellingShingle | Anne Marie Mork Rokstad Knut Engedal Øyvind Kirkevold Jūratė Šaltytė Benth Geir Selbæk The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study BMC Health Services Research Dementia Day care Nursing home admission |
| title | The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study |
| title_full | The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study |
| title_fullStr | The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study |
| title_full_unstemmed | The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study |
| title_short | The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study |
| title_sort | impact of attending day care designed for home dwelling people with dementia on nursing home admission a 24 month controlled study |
| topic | Dementia Day care Nursing home admission |
| url | http://link.springer.com/article/10.1186/s12913-018-3686-5 |
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