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Moving in: adjustment of people living with dementia going into a nursing home and their families

Published online by Cambridge University Press:  21 February 2013

Laura Sury ,
Kim Burns  and
Henry Brodaty
Laura Sury
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
Kim Burns
Affiliation:
Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia Aged Care Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
Henry Brodaty*
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia Aged Care Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
*
Correspondence should be addressed to: Henry Brodaty, Professor, Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW 2052, Australia. Phone: +61-2-9385-2585; Fax: +61-2-9385-2200. Email: h.brodaty@unsw.edu.au.
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Abstract

Background: Most people with dementia in Western societies will eventually be placed in a nursing home. This can be stressful to those with dementia and to their families. The adjustment to this new caring environment by both residents and their family caregivers and the factors that influence this are the focus of this review.

Methods: A literature search of Embase, Scopus, and Medline databases of articles published in English between 1990 and 2011 using specified search terms was performed to examine this transition. The 174 titles located were screened and reference lists hand searched resulting in the 49 relevant articles included in this review.

Results: This decision and the subsequent adjustment period is a difficult time for people with dementia and their family caregivers. Admission has been linked to increased behavioral symptoms and in particular depression and agitation, decreasing cognition, frailty, and falls in people with dementia. For caregivers, guilt, depression, feelings of failure, and continuing burden but also improvement in quality of life have been variously reported. Research to determine what influences the trajectory of these different outcomes and the prevalence of positive outcomes for people with dementia is lacking. Successful transitions may be assisted by ensuring that the person with dementia has input into decision making, orientation procedures for the person with dementia and family member prior to and on admission, a “buddy” system for new arrivals, and a person-centered approach.

Conclusions: Adjustment to admission to residential care can be difficult for people with dementia and their family caregivers. Longitudinal research examining factors influencing the adjustment can provide a basis for intervention trials to improve this transition.

Keywords

nursing homedementiacarersresidential facilitiesquality of life
Type
Review Article
Information
International Psychogeriatrics , Volume 25 , Issue 6 , June 2013 , pp. 867 - 876
Copyright
Copyright © International Psychogeriatric Association 2013

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