Very-late-onset obsessive-compulsive disorder (VLO-OCD) is rather rare. Although VLO-OCD should prompt a thorough workup, most cases do not evidence an underlying medical illness nor structural brain abnormality. A subset manifests somatic obsessions, bringing about diagnostic challenges.

Critical literature review based on a case study.

A 73-year-old male patient, was hospitalized for intrusive, repeated, distressing mental images and thoughts about hell, describing difficulty to disengage from these obsessions, alongside secondary mystical and ruin delusion-like ideas, modulated by the pathoplastic effect of core religious beliefs, and inflated sense of responsibility. He had previously experienced those intrusive mental images, yet not in a recurrent nor uncontrollable manner.

Preceding the OCD, he presented mild depressive symptoms triggered by financial hardships. After the emergence of OCD, depressive disorder aggravated, with psychomotor retardation, hopelessness, insomnia, anorexia. Obsessive hyperawareness of autonomic processes, distressing body-focused preoccupations raised by interoceptive stimuli, became noticeable, with overestimation of threatening consequences, day-long swallowing rituals/compulsions, avoidance of nutritional intake, general unease, and even panic. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scored 25. Ancillary tests were unremarkable. Transglutaminase antibodies were negative, ruling out gluten-sensitive enteropathy, hence tryptophan-serotonin metabolism impairment. Neuroimaging did not evidence structural disruption of cortico-striatal circuitry. Therapeutic regimen comprised sertraline 200 mg/day, augmented with mirtazapine 45 mg/day, aripiprazole 15 mg/day. Additionally, trazodone, buspirone and benzodiazepines were used to manage anxiety and insomnia. At the fourth week of treatment the anxiety burden driven by religious obsessions ameliorated. Meanwhile lamotrigine 100 mg/day and gabapentine 200 mg/day were added with further improvement (60% Y-BOCS score reduction, at seventh week).

This case highlights the clinical relevance of the OC spectrum concept, wherein at the compulsive end are OCD-related disorders which feature high degrees of harm avoidance, intolerance to uncertainty, anticipatory anxiety, engagement in repetitive behaviors. We hypothesize that somatoform variant of OCD constitutes a distinct phenotypic subtype, stemming from a complex interplay of neurobiological substrates, psychosocial, and genetic factors, shared with hypochondriasis. This assumption might be addressed in future studies.

Furthermore, this case illustrates the fact that VLO-OCD might exhibit prodromic periods of subclinical OC symptoms before the manifestation of full-blown OCD.

In recent years, the significance of robust social networking is being increasingly recognized due to its association with better cognitive performance. On the other hand, social isolation is linked to higher risk of developing dementia in mid-life and in older age groups. Only few studies have examined social networking in individuals with Mild Cognitive Impairment (MCI). The lack of social connectedness could increase the chances of these individuals progressing to dementia.

We cross-sectionally assessed social networking among 122 subjects with MCI and 2403 cognitively healthy subjects, aged 45 years and above, from the Srinivaspura Aging, NeuroSenescence and COGnition (SANSCOG) study cohort in rural southern India. Cohen’s Social Network Index (SNI) was used to assess social networking, wherein three dimensions are assessed: network diversity, number of people in social network, and number of embedded networks. The diagnosis of MCI was made using the Clinical Dementia Rating (CDR) instrument. This is an extensively validated 5-point scale, wherein six cognitive and functional domains are assessed: Memory, Orientation, Judgment & Problem Solving, Community Affairs, Home & Hobbies, and Personal Care. The overall CDR score of ‘0’ was interpreted as cognitively normal and CDR score of ‘0.5’ as MCI. The SNI dimension scores were compared between subjects with MCI and cognitively healthy subjects using t-test and a p-value of <0.05 was considered significant.

The mean scores of all three SNI domains were significantly lower in MCI compared to cognitively healthy subjects: network diversity (5.30 ± 1.54 vs. 5.94 ± 1.60, p < 0.001), number of people in social network (18.4 ± 8.61 vs. 20.3 ± 8.87, p = 0.023), and number of embedded networks (1.80 ± 1.26 vs. 2.03 ± 1.14, p = 0.038).

Aging rural Indians with Mild Cognitive Impairment (MCI) have poorer social networks than their cognitively normal counterparts. Hence, social connectedness should be routinely evaluated in individuals with MCI and prompt social interventions should be instituted to enhance their social functioning. Social isolation may indeed be a contributory risk factor for developing cognitive impairment. However, causal relationships and reverse causality should be evaluated in further longitudinal studies.

it has been shown that having negative-self perceptions of aging significantly predicts depressive symptomatology. Although the partner relationship may have an impact on the effects of perception of aging on distress, the number of studies assessing the effect of partner on negative self-perception of aging and mental health is limited. The stress of one partner may elicit dyadic coping (DC) responses in the other partner. The stress of one partner may elicit dyadic coping responses in the other partner. Depending on whether the responses are positive (supportive) or negative (hostile)a close relationship can go along with additional stress or resources and benefits. The present study analyzes the relationship between negative self-stereotypes and depressive symptomatology, considering the partner’s dyadic coping as a moderator variable in this association.

Participants were 365 individuals (59.3% women) 40 years or older (M= 60.86, SD=10.66) involved in a marital/partner relationship. Participants completed a questionnaire that included the variables: negative self-perception of aging, positive DC (e.g., “My partner shows empathy and understanding to me”), negative DC (e.g., “When I am stressed, my partner tends to withdraw”), and depressive symptomatology. Two moderation models were tested by linear regression: the first considered positive DC and the second negative DC as a moderator in the relationship between negative self-perception of aging and depressive symptoms.

The effect of negative self-perceptions of aging on depressive symptoms was smaller among those who perceived higher levels of positive DC and lower levels of negative DC by their partners than among those perceiving lower positive DC and higher negative DC. The influence of supportive dyadic coping was higher when the levels of negative self-perception of aging were higher. Gender was a determinant factor in the moderation.

Positive DC mitigates the negative effects of negative self-perception of aging on wellbeing (by the mechanism of moderation), while negative DC amplifies this association and goes along with lower well-being in persons who report negative self-perceptions of aging. Training couples in supportive dyadic coping may be a resource to buffer the negative effect of negative self-perceptions of aging on well-being.

Despite positive findings around the use of eHealth in dementia care, evidence for its efficacy is insufficient to ensure its adoption into routine care. Early involvement of end-users in the design of an implementation plan is a key strategy for promoting translation of findings into practice.

This study aimed to identify the requirements for use of an eHealth intervention to support assessment and decision making for use with people with dementia in care homes, and co-design strategies for its implementation.

A qualitative co-design method was applied through a series of workshops. Participants included family carers of people with dementia, and health and social care practitioners with direct experience of working with people with dementia. The workshops focused on identifying requirements for use and co-developing implementation strategies in response to factors identified to influence implementation. A deductive thematic analytic approach was taken, guided by the key concepts of the Normalisation Process Theory.

Three workshops were conducted from July’21-November’21, attended by 39 participants. Three overarching phases of requirements were identified: 1) incentivising adoption of eHealth; 2) enabling operation of an eHealth intervention; 3) sustaining use of eHealth. Initial adoption requires promotion of the interventions benefits to engage stakeholders, and its alignment with national recommendations for good quality dementia care. Operationalising eHealth involves ensuring its compatibility with current care home processes and technology, provision of sufficient training and support from ‘champions’. To sustain its use, ongoing monitoring of the implementation plan and provision of feedback to allow stakeholders to appraise its effects is required.

Implementing eHealth across a complex system of care homes is a multifaceted process. Using the key requirements identified in the workshops, we have developed a multi-strategy plan centered around three phases of implementation, to promote uptake of eHealth to support assessment and decision making for people with dementia in care homes. This is strengthened through collaborating with end-users to increases its value, credibility and real-world relevance. The theoretically informed strategies target mechanisms previously demonstrated to shape the implementation process and outcomes, ready for testing in care homes.

Vascular abnormalities have been frequently reported in elderly adults as a potential risk factor of late-life depression. However, it is still unclear whether stenosis of cerebral arteries may increase risk of depression in the elderly.

Study participants were 365 patients 65 years or older with depressive disorder who had undergone brain MRI and angiography (MRA) which were assessed by trained radiologists, and the 15-item Geriatric Depression Scale (GDS-15) and the Mini Mental State Examination (MMSE), and blood glucose and lipid profiles.

Of the 365 subjects, 108 had at least one location of cerebral artery stenosis (29.59%). Stenosis was associated with age, marital status, infarction, and atherosclerosis. In multivariable linear regression analysis of different locations of stenosis among the whole sample, only bilateral middle cerebral artery (MCA) stenosis was found to have a significant association with higher GDS-15 score (p= 0.0138), and more than 8 scores in the GDS-15 (p= 0.0045), but no significant associations with ACA (anterior cerebral artery), PCA (posterior cerebral artery) or ICA (internal carotid artery). In multivariable linear logistic analysis of different locations among patients with at least one cerebral artery stenosis, left MCA was found to be significantly related to higher GDS-15 scores but not with right MCA (p = 0.0202).

MCA stenosis is significantly associated with severity of depression in elderly adults with cerebral artery stenosis, especially in those with left MCA stenosis.

• Patients with cerebral artery stenosis found with brain magnetic resonance angiography (MRA) were associated with higher depression severity.

• Stenosis of both left and right middle cerebral artery (MCA) was associated with greater depression severity, with left MCA stenosis having a greater influence on depression severity than right MCA stenosis.

• Higher depression severity in patients with MCA stenosis suggests that depression in elderly patients is mediated at least in part by vascular pathology of MCA supplied regions and careful investigation and management of cerebral artery stenosis and their risk factors may help reduce the severity of depression in elderly patients who visit psychiatrists.

Dementia grief can be described as a caregiver’s anticipatory grief experience due to losses occurring before the care recipient’s physical death. Among other things, these losses can include loss of memory, intimacy, communication, relationship resolution, and family identity. Psychosocial interventions have been developed to address and reduce these pre-loss grief reactions. The objective of this systematic review was to synthesize the evidence on existing dementia grief interventions for caregivers of persons with dementia (PwD).

Electronic databases Web of Science (SSCI), PsycArticles, Psychology and Behavioral Sciences Collection, PsycINFO, PSYNDEX Literature with PSYNDEX Tests and MEDLINE were searched from September 2016 to September 2021. The systematic review was carried out following PRISMA guidelines and it was registered to the PROSPERO database (CRD42021268998). All adult family or friend carers of older persons with dementia were included. All types and severity stages of dementia were included except studies about young onset dementia and dementia grief. Also, family carers could not be bereaved.

The 12 included studies contained multifaceted interventions with heterogenous formats. Eight studies had a quantitative, two a qualitative and two a mixed method design. Sample size ranged from two to 273 participants. Interventions included elements of psychoeducation, cognitive and emotional therapeutic strategies based on CBT, acceptance- based and mindfulness-based strategies. The interventions showed statistically significant small to moderate effects on dementia grief. In addition to the effects on dementia grief, the interventions also had a positive impact on mental health-related variables such as burden, depression, empowerment, and resilience.

There has been an increase in dementia grief interventions suggesting that dementia grief has been acknowledged as a valid and important construct to describe the dementia caregiver experience. It remains unclear whether health care providers know about and implement elements of the grief interventions in every day clinical encounters with dementia caregivers. Thus, future research should determine the practicing health care providers’ knowledge about dementia grief and its available interventions. Furthermore, it should be examined whether the intervention effects are transferable to caregivers of patients with other terminal illnesses or degenerative disorders, or whether they must be modified.

To explore the benefits and barriers of using an interactive robotic seal (PARO, Figure 1) based on the experiences of nursing home residents living with dementia and chronic pain, their family members, and formal caregivers.

Semi-structured interviews were conducted alongside a feasibility randomized controlled trial at one nursing home in Brisbane, Australia between July 2021 and January 2022 (Trial registration: ACTRN 12621000837820). Residents with dementia and chronic pain interacted with PARO individually for 15 min once or twice daily, five days per week for three consecutive weeks. After which, individual interviews were conducted with residents who were capable of communicating (n=13), family members (n=3), registered nurses (n=4), care assistants (n=11), a physical therapist (n=1), a diversional therapist (n=1) and the facility manager (n=1) who experienced or observed the residents’ interactions with PARO. The interviews were audio-recorded, transcribed, and analyzed using thematic analysis.

Almost all participants reported that interacting with PARO benefited residents with dementia and their caregivers. These benefits included (1) reducing pain by providing distraction and stimulation; (2) reducing behavioral and psychological symptoms of dementia; (3) promoting positive emotions by recalling memories; and (4) reducing anxiety and care burden for family and formal caregivers. Neutral attitudes toward PARO were reported by three residents with mild cognitive impairment as they reported it did not make any difference. Barriers to using PARO included limited staff training and the implementation of person‐ centered care due to limited resources.

Overall, multiple stakeholders were positive about using PARO to reduce pain and behavioral symptoms of nursing home residents living with dementia and chronic pain. PARO may also reduce the care burden of family and formal caregivers. PARO might be incorporated into daily practice to support nursing home residents living with dementia. Improving staff training and understanding individual preferences of residents may enhance the implementation of PARO in this population.

Figure 1

A resident living with dementia and her family after interacting with PARO (Distribution of this photo has been approved by the resident and her family)

The objective of this study is to describe the prevalence of benzodiazepine in a sample of patients (≥65 years) attended by liaison psychiatry units (LPU) in Spain and its possible relation to falls.

This is an observational., cross-sectional, multicenter study. We obtained data from a sample of 165 patients (≥65 years) admitted to 7 general hospitals in Spain referred from different departments to each liaison psychiatry unit. Data was collected for a month and a half period. Psychiatric evaluations were performed while the patients were on wards.

We obtained a sample of 165 patients (78 women, 88 men) with a mean age of 76,03 years old (42.10% <75 years, 57,83% ≥ 75 years). Most of them were married and they lived accompanied (67,27%). Only 5,45% lived in a nursing home. 65,45% of patients had prescribed at least one psychotropic drug before LPU intervention; mainly (50,9%) benzodiazepines (60%women/40%men). 70,9% of these group of patients had more than one psychotropic drug prescribed before LPU. After LPU intervention in 39,39% at least one drug was withdrawn (in 50,81 % of cases benzodiazepines). Falls in the past 6 months were reported in 24.8% of total patients. Patients under benzodiazepine treatment had fallen in 29% of cases. After LPU intervention benzodiazepines were withdrawn in 56,25% % of them.

Benzodiazepines are widely used in our sample and frequently is associated with polypharmacy. LPU intervention might be a useful tool to reduce the use of them, specially for those who reported falls.

Longitudinal studies might be carried out to study these factors and their possible relationship with falls, given that Benzodiazepines are consistently associated with a higher risk of falls. It is unclear whether specific subgroups such as short-acting benzodiazepines and selective serotonin reuptake inhibitors are safer in terms of fall risk. Ppropriate prescription of medications such as BZDs is an important public health issue.

We have reported parkinsonism and psychiatric symptoms were the most important treatment needs of patients with dementia with Lewy bodies (DLB) and their caregivers, respectively 1). However, the frequency presenting clinical symptoms and the onset time vary among patients. We investigated the impact of the disease duration on clinical symptoms, prescribed medication and treatment needs of patients and their caregivers.

Disease duration was defined as time after diagnosis with DLB. Patient-caregiver pairs were classified into two groups; one with a disease duration <24 months (S-group) and the other with a disease duration ≥24 months (L-group). Comparisons were made between two groups regarding background characteristics and treatment needs of patients and caregivers. Treatment needs were defined as symptom domains most distressing to patients and caregivers.

S-group and L-group were consisted of 126 and 137 pairs of patients and their caregivers, respectively. Regarding patientsʼ current symptoms, parkinsonism and autonomic dysfunction were significantly higher in L-group than S-group. MDS-UPDRS Part III total score and the frequency of prescription for memantine and antiparkinsonian were also significantly higher in L-group than in S- group. The treatment needs most frequently selected by patients was cognitive impairment (20.6%) followed by autonomic dysfunction (16.7%) and parkinsonism (11.9%) in S-group, and parkinsonism (24.6%), followed by cognitive impairment and autonomic dysfunction (11.1% each) in L-group, suggesting no significant difference in the tendency of symptom domains to desire treatment between groups (P=0.056). However, residual analysis showed that patients in S-group were more likely to select cognitive impairment than in L-group (P=0.045), and those in L-group were more likely to select parkinsonism than in S-group (P=0.003). The treatment needs most frequently selected by caregivers in S-group was cognitive impairment (29.4%) followed by psychiatric symptoms (20.6%) and parkinsonism (10.3%) in S-group, and psychiatric symptoms (24.6%), followed by parkinsonism (16.7%) and cognitive impairment (14.3%) in L-group, suggesting significant difference in the tendency of patientsʼ symptom domains to desire treatment between groups (P=0.032). Dara from the onset will be added at the poster presentation.

It was suggested that the treatment needs of patients and their caregivers might change with duration after diagnosis.

The use of side-rails from the headboard to the foot of both sides of the bed (from now on “the rails”) is the most used tool to prevent falls in our hospital setting. However, its consideration as physical restraint in the different international consensus is not clear. In the GERBAR study (NCT04861025), we intend to evaluate the perception of the rails as a measure of physical restraint, both by hospitalized users and by the health personnel who care for them. The trial is being performed at the Consorci Sanitari Alt Penedes-Garraf, CSAPG (Barcelona, Spain). In this report we show partial results of the data obtained from the health personnel belonging to Nursing Department.

An online poll has been carried out through the intranet and corporate emails in the last two months of 2022. All the people who works as health personnel at the CSAPG (1652 people) have been invited to this poll.

We obtained a total of 246 responses, of which 27 responses have been removed for not being completed correctly. 152 responses were made by health personnel attached to the Nursing Department: 72 auxiliary nursing personnel (15.38% of the total CSAPG professionals in this professional group) and 80 nurses (14.47%). Proportion of job seniority greater than two years was 74.34% (69.44% auxiliary personnel, 78.75% nurses). 91.67% have been women with a median age of 40.87 years. 46.40% of this sample does not considered the rails as physical restraints (50% auxiliary personnel and 41.25% nurses). When analyzing by job seniority, 48.72% of the professionals with <2 years of seniority does not consider the rails as a physical restraint (44.25% in those with >=2 years). Professional group and job seniority were not significantly associated with perception of the rails as a physical restraint (chi-square 1.17, p 0.2793 for professional group and chi-square 0.23, p 0.6288 for job seniority).

An important proportion of health professional belonging to Nursing Department does not consider the rails as a physical restraint. This perception was not related to the professional group or job seniority.

Major depression is one of the most widely recognized psychiatric disorders in cancer patients. In Spain,16.49% of cancer patients develop a Major Depressive Disorder. It arises as a reaction to a traumatic experience influenced by events and environmental conditions and develops as a consequence, of an adverse event, whether single or recurring. When depressive symptoms interfere with the proper functioning of cancer patients, antidepressants are the first line of treatment. We refer to Vortioxetine as the antidepressant of choice.

We present a 68-year-old patient diagnosed with Prostate Neoplasm (Gleason Grade 6 STAGE IV Adenocarcinoma) with Bone and Pulmonary Metastasis, who was referred, to the PADES Service of CSS Bernat Jaume, for poor pain control at the L5-L7 lumbar spine level. (VAS 9/10), immobility and depression after his prognostic information and short-term expectations.

We want to assess the usefulness of Vortioxetine for depression in cancer terminal patients. The diagnostic criteria for depressive disorder were evaluated according to the DSM-V(6) risk factors for depression in palliative patients. The Visual Analogue Scale for the evaluation of the pain (0 no pain and 10, unbearable pain). Previously used medications for pain control, and depression were assessed. It was decided to start treatment with Vortioxetine and assess the response.

We started Vortioxetine 5 mg for a week and appetite improved, as well as VAS 5/10. After fifteen days, he was able to walk, and his insomnia and anxiety decreased. He remained stable with the prescribed medication until, due to complications secondary to his oncological pathology, he was admitted to The Palliative Care Unit to begin sedation.

In terminal cancer patients with depression, it would be advisable to use Vortioxetine to improve their quality of life in situation of last days.

Cognitive impairment is common and underdiagnosed in patients in hemodialysis (HD) can be moderate and severe. About 38% of patients in Dialysis has serious deficits in executive function and this affects patients of all ages.

Based on the case of an 82-year-old patient in a HD program who enters from Nephrology to the Convalescence Unit for miscontrol of pain due to ganglion and liver recidivism after years of cystectomy by bladder neoplasia and having acute confusional syndrome (ACS) subsequently presented after treatmet with morphine MST and Tramadol. We performed an integral geriatric evaluation that showed a deterioration of the executive functions. Through medical literature we analyze this find of atypical pattern and its possible relationship to renal disease.

BI 100/100. No known history of cognitive impairment. Despite optimal pain control with fentanyl patch, pregabalin, paracetamol, metamizol and dexamethasone, without new episodes of ACS, we saw high difficulties in comprehension time schedule, spatial location, bad understanding of medical treatment, etc. Neuropsychological study showed MMSE 24/30; SKT subtest of immediate memory 1/12, null recognition without understanding the task. Memory Imparily Screen 5/8, Test clock 3/7. In summary there were deficits in executive functions such as complex attention, mental control, fluency and reasoning. Fluctuating memory abilities. Mild multiple cognitive impairment executive domain. Atypical Profile.

There is a strong correlation between the decrease in GF and the degree of cognitive impairment. This worsens with the Dialysis due to hemodynamic changes. It is essential to evaluate the cognitive situation in all patients with CKD. Being the most affected cognitive domain, the function executive,it can avoid in these patients the correct assesment of established medications and dietary restrictions that are so important in the control of potassium, phosphorus and liquids that cause greater complications and even more mortality.

Being diagnosed with dementia can be a hectic and critical period. While severe dementia may act as a shield when it comes to suicidal risk, mild and early dementia stages may still preserve cognitive functions to elaborate a suicidal plan. Having insight may lead to feelings of despair and sadness that patients find unbearable to deal with. The aim of this article is to review the current literature regarding suicidal risk after a dementia diagnosis.

Review of the most recent literature regarding the risk of suicide among patients with a recent dementia diagnosis. The research was carried out through the PubMed and UptoDate databases, using the terms “dementia”, “diagnosis” and “suicidal risk”.

Previous research showed inconclusive findings, with some authors suggesting a higher risk of an early suicide attempt in patients recently diagnosed with dementia, and others suggesting otherwise. Nowadays, the literature mainly reports that older adults with recent dementia diagnoses are at increased risk of endeavoring suicide. There is an important requirement to offer appropriate support to patients and their families, at the time, or as soon as possible, when a dementia diagnosis is made, to diminish the risk of suicide attempts in these patients.

Patients with recent diagnosis of dementia, or diagnosed at an earlier age, seem to have higher suicidal risk. The period immediately after diagnosis is when individuals need greater support, so these results demand for better assistance for those experiencing such intellectual decline.

The amyloid hypothesis suggests that errors in production, accumulation, or disposal of beta-amyloid are the primary causes of Alzheimer's disease (AD). Since this was hypothesized, there has been significant effort in developing treatments that prevent the build-up of amyloid beta (Aβ) plaques in the brain. A disease modifying therapy (DMT) changes the clinical progression of AD by interfering in its pathophysiological mechanisms.

The aim of this article is to review the current literature regarding the role of new DMTs for Alzheimer’s dementia and assess the preparedness of health care systems to implement these treatment options.

Review of the most recent literature regarding the role of new DMTs for Alzheimer’s dementia and the challenges faced by the health care system to implement these treatment options. The research was carried out through the PubMed and UptoDate databases, using the terms “amyloid hypothesis”, “Alzheimer”, “disease modifying treatments” and “dementia”.

Research has been focusing on developing monoclonal antibodies as potential DMTs that target Aβ. Aducanumab, a human antibody, or immunotherapy, is the only disease-modifying medication currently approved to treat AD. It targets the Aβ protein and helps to reduce amyloid plaques and is currently the only FDA approved medication to slow the progression of AD. Lecanemab, a humanized IgG1 monoclonal antibody, binds to Aβ soluble protofibrils with high affinity. Even though there is considerable optimism about its potential, lecanemab will probably be more useful to patients on early stages of the disease.

DMTs administration obeys to certain needs such as a vacancy in Day Hospital for infusion and regular monitorization and for lumbar punction. It demands a complex network involving general practitioner, neurologist, psychiatrist, psychologist, and social services. It also involves a genetic study and complementary diagnosis exams such as PET (Positron emission tomography) scans and MRIs (Magnetic resonance imaging), which are expensive. There is an emerging need to develop enhanced and safer treatments.

Elderly people who live in nursing homes can be faced with intramural relocations for various reasons, whether individual or per group. Because the impact of these intramural relocations on residents is unknown, our aim is to explore how relocations within nursing homes affect residents from different stakeholder-perspectives.

We performed semi-structured individual interviews and a focus group with various stakeholders of intramural relocations to collect a broad outlook on its practice based on diverse perspectives and lived experiences. The interviews and focus group were audio-recorded, transcribed verbatim and analyzed using responsive and thematic analysis.

Seventeen interviews were held and one online focus group with six participants. In the interviews, participants mentioned various reasons for intramural relocations, such as outdated real estate for group relocations or changing healthcare demand for individual relocations. Participants distinguished various levels of impact on residents on different moments in time (before, during and after the relocation). The impact varied from very positive (e.g. looking forward and excited) to very negative (e.g. stressful, traumatic, hard to understand). Aspects that influenced the impact of relocation were related to 1) the mental resilience of residents, 2) how relocations were organized, 3) the presence and quality of social connections of residents and 4) if benefits of the new (care) environment were experienced. The focus group added insights on the importance of clear and timely communication with residents and recognizability of (personal) items and personnel from the former nursing home to reduce negative experiences of residents relocating within nursing homes.

The impact of relocations within nursing homes differs per situation, moment in time and resident. Aspects found that influence the impact provide targets to reduce the negative impact on residents: practices should focus on good preparation, clear communication, preserving social connections of residents where possible and paying attention to the benefits of the new (care) environment for the residents. Further research may focus on the lived experiences and perceived impact of relocations within nursing homes of residents themselves to develop in depth insights into tailored (care) needs of residents during the relocation process.