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Keeping People With Dementia at Home Longer

Addressing safety, medical issues key to independent living, researcher says

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

FRIDAY, Dec. 20, 2013 (HealthDay News) -- Most Americans with dementia who live at home have numerous health, safety and supportive care needs that aren't being met, a new study shows.

Any one of these issues could force people with dementia out of the home sooner than they desire, the Johns Hopkins researchers noted.

Routine assessments of patient and caregiver care needs coupled with simple safety measures -- such as grab bars in the bathroom -- and basic medical and supportive services could help prevent many people with dementia from ending up in a nursing home or assisted-living facility, the researchers added.

"Currently, we can't cure their dementia, but we know there are things that, if done systematically, can keep people with dementia at home longer," said study leader Betty Black, an associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. "But our study shows that without some intervention, the risks for many can be quite serious," she said in a Hopkins news release.

For the study, published in the December issue of the Journal of the American Geriatrics Society, Black's team performed in-home assessments and surveys of more than 250 people with dementia living at home in Baltimore. They also interviewed about 250 family members and friends who provided care for the patients.

Ninety-nine percent of patients and 97 percent of caregivers had one or more unmet need in areas such as safety, health, meaningful activities, legal issues and estate planning, assistance with activities of daily living and medication management.

Ninety percent of those needs were safety-related. More than half of the patients had inadequate meaningful daily activities at home or a senior center, and one-third of patients still required a dementia evaluation or diagnosis.

More than 60 percent of the patients needed medical care for conditions related or unrelated to their dementia. This is a serious issue because dementia patients are more likely to have a serious illness for which they may eventually be hospitalized, according to Black.

"This high rate of unmet medical care need raises the possibility that earlier care could prevent hospitalizations, improve quality of life and lower the costs of care at the same time," she said.

Most caregivers also had numerous unmet needs, including lack of access to support services and education about how to best care for their loved one.

About 5.4 million people in the United States have Alzheimer's disease and other types of dementia, and 70 percent are cared for in the community by family members and friends.

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