Coordinated Care May Help Reduce Harmful Transitions for Patients With Dementia

Coordinated care and a long-term care plan may help reduce unnecessary transitions for patients with dementia according to a study published in the Journal of the American Geriatrics Society.

A transition is a physical move from one location to another, with a stay of at least one night. For older adults with dementia, these transitions can lead to problems such as hospital readmissions, increased risk of death, and medication errors, among other complications. Having a physical exam, participating in counseling, receiving recommended lab tests, and seeing a dementia specialist are recommended by researchers to help lessen transitions for patients with dementia.

Researchers from the UBC Centre for Health and Policy Research in Vancouver, British Columbia, conducted a study of patients with dementia to identify points of care when transitions are highest, as well as any contributing factors. Participants included 6876 people aged 65 and older who were diagnosed with dementia between 2001 and 2002. Health care data from 2000 were analyzed until the study ended in 2011. Besides dementia, 23% of the group had no other chronic diseases at the beginning of the study, while 44% of the group had two or more chronic diseases. 

Results suggest an increase in the number of transitions during the initial year after a dementia diagnosis. Sixty five percent of participants experienced at least 1 transition during the first year, while 17% experienced 3 or more transitions, most of which were hospitalizations. Moreover, 60% of participants were hospitalized during the first year after diagnosis, generally for a month or longer.

 “The spike in transitions in the year of diagnosis highlights a distressing period for individuals with dementia during which unwanted or unnecessary transitions might occur and suggests a useful target for interventions,” researchers said. “There is an association between recommended dementia care and outcomes and evidence of the continued value of high-quality primary care in a complex population at a critical point when gaps in continuity are especially likely.”—FRMC Editor

Reference: Sivananthan SN, McGrail KM. Diagnosis and disruption: population-level analysis identifying points of care at which transitions are highest for people with dementia and factors that contribute to them. Journal of the American Geriatrics Society. March 21, 2016.