Appraising the need for care in alzheimer’s disease

BMC Psychiatry

Matthias W Riepe³  Friedemann Müller²  Constanze Lahmeyer³  Christina Jonas³  Barbara Romero¹  Claudia Schiffczyk³ 

[1] Freelance Psychologist, Berlin, Germany;Alzheimer Therapiezentrum Bad Aibling, Bad Aibling, Germany;Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany

关键词: Caregiver;    Nursing care insurance;    Care level;    Dementia;   

Others  :  1124120
DOI  :  10.1186/1471-244X-13-73

 received in 2012-02-23, accepted in 2013-02-26,  发布年份 2013

【 摘 要 】

Background

Increasing incidences of dementia necessitate the improvement of supportive measures for patients suffering from this disease and their proxies. Clinicians without psychiatric backgrounds and others involved in appraising the supportive needs of dementia patients, such as those who allocate nursing insurance, base their appraisals on the ability of patients to perform basic and instrumental activities of daily living (B-ADL, iADL). Our aim was to investigate whether a reduced ability of the patient to perform ADL is sufficient to adequately assess the supportive needs of family caregivers.

Methods

Cross-sectional baseline data were obtained from dementia patients and their proxies in the context of a nationwide prospective cohort study on non-pharmacological treatment of dementia. To our knowledge, the present study is the first country-wide study to assess patients and proxies in their domestic surroundings (e.g. Mini-Mental State Examination (MMSE) Behave-AD, B-ADL and iADL for patients; Quality of Life (QOL) and depression of the proxy).

Results

Logistic and linear regression analysis show that the allocation of nursing care allowance provided by German mandatory nursing insurance is associated with scores on the B-ADL- and iADL scales, but not with the severity of behavioural symptoms or the supportive time the proxies spend on caring. However, the severity of cognitive and non-cognitive symptoms of dementia patients, correlate with each other and both parameters correlate with the time the proxy spends on caring. The time spent on caring is associated with an increase in depression and a reduction in the quality of life of the proxy.

Conclusions

Basic and instrumental activities of daily living do not sufficiently reflect the perceived burden of care experienced by the proxy who has to cope with the imposition of the dementia patients’ behavioural symptoms. When allocating nursing care, patients’ behavioural symptoms should also be taken into consideration, because depressive symptoms of proxies are linked to non-cognitive symptoms in dementia patients. To provide better health care, it is necessary to identify and treat psychiatric symptoms in proxies who care for dementia patients as early as possible.

【 授权许可】

   
2013 Schiffczyk et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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