Care transitions problematic for those with dementia: study

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Unnecessary transitions are linked to problems such as medication errors, hospital readmissions and increased risk of death in older adults, especially those with dementia. Such transitions can be reduced, however, by having coordinated care and a long-term care plan in place, say the authors of a new study published in the Journal of the American Geriatrics Society.

Researchers from the UBC Center for Health Services and Policy Research in Vancouver, British Columbia, followed 6,876 people aged 65 or more years in whom dementia had been diagnosed between 2001 and 2002. They analyzed healthcare data from 2000 until the study ended in 2011.

The number of transitions spiked during the first year of dementia diagnosis, the investigators found. Sixty-five percent of the study participants experienced at least one transition during the year of their diagnosis, and 17% experienced three or more transitions, most of which were hospitalizations. More than 60% of those studied were hospitalized in the year of their diagnosis, and these hospital stays generally lasted for a month or more.

The researchers also discovered that people experienced a higher number of transitions the year before and the year of their death. Receiving a prescription for an antipsychotic medication or benzodiazepine, as well as living in more rural areas, were linked to a higher number of transitions, too.

Receiving care consistent with dementia guidelines and receiving ongoing care from a known primary care physician were linked to fewer transitions.

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