International Psychogeriatrics

Studies on Cognition and Dementia

A Dynamic Long-Term Care System for the Demented Elderly

Lena Annerstedt a1, Junko Sanada a2 and Lars Gustafson a3
a1 Department of Community Medicine in Malmö, Lund University, Sweden
a2 Kochi Medical School, University of Kochi, Japan
a3 Department of Geriatric Psychiatry, University of Lund, Sweden

Article author query
annerstedt l   [PubMed][Google Scholar] 
sanada j   [PubMed][Google Scholar] 
gustafson l   [PubMed][Google Scholar] 


The dynamic processes and the way they interact in shaping a care system for demented patients are analyzed and discussed. The development of disability/dependency, interpreted in a simulation model based on Katz's index of ADL and Berger's scale “Rating the severity of senility,” gave insight into the interplay of four care levels: psychogenatric long-term care for patients with severe behavioral disturbances, nursing-home care for patients with highly reduced ADL capacity who are often moderately to severely demented, group-living care for the demented with less dominating ADL dependency, and residential care for the elderly frail with or without symptoms of dementia. For each facility in this chain of care, characteristics in patients' symptomatology and behavior could also be identified. Resources necessary in order to fulfill goals in caring differed between each facility.