A Dynamic Long-Term Care System for the Demented Elderly
Lena Annerstedt a1, Junko Sanada a2andLars 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
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.