Patient and Caregiver Characteristics and Nursing Home Placement in Patients With Dementia

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Abstract
Cognitive impairment, especially severe impairment or dementia, is one of the primary indications for nursing home placement. As many as 90% of patients with dementia reportedly become institutionalized before death.1 However, most patients with dementia continue to live in the community until family caregivers are no longer able to care for them.2 The decision to place a patient with dementia in long-term care is complex and is based on patient and caregiver characteristics and the sociocultural context of patient and caregiver. Yet most studies that have assessed the predictors of nursing home placement have focused primarily on the characteristics of either the patient, such as dementia severity or difficult behaviors,1,3-8 or the caregiver, such as subjective burden or health status,9,10 and few studies have comprehensively investigated how both caregiver and patient characteristics influence nursing home placement. In addition, most studies that have investigated predictors of nursing home placement of patients with dementia have been small (no more than several hundred patients) and have not included different ethnic groups. More research is needed to understand factors contributing to the complex decisions about nursing home placement in an ethnically diverse cohort.