Tailored mental health care after nursing home admission: improving transfers of people with dementia with behavioral problems. An explorative study

Abstract

Objectives: In the Netherlands, many community-dwelling people with dementia and behavioral disturbances and their family caregivers receive mental health care from a community psychiatric nurse (CPN). To promote continuity of care for these persons after moving to a nursing home, a transfer intervention was developed. The aim of this explorative study was to evaluate this intervention and its implementation.

Method: A qualitative explorative study design was used. CPNs visited professional nursing home carers, people with dementia and family caregivers six weeks after moving, advised on how to manage behavioral problems of their former clients and provided support to family caregivers. Twenty-two interviews were conducted with participants exposed to the intervention (5 CPNs, 5 family and 12 nursing home carers) and with 11 stakeholders (i.e., nursing home and mental health care managers, professional caregivers) to identify facilitators and barriers to the implementation. Data were collected in 2012 and 2013.

Results: The follow-up visit at six weeks met the need for background information of new admitted patients and helped family caregivers close off the period prior to the move. It did not meet the original purpose of providing nursing home staff with advice about problem behaviors on time: six weeks after the move was experienced as too late.

Conclusion: The transfer intervention increased the awareness of nursing home staff about personal and behavioral characteristics of residents with dementia and supported caregivers in coping with the new situation. The timing of the intervention could be improved by scheduling it immediately after the move.

Keywords:

• dementia
• behavioral problems
• intervention
• nursing home
• transfer

Acknowledgements

This study was conducted in cooperation with the geriatric networks of the Amsterdam University Medical Center and the VU University Medical Center. The authors would like to thank Minke Eilander and Bart Hattink who both assisted with data archiving, logistics and conducted interviews with participants at baseline.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the National Programme Elderly Care (ZonMw) [grant number 313080201]. Additional funding was received from Vita Valley. ZonMw nor Vita Valley contributed to the study design or manuscript preparation.