Pathways through care for patients with dementia: a 3-year follow-up study

Many people are admitted from primary care to old age psychiatric services as in-patents or day patents for the investigation and management of dementia. However, little is known about the long-term outcome for these patents. Sixty patients admitted to hospital from the community and diagnosed as having dementia (33 day patents and 27 in-patents) were interviewed at admission and followed-up 3 years later. Information was collected on their use of services and outcomes. The day patents had a similar severity of dementia to the in-patients at admission, but were less functionally impaired (P < 0.05). The day patents were more likely to be discharged home (P < 0.05) and spent more time living at home in the first 2 years of follow-up (P < 0.05). However, the significance differences in the use of services disappeared in the third year. A total of 31 patients (52%) were alive at follow-up, of whom only two patents (6%) were living at home. In summary, people with dementia who were admitted from the community for specialist assessment as inpatents or day patents tended to be admitted to long-term institutional care within a short period. However, the day patents spent a higher proportion of time living in the community.