Survey for management of BPSD in care managers and special psychiatric wards for people with severe dementia

OBJECTIVES: The integration of medical care and long-term care services is very important in managing dementia patients. We performed two surveys to explore how dementia patients and their symptoms were managed in care facilities (study 1) and at special psychiatric wards for people with severe dementia (study 2). METHODS: (Study 1) One hundred and sixty-six care managers were subjects for the survey. The questionnaires were distributed at the meeting and recovered at the same meeting place. (Study 2) The questionnaires were sent by mail to 405 psychiatric hospitals with special psychiatric wards. The questionnaires were recovered from 105 wards (recovery rate: 26.0%). RESULTS: (Study 1) Over 60% of people the care managers take care of have dementia, and 1/3 of them showed severe dementia. The care managers felt that it is very difficult to manage dementia patients with severe BPSD. They were of the opinion that psychiatric care should be administered to those people. (Study 2) The average period of stay on the wards was about 2 years. One third of people stayed on the wards for over 3 years. The reasons why the people have to stay longer on the wards were as follows: severe BPSD, limited number of care facilities for patients to go to after discharge from the wards, and patients' families do not accept them in their homes. CONCLUSIONS: Care managers supposed that dementia patients with severe BPSD should be managed by specialists in dementia, psychiatrists, etc., at psychiatric hospitals. Patients on special psychiatric wards stayed for longer because of a limited number of care facilities which can manage them.