ACUTE CARE UNITS FOR ALZHEIMER’S PATIENTS

Abstract

Patients with behavioral and psychological symptoms of dementia (BPSD) due to a concomitant acute somatic disease are at risk of not being adequately treated in respect to all their problems either in a somatic or in a psychiatric setting. This results in frequent and often repetitive transfers between institutions. The need for new models of care for patients with dementia hospitalized for somatic disease concomitant with challenging BPSD has led to the development of acute care units for Alzheimer patients. The main target of these units is an improvement in quality of care resulting in better outcomes for these patients. In addition, important issues are the safety for wandering patients, reduction of psychological stress and workload for the staff and better integration of proxies in the care process. To reach these goals a training program of the multidisciplinary team is mandatory.However, these special acute care units, located for the majority in the somatic geriatric hospital, are still rare. Similitude and differences between these units will be presented. To validate our model in our unit (SOMADEM, somatic and dementia) in the Department of Internal Medicine, Rehabilitation and Geriatrics at the Geneva University Hospital in Switzerland, we compared clinical features between SOMADEM unit and a normal general geriatric unit in the same hospital. Results on cognitive, functional, nutritional status and adverse hospitalization outcomes (longer length of stay, institutionalization and mortality) will be presented.These units represent an innovative advance in the care of acutely ill hospitalized old persons with dementia.