NURSING HOME CARE OF DEMENTIA PATIENTS (A NATIONAL SURVEY IN CYPRUS )

1. NURSING HOME CARE OF DEMENTIA PATIENTS(A NATIONAL SURVEY IN CYPRUS) C. MESSIS, Y. KALAKOUTAS, C. IOANNIDES Cyprus Mental Health Commission with the support of: Cyprus Neurological Society Cyprus Psychiatric Association Nursing Home Owner’s Association

2. Estimated number of patients with Dementia in 2001 in Cyprus Total number of people 700.000 Age Groups: 65+ (5-10%) 3.500-7.500 80+ (20-30%) 3.000-5.000

3. Age group 65+

4. Age group 80+

5. NURSING HOME DISTRIBUTION IN CYPRUS Nicosia 61 Limassol 49 Larnaca 16 Paphos 8 Famagusta 3 ------ Total 137

6. TYPE OF NURSING HOMES IN CYPRUS Private 103 Community 27 State 7 ------ Total 137 Total number of Residents : 3.300

7. NURSING HOME SURVEY • Primary Target Estimate number (%) of residents with Dementia • Secondary Targets Standard of care of Dementia residents Family satisfaction with care

8. METHOD Anonymous Questionnaire: • Personal interview with directors of nursing homes • Modified MMSE test to residents • Telephone interview with family of probable Dementia cases Interviewers: 12 graduate and postgraduate students of nursing etc. after 2 days of training

9. TOTAL SAMPLE 20 Nursing Homes (with an average number of 24 residents) were randomly selected from 4 Districts of Cyprus Information was received from: 20 Directors of nursing homes 109 Families of residents with probable Dementia 422 Residents

10. TOTAL SAMPLE OF RESIDENTS ACCORDING TO TYPE OF NURSING HOMES STUDIED

11. AGE DISTRIBUTION OF NURSING HOME RESIDENTS

12. GENDER DISTRIBUTION OF NURSING HOME RESIDENTS

13. GENDER DISTRIBUTION IN RELATION TO AGE

14. NURSING HOME RESIDENTS WITH DEMENTIA

15. EXCLUSION CRITERIA (PSYCHOTIC, STROKE, BLINDNESS, DEAFNESS, RETARDATION, ETC)

16. AGE DISTRIBUTION OF PATIENTS WITH DEMENTIA

17. DEMENTIA RESIDENTS AND TYPE OF NURSING HOME

18. DEMENTIA RESIDENTS AND GENDER

19. DEMENTIA AND PRIMARY EDUCATION

20. Age, Gender, Primary education as independent variables Statistical analysisshowed: Old age, female gender and no primary education to be significant independent variables in increasing the number of residents with Dementia (95% CI)

21. Degree of severity of Dementia according to MMSE score 0 – 9 Severe 10 – 14 Moderate 15 – 20 Mild 20 points instead of 24 used as cut off between normal and abnormal

22. DEGREE OF SEVERITY IN RESIDENTS WITH DEMENTIA

23. SEVERITY OF DEMENTIA IN RELATION TO PRIMARY EDUCATION

24. STATE OF MOBILIZATION OF NURSING HOME RESIDENTS

25. BEDRIDDEN RESIDENTS DEPENDING ON MENTAL STATE

26. IS THERE SATISFACTORY COMMUNICATION WITH RESIDENT?

27. SATISFACTORY COMMUNICATION WITH RESIDENT IN RELATION TO MENTAL STATE

28. DOES THE RESIDENT FOLLOW SIMPLE COMMANDS?

29. FOLLOWING SIMPLE COMMANDS IN RELATION TO MENTAL STATE

30. DIAGNOSIS ON ADMISSION

31. MEDICATION TAKEN

32. MEDICATION TAKEN ACCORDING TO FINAL DIAGNOSIS

33. FAMILY SATISFACTION WITH CARE OF RESIDENTS WITH DEMENTIA

34. IS THE RESIDENT ISOLATED?

35. IS THE RESIDENT PHYSICALLY RESTRAINED?

36. IS PHYSICAL VIOLENCE USED?

37. IS THERE SATISFACTORY ENTERTAINMENT?

38. IS THE RESIDENT SECURE?

39. CONCLUSIONS • Over half the population of nursing homes in Cyprus has Dementia • Most cases are unsuspected • Very few patients receive anti AD medication available free from government • ¾ of residents do not take neuroleptics or hypnotics

40. CONCLUSIONS (Cont.) • Nursing Homes are becoming geriatric institutions • Although satisfaction with care is presently high, more medical, nursing and other treatment facilities will be necessary in the future.