MEDICAL OUTCOME OF PSYCHOSOCIAL INTERVENTION IN DEMENTED PATIENTS - ONE-YEAR CLINICAL FOLLOW-UP AFTER RELOCATION INTO GROUP LIVING UNITS

Care of demented elderly in group living units is developing rapidly in Sweden. Group living (GL) offers a secure, small-size, homelike physical setting and an individualized, psychosocial and integrity-promoting therapy. Twenty-eight patients suffering from dementia of Alzheimer type (DAT) or/and vascular dementias (VD) were evaluated before relocation from traditional long-term care institutions (TI) into GL units and followed up 6 and 12 months later by psychogeriatric ratings, regional cerebral blood flow measurements, somatic investigations and registration of pharmacological treatment. The patients relocated into GL were compared to a matched sample of 28 patients permanently cared for in TI. GL patients showed less dyspraxia, dysphasia and less prominent symptoms of depression and anxiety after both 6 and 12 months compared to the control group. Restlessness diminished among GL patients while the patient group in TI got more restless. Neuroleptic treatment was found to be used significantly more often among the TI patients during the whole study and anxiolytic-hypnotic treatment after 6 months. No difference was observed in antidepressive treatment. The results show that psychosocial stimulation and therapy offered in GL care has positive effects on emotional symptoms and performance compared to care in TI. These clinical changes abate later in the study as a consequence of the underlying organic disease. The major benefit of GL was slightly different between the diagnostic groups: for VD patients improvement of practical abilities, for AD patients abated agitation and restlessness.