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Geriatr Psychol Neuropsychiatr Vieil. 2013 Mar;11(1):49-55. doi: 10.1684/pnv.2013.0390.

[Refusal of application to care in Alzheimer's disease and related diseases: establishment of a mobile unit hospital extra].

[Article in French]

Author information

1
CM2R, CHU de Saint-√Čtienne, France.

Abstract

Refusal of care and support in these patients with Alzheimer's disease and related illnesses at home is a cause of accelerated loss of autonomy and increases the risk of a crisis with early institutionalization. Factors contributing to the denial of care are poorly understood and very few epidemiological data exist.

MATERIALS AND METHODS:

we compared age, diagnosis, level of severity of the disease, the type of behavioral, family status of 101 patients living in denial of care and support as seen by a mobile home (group UPEPc) to 136 control patients seen at the memory clinic (group CM). Patients living in denial of care appear to significantly low age [82/80.5, p<0.0001], with more advanced disease [average MMSE 18/22, p<0.0001], the presence family conflicts and behavioral disorders [delirious--hallucination, agitation--aggression, depression, apathy, p<0.05].

CONCLUSION:

the profile of patients refusing home care is specific and it is important to educate GPs conditions that favor an obstacle to medicalization. The advantage of a mobile extramural to analyze risk factors for refusal of care and propose alternatives should be further investigated.

KEYWORDS:

Alzheimer's disease; dementia symptoms psychobehavioural; descriptive study; home; refusal of treatment

PMID:
23508319
DOI:
10.1684/pnv.2013.0390
[Indexed for MEDLINE]
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