WHAT BECOMES OF PEOPLE WITH DEMENTIA REFERRED TO COMMUNITY PSYCHOGERIATRIC TEAMS

Objective: To monitor key processes and outcomes in joint health and s ocial services community psychogeriatric teams. Design: Six month foll ow-up of new referrals to 4 teams in Cambridge. Data collected from st ructured clinical assessment forms at baseline and interviews with key workers at follow-up. Data for groups with and without dementia were c ompared. Setting: Two rural and two urban teams in area with relativel y large long stay inpatient facility but low independent sector provis ion. All were routine service teams, rather than run for research purp oses. Main outcome measures: The main outcome measures were survival, institutionalisation, key worker assessments of avoidable admissions, appropriateness of placement, unmet needs, carer stress and global out come for patient and carers. Results: Rates of referral to urban teams were double rural rates. Around forty percent of the dementia group h ad a social worker as assessor and keyworker. The dementia group was s ignificantly more dependent and received more informal and formal care . After six months, only 54% of the dementia group were alive and livi ng outside institutional care, compared to 79% in the functionally ill group. Unplanned admissions to hospitals or homes were rarely judged avoidable by keyworkers. Outcomes for carers were judged poor in 15% o f both groups, and 13% and 11% of carers respectively were judged to b e under severe stress. Unmet needs were more common in the dementia gr oup, and related principally to residential care and carer respite. A number of measures, including evidence of geographical inequity and id entification of unmet needs, provided an important contribution to loc al policy development. Further work is needed on the validity of keywo rker assessments of carer stress, given the findings of the carer inte rview sub-study.