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 i n Sweden. Group living (GL) offers a secure, small-size, homelike phys ical setting and an individualized, psychosocial and integrity-promoti ng therapy. Twenty-eight patients suffering from dementia of Alzheimer type (DAT) or/and vascular dementias (VD) were evaluated before reloc ation from traditional long-term care institutions (TI) into GL units and followed up 6 and 12 months later by psychogeriatric ratings, regi onal cerebral blood flow measurements, somatic investigations and regi stration 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 prominen t symptoms of depression and anxiety after both 6 and 12 months compar ed to the control group. Restlessness diminished among GL patients whi le the patient group in TI got more restless. Neuroleptic treatment wa s found to be used significantly more often among the TI patients duri ng the whole study and anxiolytic-hypnotic treatment after 6 months. N o difference was observed in antidepressive treatment. The results sho w that psychosocial stimulation and therapy offered in GL care has pos itive effects on emotional symptoms and performance compared to care i n TI. These clinical changes abate later in the study as a consequence of the underlying organic disease. The major benefit of GL was slight ly different between the diagnostic groups: for VD patients improvemen t of practical abilities, for AD patients abated agitation and restles sness.