Outcome of referral to social services departments for people with cognitive impairment

The objective of this study was to determine how the entry into long term c are of people assessed by their local social services department (SSD) unde r the National Health Service and Community Care Act 1990 is predicted by t he severity of their cognitive impairment, care provided by family members, and the receipt of community care services. The design involved a cohort s tudy of people over one and a half years following referral (min-max: 1-2 y ears) from three SSDs (county council, metropolitan and inner London boroug hs). Consecutive recruitment of 141 people with cognitive impairment aged 6 5 and over took place over a 4 month period. The main outcome measure was s urvival analysis of time taken from referral to entering long term care at follow-up. The receipt and intensity of community care services increased t he probability of remaining at home. People with mild or moderate cognitive impairment were more likely to remain at home if they had a spouse or daug hter carer. Analysis of the interaction between three main effects predicti ng entry to long term care (severity of cognitive impairment, access to a c arer, and the receipt of home care or day care) suggests that while carers are central in determining whether older people with cognitive impairment a re able to remain living in the community, there are limits to the care the y can provide. Copyright (C) 2000 John Wiley & Sons, Ltd.