The home hospitalization of frail elderly patients with advanced dementia

A home hospitalization service (NHS) has been operating in our hospital of Turin since 1985. HHS allows to perform diagnostic and therapeutic interven tions, which are usually made in hospital, also at home. The objectives of the study were: to assess the feasibility of HHS for elderly patients with advanced dementia and a relevant degree of comorbidity, to identify benefit s of this care setting, compared with general medical care in reduction of the caregiver's stress and the requirement for long-term institutional care . The study was conducted on 82 patients with advanced dementia: 41 were ma naged at home by HHS and 41 in a general medical ward (GMW). Both groups we re examined using the same protocol and were evaluated at admission and dis charge. No significant differences between the two groups were observed at admission for the characteristics and the level of caregivers' stress. Mort ality was not significantly different in the two groups. At discharge the u se of antipsychotic drugs was significantly reduced in the HHS patients. On ly one patient of HHS group was transferred in nursing home versus seventee n of GMW group. The caregivers' stress at discharge was significantly reduc ed only in the caregivers of HHS patients. In conclusion, HHS is a feasible care alternative to hospitalization of patients with advanced dementia and reduces the requirement for long-term institutional care.