Forty-seven patients in psychogeriatric day centre were analysed regarding use of resources, costs and well-being. The level of well-being was based on interviews with staff and relatives and related to the economic outcome--a cost utility analysis. A 6 month period prior to day care was compared with the first 6 months in such care. The use of resources at home increased by 20% while the use of institutional care was reduced by 22%. Fifty-three percent of the patients improved in their well-being after participation in day care. When the cost of utility analysis was applied, the cost for a well-year was 4293 pounds.

SUMMARYThe increasing number of patients with dementia requires new forms of care management. Group living (GL) is an alternative, and two units were established in Sundsvall, Sweden, in 1984. The patients in GL used institutional care to a significantly lower extent (nursing homes, emergency hospital care, psychiatric care) after admission to GL (p c 0.001). The costs for the Municipality and the County Council changed from f49 to f42/day (p = 0.21) and patient during the first six-month period in GL compared to the six-month period prior to GL. If the costs for GL are compared to the costs for nursing home care (E68/day), GL is significantly cheaper (p c 0.05).KEY woms-Dementia, group living, costs, alternative care.The high prevalence of dementia, 5% of the population over 65 years of age (Mortimer and Schuman, 1981) and about 25% of those 85 and older (Office of Technology Assessment Task Force, 1988), requires an efficient organization to care for the demented patients and to support their relatives. In times of restricted economy it is also necessary to find satisfactory and economical ways of caring for the demented.Psychogeriatric day care (DC), offering activities

Sixteen patients with dementia were studied 4 years after admission to group-living (GL) units, an intermediate level of dementia care. Of eight patients who were still alive, four lived in the GL units and four had been institutionalized. The eight patients who had died had spent 89% of their survival time in GL. Aggression was the most frequent cause of institutionalization.