Reasons for psychiatric consultation referrals in Dutch nursing home patients with dementia: a comparison with normative data on prevalence of neuropsychiatric symptoms

Abstract

This study is the first to examine psychiatric consultation for dementia patients in Dutch nursing home. Large differences exist between referral reasons and normative data on symptom prevalence. Specialized mental health service was provided for the agitated and disinhibited patient in particular. Chances are that this is at the expense of the apathetic, retarded and quietly 'not causing any trouble' patient.

Treatment patterns and burden of behavioral disturbances in patients with dementia in the United States: a claims database analysis

“…Although patients with dementia frequently experience NPS such as agitation, and NPS places a significant clinical and economic burden on patients, caregivers, and the healthcare system, few studies have evaluated the clinical and economic characteristics of agitation or agitation-related symptoms in dementia [5–7, 18, 22–25]. The objective of this retrospective claims study was to characterize the clinical and economic burden of BD in dementia by examining the clinical characteristics, treatment patterns, and healthcare utilization and costs associated with agitation in patients with dementia (including AD) using a large representative sample identified from the Truven MarketScan® Medicare 2012–2015 database.…”

Multidisciplinary, Nurse-Led Psychiatric Consultation in Nursing Homes: A Pilot Study in Clinical Practice

“…Professionals in nursing homes in The Netherlands have repeatedly stated that they need more structural support from psychiatric services (Kat et al., ; Meesters, ). This study shows, apart from a reduction in symptoms on resident level, that experienced work stress in nursing staff decreases significantly and substantially without residents being transferred to psychiatric services.…”

“…Depressive symptoms in cognitively impaired residents, as well as psychotic symptoms in all residents, are less well detected, thus seldom resulting in a consultation request (Brodaty et al., ,; Callegari et al., ; Fenton et al., ; Leo et al., ). Recent Dutch research confirms this international picture: aggression is an important reason for consultation, but apathy hardly is—and as such is often missed as a symptom of a possible psychiatric disorder (Kat et al., ).…”

When Help Becomes a Hindrance: Mental Health Referral Systems as Barriers to Care for Primary Care Physicians Treating Patients With Alzheimer's Disease

“…The authors hypothesized that PCPs perceived themselves as better able to orchestrate ongoing care because dementia is so often accompanied by other chronic diseases associated with aging for which they provide primary care. Selective reporting by community and family care providers also influences PCPs’ ability to provide adequate care for their elderly dementia patients with neurobehavioral symptoms (17, 19, 34–36). …”