Crisis resolution for people with dementia living at home

This project aimed to find out what is important for successful home treatment of crisis for a person with dementia.

People with dementia in crisis can receive home treatment that prevents admission to hospital. They prefer home to hospital treatment and care, which is known to have better clinical and other outcomes.

A dementia crisis is when a person with dementia presents to a health or public service in a state where they, or a family member, are at risk of serious harm or death. They will present in a state of physical neglect, at risk of suicide, in squalid home conditions, with a carer unwilling or unable to continue caring, lost (unsafe outside and unable to find their way home), or resisting/refusing services.

This research used case study methodology to explore what happens before, during and after crisis for a person with dementia. It identified important factors for the avoidance of hospital admission. It also considered if earlier or different intervention might prevent crisis.

Data was collected by:

reviewing medical records of all dementia crisis referrals for home treatment and in-patient treatment in one geographical location over a 12 month period
observing the management of patients with dementia in crisis
interviewing patients and their carers after the crisis
interviewing healthcare professionals managing the crisis
conducting focus groups with a home treatment crisis team and an in-patient mental health team.

A group of people with dementia and their carers supported the project. A group leader co-ordinated help to prepare documents, to plan the study process and to disseminate study findings. The group leader was a former dementia carer and member of the project Advisory Group.

The findings of the research were presented at local and national conferences and two papers reporting findings have been published in academic peer reviewed journals.