1) Context and nature of hospitalizations in our study | • Planned treatments/operations | |
• Unplanned treatment | • Aggravation of the general condition • Exsiccosis • Ealls in the nursing homes/at home • Other conditions | |
2) Preventability of hospitalizations | • Most hospitalizations not preventable/unjustifiable from interviewees point of view | |
• GPs strive to prevent hospitalizations wherever possible | ||
• Informal caregivers do not see themselves in a position to decide about the necessity of a hospitalization | ||
3) Factors contributing to hospitalizations | ||
• Dementia-specific factors | • Agitation/restlessness | |
• Tendency to stray/tendency to run away | ||
• Neglect of restricted mobility | ||
• Declining ability to communicate about symptoms (and accidents) | ||
• Shift of responsibility from person with dementia to informal or formal caregivers | ||
• Context-specific factors | • Nursing-home-specific factors | • Safeguard against legal consequences |
• Qualification of nursing home staff/resident-nurse-ratio | ||
• Non-availability of the GP | ||
• Hospitalizations for examinations/treatments also available in ambulatory settings | ||
• Communication (problems/lack of communication) | ||
• Interrelation between dementia- and context-specific factors | ||
4) Ideas for reducing hospitalizations | • Qualification of formal caregivers in nursing homes | |
• Twenty-four-hour-GP-emergency service | ||
• Adequate compensation of regular home visits and supporting visits from ambulatory care services |