[Improvements in mental and physical status of elderly patients with dementia after institutionalization--assessment...

Using a Minimum Data Set, we studied how the mental and physical status of elderly people with dementia was modified by institutionalization. We assessed patients with dementia at the time of their admission in Kyoto Higashiyama geriatric hospital, and again three months later. On admission, both mental and physical problems were noted with a Resident Assessment Protocols. The former included cognitive loss/dementia, delirium, behavioral problem, activities, and mood state; the latter included visual function, activities of daily living (functional), urinary incontinence and indwelling catheter, nutritional status, dehydration/fluid maintenance, and dental care. Three months later, marked improvements were observed in 8 areas: delirium, psychological well-being, mood state, activities, urinary incontinence and indwelling catheter, nutritional status, dehydration/fluid maintenance and dental care. Cognitive loss/dementia and visual function were changed little. The unchanged areas were considered to be "core" manifestations of dementia, and those that changed were believed to reflect emotional problems and to be affected by the environment. Therefore, individualized care for elderly institutionalized patients with dementia should focus on these "peripheral" problems rather than on those that cannot be changed.