The increasing number of people living at home with (advanced) dementia poses a significant challenge to providing care. Informal caregivers often experience substantial strain, which can ultimately result in a crisis admission of a person with dementia to a nursing home. Moreover, the behavioral symptoms of people with dementia, such as aggression, may worsen, making it suddenly impossible for them to continue living at home. A crisis admission of a person with dementia has a profound impact on the client, their loved ones, and the care professionals involved. Immediate choices have to be made, which are not always in line with the wishes, goals, and preferences of the person with dementia and their family caregiver. While preventing all crisis admissions may not be feasible, good organization of care for people with dementia can reduce the need for emergency care. Therefore, it is important to better understand and research the causes and impact of crisis admissions on care.
In the Netherlands, approximately 300.000 people have dementia. The majority of them continues to live at home as long as possible, even as their health declines . Dementia is a long-term, progressive, and irreversible deterioration of mental health, with physical, familial, and social consequences. Keeping people with advanced dementia at home longer may lead to situations where crisis admission to a nursing home becomes necessary. The Dutch Association of Elderly Care Physicians, Verenso, defines a crisis admission as a situation in which a general practitioner assesses that admission to a nursing home is necessary for a patient living at home, either immediately or within 24 hours. However, in such a stressful situation, it is challenging to address the wishes, goals, and preferences of both the person with dementia and their family caregiver due to the limited time available. A recent literature review from 2021 shows that little research has been done on crises in people with dementia living at home, indicating a clear knowledge gap.
Therefore, the purpose of this study is to better understand the causes and impact of crisis admissions on care. Through a survey among healthcare workers, we aim to examine how crisis admissions in nursing homes are handled and what their consequences are. Additionally, we will conduct interviews with people with dementia and caregivers involved during a crisis admission to gain deeper insights of their experiences and perceptions. This will help us better understand how these situations unfold and what preventive measures might be beneficial.