NIHR Policy Research Unit in Health and Social Care Workforce, King's College London, London, UK.
Int J Geriatr Psychiatry. 2021 Jan;36(1):136-142. doi: 10.1002/gps.5405. Epub 2020 Sep 10.
The decision about the best time for a person living with dementia to move to a care home involves the individual and others, particularly family. However, little is known about care professionals' views on the best time to move, particularly those with decision-making authority. This study investigated social workers' and care home managers' views on whether there is an "optimal time" for a move.
A qualitative, phenomenological approach was employed, using semi-structured interviews with 20 social workers and 20 care home managers in England; all with experience of advising people living with dementia about a care home move and making decisions about funding or acceptance. Interviews were audio-recorded, transcribed, and analyzed thematically.
Four overarching themes emerged from the data: (1) staying at home for as long as possible but avoiding crisis, (2) balancing risks proactively and anticipating triggers, (3) desires for the person living with dementia to be involved in the decision, and (4) the significance of funding in enabling choices about a care home move.
Deciding on the timing of a care home move is context and person specific. Two professional groups with substantial experience of this among their client group both recommended proactive deliberation but funding was overall the deciding factor in the extent to which they considered choice was possible. Future research should avoid seeing all care home moves as negative and explore how practitioners can best encourage discussions prior to crisis point about care home options.
对于患有痴呆症的人来说，何时搬入养老院是一个涉及个人和他人（尤其是家人）的决定。然而，对于护理专业人员而言，他们对于何时搬入养老院的看法知之甚少，特别是那些有决策权的人。本研究调查了社会工作者和养老院经理对于搬入养老院的“最佳时间”是否存在的看法。
采用定性、现象学方法，对英格兰的 20 名社会工作者和 20 名养老院经理进行了半结构化访谈；他们均具有为患有痴呆症的人提供养老院入住建议以及就资金或入住资格做出决策的相关经验。访谈进行了录音、转写，并进行了主题分析。
数据中出现了四个总体主题：（1）尽可能长时间地留在家里，但避免出现危机；（2）积极主动地平衡风险并预测触发因素；（3）希望患有痴呆症的人参与决策；（4）资金对于能够选择养老院入住的重要性。
决定养老院入住的时间是具体情况和因人而异的。两个在其服务对象群体中具有丰富相关经验的专业群体均建议进行积极的考虑，但资金是他们认为选择是否可行的总体决定因素。未来的研究应避免将所有养老院入住视为负面情况，并探讨从业者如何在危机点之前最好地鼓励有关养老院选择的讨论。
