Treatment of dementia in a medical day care program.

An analysis was completed of 34 patients with dementia who attended a mixed medical day care program over a five-year period. The parameters reviewed included age, home situation, diagnosis, incidence of co-existent medical disorders, management by the social worker, nurses and neuropsychiatrist, the extent of social and program participation, length of stay, and disposition. There was a high incidence of medical problems which were managed effectively because of close nursing observation, availability of ancillary services, specialty clinics, and frequent communication with the community physicians. The social worker assisted families with the management of long-term planning for the dementia patients and the entire social-nursing-recreational therapy team devised programs which encouraged the patients to function at an optimum level. Neuropsychiatric management, including drug therapy, was an integral part of the program. Despite the fact that the dementia patients were at high risk, with an average age of 81 years the average duration of attendance was two years four months and only nine of the 34 patients ultimately required nursing home placement. It was concluded that the day care program served as a resource which devised, integrated, and supervised, in cooperation with the community physicians, the support network and management strategies for the dementia patients.