"As Good as it Gets at Home" - Reasons for Institutionalisation in Dementia

Aim: What are the reasons for institutionalising community-dwelling persons with dementia? Method: A written survey of family caregivers and general practitioners was undertaken. Results: Within 2 years 47 of 351 people with dementia (13 %) were institutionalised. The person with dementia was involved in the decision in only 1/3 of the cases. The 3 most common reasons were: ensuring the best possible care, high expenditure of care-giving time at home, deterioration of the health of the care-receiver. Conclusions: From the ethical point of view the exclusion of the persons with dementia from the decision-making with regard to institutionalisation has to be examined critically. The often given reason of ensuring the best possible care through institutionalisation could be counteracted by the improvement of community-based care.