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US dementia strategy overlooks transitions into and out of nursing homes, analysts find

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The U.S. national strategy for tackling dementia fails to address late-stage transitions into long-term care facilities from a person's home or the hospital, according to a recently published analysis in Health Affairs.

The investigators examined the national dementia strategies of seven countries as of late 2013. All seven countries have stronger plans for early-stage transitions (such as connecting the newly diagnosed with services) than late-stage transitions (such as moving from home to residential care), the team found. Out of six transition types in the researchers' framework, the United States' strategy does not directly address any of the three later-stage transitions, they determined.

A “next-generation” national strategy should address these late-stage transitions, in part by tapping the expertise of nursing home workers and palliative care specialists, as well as by thoroughly considering the results of research and evaluation projects, the authors recommended. They noted that the current plans all tend to focus more on the provision of care within a setting than on transitions between settings, and urged more consideration of transitions in the future.

U.S. policymakers and healthcare providers could refer to other countries' strategies for guidance — for instance, Scotland has the most comprehensive current strategy, according to the researchers.

The authors were Richard H. Fortinsky, Ph.D., of the UConn Center on Aging at the University of Connecticut School of Medicine, and Murna Downs, Ph.D., of the Bradford Dementia Group at the School of Health Studies, University of Bradford, in England.

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