Collet J, de Vugt ME, Verhey FRJ, Engelen NJJA, Schols JMGA
Background: Older patients suffering from a combination of psychiatric disorders and physical
illnesses and/or dementia are called Double Care Demanding patients (DCDs). Special wards for DCDs
within Dutch nursing homes (NHs) and mental health care institutions (MHCIs) offer a unique
opportunity to obtain insight into the characteristics and needs of this challenging population.
Methods: This observational cross-sectional study collected data from 163 DCDs admitted to either a
NH or a MHCI providing specialized care for DCDs. Similarities and differences between both DCD
groups are described.
Results: Neuropsychiatric symptoms were highly prevalent in all DCDs but significantly more in MHCIDCDs.
Cognitive disorders were far more present in NH-DCDs, while MHCI-DCDs often suffered from
multiple psychiatric disorders. The severity of comorbidities and care dependency were equally high
among all DCDs. NH-DCDs expressed more satisfaction in overall quality of life.
Conclusions: The institutionalized elderly DCD population is very heterogeneous. Specific care
arrangements are necessary because the severity of a patient’s physical illness and the level of
functional impairment seem to be equally important as the patient’s behavioural, psychiatric and
social problems. Further research should assess the adequacy of the setting assignment and the
professional skills needed to provide adequate care for elderly DCDs.