Myshakivska O. Palliative care outpatients with dementia

Our thesis is based on the six-month research of clinical symptoms common with dementia. We have found that there is positive correlation between the clinical symptoms, distress of caregiver and burden of the care provided. Additionally we have evaluated the efficiency of drug correction of clinical symptoms for patients with dementia, depending on outpatient or inpatient treatment type. By the use of socio-demographic method, we have found the prevalence of vascular dementia symptoms in the inpatient group, while for the outpatient group we have found prevalence by insignificantly larger amount of both vascular dementia and Alzheimer's disease. The majority of inpatient group patients suffered from severe dementia and in the outpatient group the majority suffered from a moderate level of dementia. Based on the final results we have found that in outpatients group there was a significant clinical reduction of delutions, depression/dysphoria, sleep and nighttime behavior disorders and distress of caregivers. For the inpatients group we found the decrease of delutions, depression/dysphoria, but a significant increase in severity of clinical symptoms and distress of caregivers. Common features examined in both groups were the progression of cognitive impairment with the every next examination and strengthening of apathy/indifference. During the first time examination of inpatients group we found a significant prevalence of apathy/indifference and during the study period - strengthening of disinhibition, aberrant motor behavior, appetite and eating changes.In outpatients with dementia who received medical treatment we observed the reduction of dominated symptoms, that influenсed on the caregivers distress. For inpatients we have found that during the study period there was a strengthening of apathy/indifference, disinhibition, aberrant motor behavior, appetite and eating changes that made daily care more monotonous and more burdensome.Based on CBS evaluation we have assessed the burden of the caregivers for outpatients with dementia and we did not find any significant difference of the total score comparing the first time examination and the last examination in six months time. We have found a significant impact of the prescribtion of typical antipsychotics and the level severity of dementia on the CBS total score. Based on the results from above, we have evaluated the effectiveness of developed algorithm of providing outpatient care for patients with dementia.