A descriptive survey of acute bed usage for dementia care in old age psychiatry.

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To examine the reasons why patients are admitted to acute dementia care assessment beds in one large district health authority (Leicestershire). A prospective questionnaire was completed by the RMO for every admission to dementia care assessment beds over a 6-month survey period. The most common reasons for admission were behavioural problems (most frequently aggression). Other common reasons included self-neglect, psychotic symptoms and comorbidity with functional psychiatric illness. Classification of patients by their social circumstances before admission indicated different patterns of presenting features, length of stay and place of discharge. The need for acute beds is demonstrated by the large number of emergencies, with a significant proportion admitted under the Mental Health Act, the type and complexity of reasons for admission and the preceding involvement of community mental health services. Multi-axial classifications including presenting problems and social circumstances, rather than the traditional method of looking purely at diagnosis, may offer some advantage in assessing outcomes.