TY - JOUR T1 - Older persons living with dementia and their use of acute care services over 2 years in Alberta JF - Canadian Family Physician JO - Can Fam Physician SP - 114 LP - 124 DO - 10.46747/cfp.6902114 VL - 69 IS - 2 AU - Andrea Gruneir AU - Erik Youngson AU - Bonnie Dobbs AU - Adrian Wagg AU - Tyler Williamson AU - Kim Duerksen AU - Stephanie Garies AU - Boglarka Soos AU - Brian Forst AU - Jeff Bakal AU - Donna P. Manca AU - Neil Drummond Y1 - 2023/02/01 UR - http://www.cfp.ca/content/69/2/114.abstract N2 - Objective To characterize transitions to acute and residential care and identify variables associated with specific transitions among community-based persons living with dementia (PLWD).Design Retrospective cohort study using primary care electronic medical record data linked with health administrative data.Setting Alberta.Participants Adults aged 65 years or older living in the community who had been diagnosed with dementia and who saw a Canadian Primary Care Sentinel Surveillance Network contributor between January 1, 2013, and February 28, 2015.Main outcome measures All emergency department visits, hospitalizations, residential care (supportive living and long-term care) admissions, and deaths within a 2-year follow-up period.Results In total, 576 PLWD were identified who had a mean (SD) age of 80.4 (7.7) years; 55% were female. In 2 years, 423 (73.4%) had at least 1 transition and, of these, 111 (26.2%) had 6 or more. Emergency department visits, including multiple visits, were common (71.4% had ≥1, 12.1% had ≥4). Of those hospitalized (43.8%), nearly all were admitted from the emergency department; the average (SD) length of stay was 23.6 (35.8) days, and 32.9% had at least 1 alternate level of care day. In total, 19.3% entered residential care, most admitted from hospital. Those admitted to hospital and those admitted to residential care were older and had greater historical health system use, including home care. One-quarter of the sample did not have any transitions (or die) during follow-up; they were typically younger and had limited historical health system use.Conclusion Older PLWD experienced frequent, and frequently compound, transitions that have implications for them, their family members, and the health system. There was also a large proportion without transitions suggesting that appropriate supports enable PLWD to do well in their own communities. The identification of PLWD who are at risk of or who make frequent transitions may allow for more proactive implementation of community-based supports and smoother transitions to residential care. ER -