The impact of institution use on the wellbeing of Alzheimer’s disease patients and their caregivers
Abstract
In France, temporary institutionalization solutions for dependent elders have been encouraged since the early 2000s. They are targeting patients who are maintained at home, but may need temporary solutions to adjust the constraints of caregivers, e.g. to facilitate transitions between several informal care providers or to allow informal caregivers to leave for holidays. However, the influence of these solutions on dependent elders and their caregivers has not been explored yet. We use French longitudinal data (REAL.FR, 686 elders and their primary caregivers followed between 2000 and 2006) to explore the impact of institution placement on the wellbeing of both Alzheimer's disease patients and their primary informal caregivers. The data distinguishes permanent placements in institution from temporary stays. Using fixed-effect models, we quantify the change in patients' quality of life and caregivers' burden of care following the placement of patients. We find that permanent and temporary stays are associated with a decrease in informal caregivers' burden. However, only permanent stays lead to an improvement of patients' quality of life. Hence, taken together, the results suggest that while long-run placements may maximize the wellbeing of all the members of a household (patient and caregiver), this is not necessarily the case of short-term placements.
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Caregivers often described the facility selection process as overwhelming, shaped by financial constraints, limited availability, and urgency to accept the first available option.
“Caregivers often described the process as overwhelming, shaped by financial constraints, limited availability, and urgency to accept the first available option (Brooks et al., 2022b; Rapp et al., 2018; Rognstad et al., 2020).”
From Mind the gap: a systematic review of barriers, facilitators, and experiences of care transitions for people living with dementia and their informal caregivers. (2026) · cites this paper as Rapp et al., 2018
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Home vs. Nursing Care: Unpacking the Impact on Health and Well-BeingPreprint
Bassoli, E., Lefèbvre, M., & Schoenmaeckers, J. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5124297
- Authors
- Rapp, T., Apouey, B. H., & Senik, C.
- Affiliations
- Sorbonne Paris Cité (FR)
- Centre National de la Recherche Scientifique (FR)
- Corresponding author
- Rapp, Thomas
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 207
- Pages
- 1-10
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2797615737
- Cited by
- 81
- References
- 46
- Citations by year
- 2025: 4 · 2023: 3 · 2022: 2 · 2021: 5 · 2020: 1 · 2019: 65 · 2018: 1
- FWCI
- 27.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- PSE-Ecole d'économie de Paris (Postprint) (submittedVersion)
- HAL (submittedVersion)
- Funders
- French Ministry of Health (PHRC 98-47 N, PHRC 18-05)
- Toulouse University Hospital
- AMPA
- INSERM-University of Toulouse III
- Topics
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Aging, Elder Care, and Social Issues
- Keywords
- Alzheimer's disease, institutionalization, informal caregivers, caregiver burden, quality of life, dependent elderly, caregiver well-being
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Female, France, Health Facilities, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Caregivers
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