Survey on Discharge Support for Patients from Dementia Treatment Wards to Home and Associated Issues: A Questionnaire-Based Study in Japan

Background In recent years, the number of people with dementia and those requiring hospitalisation has continued to rise. However, several challenges remain in the provision of discharge support for this population, including inadequate collaboration between individuals and their families and inadequate support skills among care staff. This study, therefore, aimed to clarify the current state of home discharge support for individuals with dementia in specialised dementia treatment wards in Japan. Methods We conducted a 12-item questionnaire survey using a mixed research method targeting all 525 institutions in Japan with dementia treatment wards. Results Responses were received from 190 dementia treatment wards. More than 70% of people with dementia discharged home were hospitalised for more than two months. There were several barriers to discharge support, including 'giving up life at home', 'inadequate support skills', 'regional characteristics', 'immature organisational culture', and 'constraints of family background'. In addition, groups with adequate discharge support were found to have collaborated with a wider range of professionals inside and outside the hospital compared with groups with inadequate discharge support. Discharge support teams also collaborated with people with dementia, their families, and multidisciplinary teams from the beginning of hospitalisation; experimented with different approaches to facilitate the return to home life; and implemented seamless and flexible interventions, including post-discharge follow-up, to facilitate a smooth transition back to home life. Conclusion This study sheds light on the practical realities of home discharge support for individuals with dementia in Japan. Although numerous challenges persist, many institutions are implementing creative and collaborative strategies to enable home discharge. The identified effective practices may serve as models, and resolving the highlighted issues is critical for further improvement.