RT Journal Article SR Electronic T1 The Bromhead Care Home Service: the impact of a service for care home residents with dementia on hospital admission and dying in preferred place of care JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 114 OP 118 DO 10.7861/clinmedicine.16-2-114 VO 16 IS 2 A1 Gill Garden A1 Suzanne Green A1 Susan Pieniak A1 John Gladman YR 2016 UL http://www.rcpjournals.org/content/16/2/114.abstract AB People with dementia have worse outcomes associated with hospital admission, are more likely to have interventions and are less likely to be offered palliative care than people without dementia. Advance care planning for care home residents has been shown to reduce hospital admissions without increasing mortality. Studies have shown that staff confidence in managing delirium, a common reason for admission, improves with training. A service combining education for care home staff and advance care planning for care home residents with dementia was introduced to care homes in Boston, UK. There were improvements in staff confidence in recognition, prevention, management and knowledge of factors associated with delirium and dysphagia. 92% of carers rated the service >9/10. Admissions fell by 37% from baseline in the first year and 55% in the second and third years. All but one resident died in the preferred place of care.