A proactive geriatric liaison service to assess and manage medical problems on old age psychiatry wards

2016 ◽  
Vol 33 (S1) ◽  
pp. S188-S189
Author(s):  
U. Narayana ◽  
O.J. Corrado ◽  
S. Kaur
Keyword(s):  
Older People ◽  
Old Age ◽  
Quality Of Healthcare ◽  
Biliary Cirrhosis ◽  
Medical Problems ◽  
Old Age Psychiatry ◽  
Competing Interest ◽  
Outpatient Appointments ◽  
To Receive

IntroductionOlder people with mental ill health are more likely to receive lower quality of healthcare, inappropriate prescriptions and reduced access to services, leading to increased rates of mortality1,2,3. The NHS mandate 2015 to 2016 emphasises the need to deliver care, which is joined up and seamless for users of services4.Aims and objectivesTo identify the common medical comorbidities on the Old Age Psychiatry Wards and to assess the management outcomes.MethodsWe audited all patients referred to the Liaison Geriatrician from 2008 to October 2015 from the Mount Hospital Leeds, which consists of 4 Old Age Psychiatry Wards. Data was collected in October 2015 and included referral date, patients’ age and sex, number of referrals, reason for referral and the outcome.ResultsWe assessed 339 (142 F, 197 M) patients with a mean age of 77 (range: 56–94). Cardiovascular problems were the biggest group of referrals (in particular oedema, hypotension and rhythm disturbances) (34%) followed by central nervous system problems (11%), respiratory (8%), gastrointestinal (8%) and infection (8%). Some unusual problems were diagnosed including a spontaneous pneumothorax, primary biliary cirrhosis. The most common intervention was advice on treatment or investigation, very few patients needed acute admission and some unnecessary admissions were aborted as a result of the physician's intervention.ConclusionsThis audit emphasises the need for a joint coordinated approach between psychiatry and medicine in managing health problems in older people. A dedicated Geriatric Liaison service can improve care, avoid unnecessary acute admissions and is more convenient for patients who would otherwise attend repeated outpatient appointments.References are not available for this abstract.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Developing simulated training in old age psychiatry to recognise and assess medical problems in a psychiatric setting (RAMPPS)

2016 ◽  
Vol 33 (S1) ◽  
pp. S168-S169
Author(s):  
U. Narayana ◽  
O.J. Corrado ◽  
P. Rowlands ◽  
S. Kaur
Keyword(s):  
Old Age ◽  
Simulation Training ◽  
The Elderly ◽  
Biliary Cirrhosis ◽  
Physical And Mental Health ◽  
Medical Problems ◽  
Psychiatric Setting ◽  
Old Age Psychiatry ◽  
Competing Interest

IntroductionOlder people with mental ill health are more likely to receive lower quality of health care, inappropriate prescriptions and reduced access to services, leading to increased rates of mortality [1–3]. There is increase focus on supporting people with multiple long-term physical and mental health conditions, particularly by embracing opportunities created by technology [4] (references are not available for this abstract).ObjectivesTo identify the common medical comorbidities on the Old Age Psychiatry Wards.AimsTo develop simulation training from the medical scenarios.MethodWe audited all patients referred to the Liaison Geriatrician from 2008 to October 2015 from the Mount Hospital Leeds, which consists of 4 Old Age Psychiatry wards. Data was collected in October 2015 and included referral date, patients’ age and sex, number of referrals, reason for referral and the outcome.ResultsWe assessed 339 (142 F, 197 M) patients with a mean age of 77 (range: 56-94). The cardiovascular problems constituted the majority (34%) of the referrals, central nervous system (11%), respiratory (8%), gastrointestinal (8%), infection (8%), musculoskeletal (7%), renal (3%), others (19%) and the reasons were unknown in (2%) of the 440 referrals. Some unusual problems were diagnosed including a spontaneous pneumothorax, primary biliary cirrhosis.ConclusionThe audit highlights the essence for more training in recognising and assessing medical problems in psychiatric settings - the simulation programme (RAMPPS) in Old Age Psychiatry. As a result of the service model, we are developing a simulation-training course tailored to the mental and physical health needs of the elderly.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Principles of service provision in old age psychiatry

2013 ◽  
Author(s):  
Tom Dening
Keyword(s):  
Older People ◽  
Social Services ◽  
Old Age ◽  
Memory Assessment ◽  
Policy Context ◽  
Effective Care ◽  
Challenges And Opportunities ◽  
Old Age Psychiatry ◽  
Fair Access

This chapter outlines the history, underlying principles and policy context for contemporary mental health services for older people. The usual components of such services, including community health teams, memory assessment services, day facilities, consultation-liaison services in general hospitals, and in-patient psychiatric care for older people are all discussed. Alongside these more familiar elements however, there have been other recent, sometimes destabilising, changes, including moves towards age-inclusive services and changes in working patterns for psychiatrists and other professionals. Working closely with primary care, greater integration with social services and providing support to care homes are all part of the current agenda. It is important to measure the quality of services and to ensure the populations who may be disadvantaged receive fair access to effective care and treatment. Obviously, the future increase in the numbers of very old people brings both challenges and opportunities for old age psychiatry services.

Dementia in the community: Challenges for primary care development

2002 ◽  
Vol 12 (3) ◽  
pp. 243-252 ◽  
Author(s):  
Steve Iliffe ◽  
Jill Manthorpe
Keyword(s):  
Primary Care ◽  
Older People ◽  
Old Age ◽  
National Service ◽  
Specialist Services ◽  
Quality Of Primary Care ◽  
Old Age Psychiatry ◽  
Primary Care Practitioners ◽  
Care Development

The National Service Frameworks for Older People and for Mental Health are setting standards for services in areas where problems are complex and solutions limited. Primary Care Trusts seeking to raise the quality of primary care for older people and commission specialist services rationally face many challenges. Specialists in old age medicine and old age psychiatry will find themselves working closely with primary care practitioners to develop services and extend professional skills, for it is uncertain that specialist services will be able to deal with the scale of the clinical and social problems unaided.

scholarly journals Mania in late life

2011 ◽  
Vol 17 (5) ◽  
pp. 357-364
Author(s):  
Felicity Richards ◽  
Martin Curtice
Keyword(s):  
Older People ◽  
Old Age ◽  
Specific Treatment ◽  
Late Life ◽  
Aging Population ◽  
Age Group ◽  
Treatment Algorithms ◽  
Assessment And Treatment ◽  
Old Age Psychiatry ◽  
Older Populations

SummaryMania in late life is a serious disorder that demands specialist assessment and management. However, it is greatly under-researched, with only a paucity of studies specifically analysing older populations. The mainstay of the old age psychiatry workload will inevitably be concerned with assessing and managing dementia and depression, but the steady rise in the aging population with longer survival means that there will be an increase in absolute numbers of older people presenting with mania. There are no specific treatment algorithms available for mania in late life. This article reviews mania and hypomania in late life and concentrates on diagnosis, assessment and treatment, as well as on the management considerations associated with this important age group.

Principles of service provision in old age psychiatry

2020 ◽  
pp. 281-306
Author(s):  
Tom Dening ◽  
Kuruvilla George
Keyword(s):  
Mental Health ◽  
Older People ◽  
Old Age ◽  
Religion And Spirituality ◽  
Liaison Psychiatry ◽  
Memory Assessment ◽  
Challenges And Opportunities ◽  
Recent Developments ◽  
Old Age Psychiatry ◽  
Consultation Liaison Psychiatry

Globally increasing numbers of older people bring both challenges and opportunities for old age psychiatry services. This chapter outlines the history, underlying principles, and policy context for contemporary mental health services for older people. It discusses components of services, including community health teams, memory assessment services, consultation-liaison psychiatry, and in-patient mental health care, as well as newer types of service, such as crisis teams and outreach to care homes. Other recent developments include various models of case management and emphasis on post-diagnostic support. Equally important are issues of equality and access, and the chapter covers several key areas, such as age, gender, sexual orientation, religion and spirituality, and rurality. Major challenges to old age psychiatry come from limited resources and non-recognition of the distinct needs of older adults, as well as the demands of the growing older population, advances in science and technology, and the need to attract talented psychiatrists into this field.

An Age-Based Mobilisation: The Emergence of Old Age in American Politics

1995 ◽  
Vol 15 (3) ◽  
pp. 299-324 ◽  
Author(s):  
Cheryl Elman
Keyword(s):  
Older People ◽  
Old Age ◽  
American Politics ◽  
Elderly Population ◽  
Social Dimension ◽  
Political Environment ◽  
The Social ◽  
Movement Models ◽  
Shape Characteristics ◽  
To Receive

AbstractOlder people became a highly visible force in the American politics of the 1930s. The Townsend organisation mobilised one tenth of the U.S. elderly population prior to their direct representation in the polity as an interest group. This article utilises several theoretical social movement models to analyse how and why mobilisation occurred. It demonstrates that many factors, including phenomena associated with the social dimension of age, influenced the mechanisms of mobilisation and the movement's shape. Characteristics of this cohort of older people, including its size, life expectancy, spatial distribution, shared traditions, and symbolic frameworks were conducive to club formation and mobilisation. The period event of the Depression also triggered collective action, by exacerbating trends of changing old-age institutional supports. But the organisation expanded most where it channelled inducements to participants and evoked the cohorts' symbolic frameworks and ideals. Mobilisation also occurred within a political environment, the national stage of U.S. politics, where non-represented interest groups (such as elderly people) find it difficult to receive benefits.

Clinicians' attitudes to spirituality in old age psychiatry

2006 ◽  
Vol 19 (5) ◽  
pp. 962-973 ◽  
Author(s):  
Robert M. Lawrence ◽  
Julia Head ◽  
Georgina Christodoulou ◽  
Biljana Andonovska ◽  
Samina Karamat ◽  
...  
Keyword(s):  
Mental Health ◽  
Older People ◽  
Old Age ◽  
Spiritual Care ◽  
Health Needs ◽  
Mental Health Needs ◽  
Care Services ◽  
The United Kingdom ◽  
Old Age Psychiatry ◽  
Chaplaincy Service

Background: The aim of this survey is to investigate professional attitudes to the presence and value of spiritual care from Old Age Psychiatrists.Method: All registered members of the Faculty of the Psychiatry of Old Age in the United Kingdom were asked to complete a 21-question semi-structured questionnaire. The first mail shot took place in 2002 and the second mail shot to non-respondents in 2003. Quantitative and qualitative analyses were carried out on the answers received.Results: The response rate was 46%. The majority of respondents (92%) recognize the importance of spiritual dimensions of care for older people with mental health needs and about a quarter of respondents appear to consider referring patients to the chaplaincy service. In contrast, integration of spiritual advisors within the assessment and management of individual cases is rare.Conclusions: Opinions vary as to whether provision of spiritual care should become widely available to older people with mental health needs who are admitted to hospital. Old age psychiatrists recognize that awareness of spiritual dimensions may be important for their patients. They seem less clear about the role of spiritual advisors and how NHS multidisciplinary clinical teams and spiritual and pastoral care services can be best integrated. Much work needs to be done on developing effective training and operational policies in this area.

scholarly journals Should old age psychiatry develop memory clinics? A comparison with domiciliary work

2004 ◽  
Vol 28 (3) ◽  
pp. 78-82 ◽  
Author(s):  
S. Simpson ◽  
D. Beavis ◽  
J. Dyer ◽  
S. Ball
Keyword(s):  
Old Age ◽  
Clinical Implications ◽  
Memory Clinic ◽  
Retrospective Case ◽  
Memory Clinics ◽  
Old Age Psychiatry ◽  
Psychiatric Complications ◽  
To Receive ◽  
Case Note Review

Aims and MethodMemory clinics have become very popular in old age psychiatry and there is some pressure for them to be developed in old age services. However, there is little evidence to suggest that they are more advantageous over the traditional domiciliary visits or who should be seen in clinic. This was a naturalistic comparison of 76 consecutive new referrals to a memory clinic, with 74 consecutive new domiciliary requests within the same service over the same period of time. A retrospective case note review collected the clinical features and an 18-month prospective follow-up examined the subsequent clinical management.Clinical ImplicationsThe two groups were characterised more by their similarities than their differences. However, the domiciliary group had greater behavioural and psychological complications. The memory clinic patients were less likely to receive psychotropic medication and here more likely to be followed up.ResultsWe conclude that memory clinics might be less suitable for patients with prominent psychiatric complications. Memory clinics could complement the domiciliary model by providing early psychosocial/neuropsychiatric approaches, although this is likely to lead to an increased clinical case-load.

Perception on service quality in old age homes: a qualitative study in Karachi, Pakistan

2020 ◽  
pp. 1-13
Author(s):  
Samina Vertejee ◽  
Saleema Allana ◽  
Rozina Somani ◽  
Saher Aijaz
Keyword(s):  
Qualitative Study ◽  
Older People ◽  
Old Age ◽  
Community Support ◽  
The Elderly ◽  
Structured Interview ◽  
Entire Study ◽  
Purposive Sampling ◽  
Old Age Homes

Abstract Objectives: The growing number of older people due to demographic transition is paving the way for non-governmental organizations and the private sector for mushrooming of old age homes (OAHs). These homes function either free or fee for services, and the services provided at these OAHs determines the quality of life of older people. The aim of the study was to explore the stakeholders’ perception on the quality of services offered to people living in OAHs. Methods: A descriptive qualitative study design was used to explore stakeholders’ perception of elderly living experiences in old age homes. Three OAH were selected through purposive sampling for the study. Data collected from February –March 2015 through the structured interview guide. Participants’ for FGDs were recruited through universal sampling, while purposive sampling was used for KIIs selection. Researcher ensured all ethical considerations for entire study period. Results: Two major themes were drawn including the reasons and experiences of older people living in OAH, secondly the need for caregivers’ academic competencies. Majority of KIIs and FGDs reported common responses under the two themes. Also the elderly experiences varied from living comfortable to being depressed. KIIs and caregivers’ FGD participants’ strongly urged the need for caregivers’ training and institutional accreditation. Conclusion: In conclusion, the older people experiences challenges of living in OAHs, therefore the study findings strongly proposes community support system and credentialing of the caregivers for age appropriate care. Continuous...  

scholarly journals EDUCATOR COMPETENCIES OF PRE-SENIOR PREPARATION

2021 ◽  
Vol 10 (1) ◽  
pp. 47-54
Author(s):  
Michal Koricina
Keyword(s):  
Older People ◽  
Old Age ◽  
Older Adult ◽  
Adult Educators ◽  
Active Ageing ◽  
Adult Educator ◽  
Relational Competence ◽  
The Future ◽  
Paper Author

Pre-Senior Education will be one of the main pillars of active ageing policy in the future. Requirements on adult educators, lecturers, trainers of older people, grow. In the paper author presents theoretical starting points of competencies of educator of pre-senior preparation, deals with general competencies defined in Slovak national documents and indicates specific requirements on older adult educator. He also talk about aspects as relational competence and charizma of lecturer which are important elements of quality of educational event. The article is the output of author within the project VEGA no.1/0001/18 called Preparation for ageing and old age – possibilities of andragogical intervention.

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