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.

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.

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 Higher training in liaison psychiatry for older adults: experiences of two specialist training posts

2007 ◽  
Vol 31 (9) ◽  
pp. 354-356
Author(s):  
Maura Young ◽  
Siobhan Morris
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older People ◽  
General Hospital ◽  
Old Age ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Health Problems ◽  
Liaison Psychiatry ◽  
The Past

Over the past decade, old age liaison psychiatry services have been developing across the UK. The driving force behind this has been the recognition of the inequity in service provision for people over the age of 65 with mental health problems in a general hospital setting. A postal survey of consultants in old age psychiatry in April 2002 showed that most respondents (71%) considered that the service they provided to older people in general hospitals was poor and needed to be improved (Holmes et al, 2002). Much work has been done to highlight this issue, and liaison psychiatry for older adults is gaining prominence. The national conference on liaison psychiatry for older people, which has been held in Leeds for the past 4 years, attracts large numbers of enthusiastic participants. The Department of Health (2006) document A New Ambition for Old Age specifically mentions the current poor standard of care that older people with mental health problems receive in a general hospital setting. The Royal College of Psychiatrists (2005) has produced guidelines for the development of liaison mental health services for older people.

scholarly journals Home assessments in old age psychiatry

2002 ◽  
Vol 8 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Barbora Richardson ◽  
Martin Orrell
Keyword(s):  
Mental Health ◽  
Older People ◽  
Old Age ◽  
Good Practice ◽  
Fire Hazards ◽  
Adequate Food ◽  
Audit Commission ◽  
Accurate Picture ◽  
Old Age Psychiatry ◽  
At Home

“For people to be successfully supported at home, a comprehensive assessment is an essential first step.” (Audit Commission, 2000: p. 43.)Home visits by old age psychiatrists remain popular with elderly patients, their carers and general practitioners (GPs). Home assessments by various disciplines working with older people have been endorsed as a sign of good practice by the Audit Commission (2000) in their recent national report on mental health services for older people: “Assessment at home is often better as people are most likely to behave and communicate in their normal way in familiar surroundings. Staff can also build a more accurate picture of people's needs and learn the views of their carers. Professionals can observe whether there is adequate food in the house, whether people can make themselves a hot drink, and whether there are any likely risks from poor hygiene or fire hazards.” (Audit Commission, 2000: p. 43.)

Eluned Woodford-Williams

2018 ◽  
pp. 202-204
Author(s):  
Itunuayo V. Ayeni
Keyword(s):  
Mental Health ◽  
Elderly Patients ◽  
Older People ◽  
Social Workers ◽  
Old Age ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Geriatric Medicine ◽  
Holistic Approach ◽  
Old Age Psychiatry

This chapter presents a profile of Eluned Woodford-Williams. Dr Woodford-Williams pioneered a holistic approach to caring for older people, and worked at the interface of geriatric medicine and old age psychiatry. She implemented age-based admittance of all patients over 65 years, irrespective of needs, for comprehensive geriatric assessment, and taught that the reintegration of mental health social workers into healthcare was crucial for elderly patients.

A Woman who Made a Difference: An Interview with Nori Graham

2018 ◽  
pp. 189-201
Author(s):  
Amanda Thompsell
Keyword(s):  
Mental Health ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
Old Age ◽  
Women Doctors ◽  
Old Age Psychiatry ◽  
Person Account

This chapter describes an interview with Dr Nori Graham, a key figure in older people’s mental health, former Chairman of the Alzheimer’s Society and of Alzheimer’s Disease International, and an inspiration to generations of doctors. This reflective interview provides a first-person account of the development of mental health services for older people over the last 40 years, paying tribute to some of the pioneers and architects of the astonishing growth of old age psychiatry services during this period, and comparing the challenges then and now. Nori Graham also provides insights and advice on how to develop a successful career, and on dealing with the challenges for women doctors with children. Finally, she describes her work in helping to build up the Alzheimer’s Society and Alzheimer’s Disease International, both of which expanded considerably during her period as Chairman.

Education on Old Age Psychiatry at Europe: Facts and Proposals

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
H. Firmino ◽  
L. Fernandes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Older People ◽  
Mental Health Care ◽  
Old Age ◽  
Mental Health Professionals ◽  
Mental Health Problems ◽  
The Elderly ◽  
Educational Training ◽  
Old Age Psychiatry

Old Age Psychiatry is a branch of psychiatry and forms part of the multidisciplinary delivery of mental health care to older people.The specialty of psychiatry of the elderly requires a grounding in general psychiatry and in general medicine as well as training in the specific aspects of both psychiatric and medical conditions as they occur in older people. Psychiatry of the elderly should be taught in the variety of settings in which it is practised.Training in mental health care of older people should be offered at both undergraduate and postgraduate level and also during continuing professional development.It is important to recognise that in some countries, resources, especially in terms of mental health professionals, are very limited. In these countries it will be necessary to establish sensible priorities for mental health problems of the elderly.In this presentation we goes to consider some ideas to develop educational training at European Countries.

scholarly journals First light: old age psychiatry in Wolverhampton 1995–1996

1997 ◽  
Vol 21 (8) ◽  
pp. 503-505 ◽  
Author(s):  
David Jolley ◽  
Rosie Jenkins ◽  
Simon Dixey
Keyword(s):  
Mental Health ◽  
Older People ◽  
Old Age ◽  
Community Services ◽  
Mental Illnesses ◽  
First Year ◽  
Old Age Psychiatry

In a survey of services conducted by the Section of Old Age Psychiatry in 1993, Wolverhampton was identified as one of 24 Districts with no consultant Old Age Psychiatrist in post (Benbow & Jolley, 1996). This encouraged the newly formed NHS Trust responsible for mental health and other community services to arrange for the secondment of D. J. from South Manchester, for a period of two years, with a view to setting up and running an appropriate service for older people with mental illnesses (Jolley, 1996). We are reporting here some of the changes which have occurred during the first year of this secondment.

The ‘loneliness pandemic’: implications for gerontological nursing

2021 ◽  
Vol 30 (11) ◽  
pp. 652-655
Author(s):  
Carlos Laranjeira
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older People ◽  
Chronic Diseases ◽  
Old Age ◽  
Social Isolation ◽  
Social Relationships ◽  
Vulnerable Groups ◽  
Negative Consequences ◽  
Gerontological Nursing

The COVID-19 pandemic compelled states to limit free movement, in order to protect at-risk and more vulnerable groups, particularly older adults. Due to old age or debilitating chronic diseases, this group is also more vulnerable to loneliness (perceived discrepancy between actual and desired social relationships) and social isolation (feeling that one does not belong to society). This forced isolation has negative consequences for the health of older people, particularly their mental health. This is an especially challenging time for gerontological nursing, but it is also an opportunity for professionals to combat age stereotypes reinforced with COVID-19, to urge the measurement of loneliness and social isolation, and to rethink how to further adjust interventions in times of crisis, such as considering technology-mediated interventions in these uncertain times.

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.

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