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.

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.

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.

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.

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.

The roles of friends and neighbours in providing support for older people

2000 ◽  
Vol 20 (3) ◽  
pp. 341-367 ◽  
Author(s):  
ANDREW NOCON ◽  
MAGGIE PEARSON
Keyword(s):  
Older People ◽  
Social Services ◽  
White Paper ◽  
Frail Older People ◽  
Policy Makers ◽  
The People ◽  
Direct Support ◽  
Published Research

Most published research on informal care for older people focuses on the support provided by relatives. The role of non-kin carers can, however, also be significant in supporting older people in their own homes. In this paper, we report the findings from an exploratory study of the support provided by friends and neighbours who are the main carers of frail older people. It draws on interviews with an opportunistic sample of friends, neighbours and older people, which explored their views about the support arrangements, the reasons why help was provided and any difficulties experienced. Several friends and neighbours provided intensive and frequent help, and some played a key role in co-ordinating other services. One of the main forms of direct support related to older people's quality of life, at a broader level than the practical help provided by statutory services. The flexibility of such support, and the friends' and neighbours' concern for older people as individuals, were particularly important to the people they helped. Nevertheless, such help was not provided without costs to the carers. The study highlights the need for policy-makers and practitioners not to take help from friends and neighbours for granted and, in line with the White Paper Modernising Social Services, to provide the support services they need.

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.

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.

scholarly journals Dobrostan finansowy osób w dojrzałym i starszym wieku w wybranych krajach Unii Europejskiej

Ekonomia ◽  
2018 ◽  
Vol 23 (4) ◽  
pp. 95-109
Author(s):  
Ewa Sobolewska-Poniedziałek
Keyword(s):  
Older People ◽  
Old Age ◽  
Well Being ◽  
Economic Effects ◽  
European Continent ◽  
Eu Member States ◽  
New Development ◽  
The One ◽  
Desk Research

The financial well-being of people in mature and old age in selected countries of the European UnionThe dynamic nature of demographic changes taking place on the European continent implies the necessity of their analysis, both in the context of causes and effects. The scope of the analysis of these works will take into account first of all the consequences of changes in the age structure of the population, as a result of which the percentage of older people increases. This, in turn, determines that the socio-economic effects of these changes may be on the one hand a barrier to development, and on the other, a chance for new development opportunities. The purchasing power of people in mature and old age, combined with their growing share in the overall population structure, may inspire and cause the emergence of new industries and market segments focused primarily on meeting the needs of older people. The aim of the article is a comparative analysis of financial well-being of older people as a factor affecting the quality of life. The analysis will cover the situation of older Poles in the context of the situation of citizens of other EU Member States. The research will use the method of desk research, data from international statistics, in particular from Eurostat, will be used. In addition, the research methods used in the work will be the description method and critical analysis of domestic and foreign literature.

scholarly journals Psychotherapy and old age psychiatry

1999 ◽  
Vol 23 (3) ◽  
pp. 149-153 ◽  
Author(s):  
Jane Garner
Keyword(s):  
Older People ◽  
Old Age ◽  
Older Patients ◽  
Psychological Intervention ◽  
Clinical Implications ◽  
Emotional Life ◽  
The Future ◽  
Old Age Psychiatry

Aims and MethodsThis report was prepared as the basis for wider consultation within the Old Age Faculty and the College. Some literature and practice is reviewed and practical suggestions made for the future in this area.ResultsAlthough older patients are less likely to be refused for psychological intervention attitudes are slowly changing.Clinical implicationsThe clinical implications of this development include a greater consideration of the unique emotional life of each of our patients and an improved understanding of our reluctance to engage in psychotherapeutic work with older people.

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