scholarly journals Early-onset dementia

2009 ◽  
Vol 15 (5) ◽  
pp. 380-388 ◽  
Author(s):  
Kate Jefferies ◽  
Niruj Agrawal

SummaryDementia is is stereotypically associated with older people. However, in a significant minority it can affect people in their 40s and 50s, or even younger. Currently there is a lack of awareness, even among healthcare professionals, and there is a dearth of appropriate services for such patients. Despite the attention given to this condition by National Institute for Health and Clinical Excellence guidelines, provision of specialist early-onset dementia services in the UK remains patchy. Carers and patients often find themselves being passed ‘from pillar to post’ between psychiatry and neurology, and also between adult, old age and liaison psychiatry. The responsibility for identifying available and appropriate help is often left with carers. This leads to unnecessary delays, causes undue distress to patients and places an added burden on carers.

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S311-S312
Author(s):  
Sarah Bradbury ◽  
George Crowther ◽  
Manimegalai Chinnasamy ◽  
Laura Shaw ◽  
Sara Ormerod ◽  
...  

AimsThe number of people over the age of 65 attending Emergency Departments (ED) in the United Kingdom (UK) is increasing. Those who attend with a mental health related problem may be referred to liaison psychiatry for assessment. Improving responsiveness and integration of liaison psychiatry in general hospital settings is a national priority. To do this psychiatry teams must be adequately resourced and organised. However, it is unknown how trends in the number of referrals of older people to liaison psychiatry teams by EDs are changing, making this difficult.MethodWe performed a national multi-centre retrospective service evaluation, analysing existing psychiatry referral data from EDs of people over 65. Sites were selected from a convenience sample of older peoples liaison psychiatry departments. Departments from all regions of the UK were invited to participate via the RCPsych liaison and older peoples faculty email distribution lists. From departments who returned data, we combined the date and described trends in the number and rate of referrals over a 7 year period.ResultReferral data from up to 28 EDs across England and Scotland over a 7 year period were analysed (n = 18828 referrals). There is a general trend towards increasing numbers of older people referred to liaison psychiatry year on year. Rates rose year on year from 1.4 referrals per 1000 ED attenders (>65 years) in 2011 to 4.5 in 2019 . There is inter and intra site variability in referral numbers per 1000 ED attendances between different departments, ranging from 0.1 - 24.3.ConclusionTo plan an effective healthcare system we need to understand the population it serves, and have appropriate structures and processes within it. The overarching message of this study is clear; older peoples mental health emergencies presenting in ED are common and appear to be increasingly so. Without appropriate investment either in EDs or community mental health services, this is unlikely to improve.The data also suggest very variable inter-departmental referral rates. It is not possible to establish why rates from one department to another are so different, or whether outcomes for the population they serve are better or worse. The data does however highlight the importance of asking further questions about why the departments are different, and what impact that has on the patients they serve.


Author(s):  
Tom Dening ◽  
Kuruvilla George

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.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S307-S307
Author(s):  
Naomi Woodspring

Abstract A long standing cultural narrative is aging appearance is neither attractive nor acceptable. This has not always been the case; the aesthetics of older appearance has been appreciated other times in history. Significant numbers of older people in the public sphere, as a result of the longevity revolution, has created a sense of visibility of among older people, particularly women. The aim of this qualitative study was to explore current notions of beauty and age among the postwar generation. A diverse group of thirty-four women and men (born between 1945 -1955) from the US and the UK were interviewed with a focus on their own self-presentation and the acts of seeing and being seen. This paper explores the some of the findings from this study which asked the central question – can old people be beautiful and, if so, how is age and beauty defined? The majority of research participants answered in the affirmative and responded with clearly defined notions of age and beauty. The findings found significant gender differences; not within the central research question but in regard to their own appearance. There were also significant gender differences in terms of a ‘competitive’ or ‘cooperative’ gaze when observing other older people. This small study invites further research and points to a possible shift in the aesthetics of old age, in part, as a result of the longevity revolution. It provides an outline for further exploration of the importance of appearance, meaning, and a sense of self in old age.


1991 ◽  
Vol 11 (4) ◽  
pp. 373-397 ◽  
Author(s):  
Ian Gibbs

ABSTRACTAccording to ‘conventional wisdom’ older people are now relatively well off and, as a result, many are in a position to pay for their own care and housing needs in old age. In reviewing the evidence for this latter proposition the article provides a brief overview for the UK population and the implications of an ageing society for the care services. A summary of the main sources of income available to older people is undertaken, including home ownership and ways of releasing equity which might be employed to generate extra income. On the basis that it is also important to match information about financial resources available to older people to the cost of different services, the article reviews the likely costs of residential and nursing home care and the little that is known about the costs of domiciliary services. In short, the article presents a summary of the relevant background information and examines the issue of whether elderly people could (but not necessarily ‘should’) finance their housing and care needs in old age.


Dental Update ◽  
2021 ◽  
Vol 48 (2) ◽  
pp. 106-113
Author(s):  
Natalie Bradley

The UK population is ageing with over a quarter of people predicted to be over 65 by 2040. People are retaining their teeth into old age, often having experienced complex restorative dental work over the years. The increasing complexity of dental treatment that older people require will create challenges for those who provide care for this population, including dental treatment under sedation or general anaesthesia. This article discusses the medical, dental and social considerations that need to be taken into account when planning dental care for older patients under sedation or general anaesthesia. CPD/Clinical Relevance: Dentists who provide sedation must be able to appropriately assess and manage their older patients safely if considering this method of pain and anxiety control for dental treatment.


Author(s):  
Fiona Thompson ◽  
Elena Baker-Glenn

Liaison psychiatry is a sub-specialty of psychiatry that specializes in the interface between physical and mental health, and involves treating patients who are attending general hospitals. This chapter provides an overview of the development of old age liaison psychiatry with consideration of the commissioning and funding of services. It discusses the importance of liaison psychiatry services being integrated within the general hospital team. It outlines different models of liaison psychiatry and provides examples of different services in the UK. It describes common conditions seen within older adult liaison psychiatry and considers screening tools and outcomes. Finally, it covers other aspects of the role of liaison psychiatry, such as teaching, training, governance and accreditation of services and considers interfaces with other services and the future of liaison psychiatry.


2007 ◽  
Vol 31 (9) ◽  
pp. 354-356
Author(s):  
Maura Young ◽  
Siobhan Morris

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.


2018 ◽  
Vol 24 (3) ◽  
pp. 188-194 ◽  
Author(s):  
Oleksandr Khrypunov ◽  
Raheel Aziz ◽  
Ban Al-Kaissy ◽  
Ketan Jethwa ◽  
Verghese Joseph

SUMMARYOlder people with mental health problems are entitled to the same level and quality of care as younger people. Several factors continue to influence policy and delivery of older adults' mental health services in the UK. Following the introduction of the Equality Act 2010, there has been a drive to create an ‘ageless’ National Health Service. This has opened up the debate about whether such a service is best equipped to meet the specific needs of older adults. In this contribution we consider the concepts of ‘old age’ and ‘frailty’ and their clinical and service provision implications in psychiatry. The management of late-life depression and early-onset dementia, advance care planning and palliation in dementia are also considered.LEARNING OBJECTIVES•Appreciate how old age psychiatric services and the concept of ‘old age’ have evolved over time•Gain an understanding of issues at the interface between old age and general adult psychiatry and those specific to old age psychiatry•Gain an overview of procedures involved in transferring care between general adult and old age psychiatric services and the need for a separate old age psychiatry subspecialtyDECLARATION OF INTERESTNone.


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