Physical Health of the Long-Term Mentally Ill in the Community

1989 ◽  
Vol 155 (6) ◽  
pp. 777-781 ◽  
Author(s):  
Traolach S. Brugha ◽  
John K. Wing ◽  
Brian L. Smith
Keyword(s):  
Hospital Admission ◽  
Medical Care ◽  
Social Services ◽  
Clinical Assessment ◽  
Mentally Ill ◽  
Unmet Needs ◽  
Medical Problems ◽  
Treatment Plans ◽  
Recorded Data

A clinical assessment was made of 145 long-term users of hospital and social-services day psychiatric facilities, and 84 consented to laboratory pathological screening. We recorded data on relevant medical care where that was being provided. Based on clinical assessment, 59 patients (41%) were judged to have medical problems potentially requiring care. Based on pathological screening 39 (44% of those assessed) had unmet needs, and this rating was associated with poor compliance with attendance and treatment plans. Altogether, 12 patients had important unmet needs, mainly for detailed medical investigation, although none required immediate hospital admission. Long-term patients should be medically reassessed and supervised at appropriate intervals.

scholarly journals Organization of Medical-Social Services for the Elderly Internally Displaced persons from the ATO Zones at the Level of Primary Medico-Sanitary Care

2021 ◽  
pp. 47-55
Author(s):  
Vera Chaykovska ◽  
Tatiyana Vialykh ◽  
Nataliya Velichko ◽  
Vadim Tolstikh ◽  
Svitlana Moskaliuk ◽  
...  
Keyword(s):  
Medical Care ◽  
Social Services ◽  
Social Protection ◽  
The Elderly ◽  
Psychological Characteristics ◽  
Term Care ◽  
Family Doctors ◽  
Internally Displaced ◽  
Health And Social Care

This paper is concerned with the organizationofmedical-socialservicesfortheelderly internally displaced personsfrom theATO zonesat the level of primary medico-sanitary aid.Sociologicalinvestigationsusingpersonal questionnairesandexperts’evaluationshave shown thatsocial-psychological characteristics oftheelderlyinternallydisplacedpersons(IDPs),Theirsocialadaptation, inadequatefinancingandlowlevelofmedico-socialcare,as well as their preferences make it necessary organize healthmonitoringsystem, treatment, rehabilitation and long-term care by family doctors, information centres, day-time stayand rehabilitation centres.WehavedevelopedthemodeloforganizingambulatoryservicesfortheelderlyIDPsat the level of primarymedico-socialcare(PMSC)that would include structural modernization and optimization of its optimal provision. Inouropinion, thismodelismostaccessibleandeconomicallygrounded. It allowsprovide interaction and co-operation of the professionals of health and social care institutions, optimization of standards and principles of medical care. Implementationofthismodelasmostaccessibleandeconomicallygroundedwould allowinteractionandcooperationoftheprofessionalsofhealthcareorganizationsandsocialprotectionsettings.Introductionofthismodel,asmostaccessibleandeconomicallygrounded,would allowensureinteractionandcooperationoftheprofessionalsofhealthcareand social protection institutions, optimizeobservation of the medical care standards and principles. Wehavedevelopedmethodologicalapproachesfortrainingthephysiciansandhealthcare-giversreceivingkeyknowledgeanddeveloping self-carehabitsfortheelderlyIDPsattheir homesconsideringtheirmedico-socialandpsychologicalneeds.

scholarly journals Medical care of the long-term mentally ill in hostels

1994 ◽  
Vol 18 (2) ◽  
pp. 114-114
Author(s):  
Jes Roberts
Keyword(s):  
Medical Care ◽  
Mentally Ill

Historical and medical aspects of the organization of medical and social services for the elderly and senile people in Russia in the late XX — early XXI centuries

2020 ◽  
pp. 49-57
Author(s):  
Lyudmila Kaspruk
Keyword(s):  
Health Care ◽  
Social Services ◽  
Social Protection ◽  
The Elderly ◽  
Primary Role ◽  
Primary Health ◽  
Geriatric Service ◽  
Delivery Of Medical Care ◽  
Older Citizens

When analyzing the historical and medical aspects of the organization of medical and social services for the elderly and senile people in Russia in the late XX — early XXI centuries not only obvious achievements in this sphere, but also a number of problems requiring solution were identified. The primary role in the delivery of medical care to geriatric patients is assigned to the primary health care sector. However the work of the geriatric service in the format of a single system for the provision of long-term medical and social care based on the continuity of patient management between differ- ent levels of the health care system and between the health and social protection services is not well organized. There is no clear coordination and interaction between health care and social protection institutions, functions of which include providing care to older citizens, and it significantly reduces the effectiveness of the provision of both medical and social services.

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

Counselling the Relatives of the Long-Term Adult Mentally Ill

1989 ◽  
Vol 154 (6) ◽  
pp. 775-782 ◽  
Author(s):  
Liz Kuipers ◽  
Brigid MacCarthy ◽  
Jane Hurry ◽  
Rod Harper ◽  
Alain LeSage
Keyword(s):  
Family Relationships ◽  
Mentally Ill ◽  
Expressed Emotion ◽  
Realistic Model ◽  
Education Session ◽  
Term Care ◽  
Interactive Education ◽  
Severely Mentally Ill ◽  
Group Facilitators

A psychosocial intervention is described geared to the needs of carers of the long-term mentally ill, which is feasible for a busy clinical team to implement: relatives were not selected for the group by patient diagnosis or motivation and little extra staff input was required. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion (EE) and to alleviate burden. The group facilitators adopted a directive but non-judgemental style, and constructive coping efforts were encouraged. The intervention was effective at reducing EE and improving family relationships. The study offers a realistic model of how to offer support to people providing long-term care for the severely mentally ill.

scholarly journals Development and evaluation of the Good Grief program for young people bereaved by familial cancer

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Pandora Patterson ◽  
Fiona E. J. McDonald ◽  
Elizabeth Kelly-Dalgety ◽  
Bianca Lavorgna ◽  
Barbara L. Jones ◽  
...  
Keyword(s):  
Social Support ◽  
Personal Growth ◽  
Unmet Needs ◽  
Meaning Making ◽  
Familial Cancer ◽  
Psychosocial Needs ◽  
Program Satisfaction ◽  
Death Of A Parent

Abstract Background Adolescents and young adults (AYAs) bereaved by the death of a parent or sibling from cancer report unique psychosocial needs and can have difficulty adjusting to their loss. Unaddressed, this can result in poor long-term bereavement outcomes. This paper describes the development and evaluation of Good Grief – a 3-day camp-based program focused on meeting coping, social support, and respite needs of AYAs bereaved by familial cancer. Methods One hundred and nine Australian AYAs (68% female; age: 12–25 years, M = 16.63) participated in the evaluation. Grief intensity (Texas Revised Inventory of Grief), meaning-making (Grief and Meaning Reconstruction Inventory), trauma coping (Perceived Ability to Cope with Trauma Scale) and unmet needs (Bereaved Cancer Needs Instrument) measures were administered pre-program and 3-months post-program. Acceptability was measured after each session and at the program’s conclusion. Appropriateness was measured at 3-month follow-up. Thirteen participants were interviewed three months post-program on their perceptions of the program. Results Participants reported high program satisfaction, engagement with psychosocial sessions, and enjoyment of recreational activities. Significant improvements were observed in trauma coping abilities and reductions in unmet needs for managing emotions, social support, respite, future planning, and accessing information and support domains. No change was evident in grief intensity or meaning-making as measured quantitatively. Interviews supported these quantitative findings but also identified evidence of personal growth, a component of meaning-making. Conclusions Good Grief is a highly acceptable and beneficial intervention that addresses the unique needs of AYAs bereaved by familial cancer.

scholarly journals Migrant children in transit: health profile and social needs of unaccompanied and accompanied children visiting the MSF clinic in Belgrade, Serbia

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tijana Topalovic ◽  
Maria Episkopou ◽  
Erin Schillberg ◽  
Jelena Brcanski ◽  
Milica Jocic
Keyword(s):  
Mental Health ◽  
Medical Care ◽  
Social Services ◽  
Social Needs ◽  
Migrant Children ◽  
Health Profile ◽  
Physical And Mental Health ◽  
Daily Stressors ◽  
Skin Conditions ◽  
In Transit

Abstract Background Thousands of children migrate to Europe each year in search of safety and the promise of a better life. Many of them transited through Serbia in 2018. Children journey alone or along with their family members or caregivers. Accompanied migrant children (AMC) and particularly unaccompanied migrant children (UMC) have specific needs and experience difficulties in accessing services. Uncertainty about the journey and daily stressors affect their physical and mental health, making them one of the most vulnerable migrant sub-populations. The aim of the study is to describe the demographic, health profile of UMC and AMC and the social services they accessed to better understand the health and social needs of this vulnerable population. Methods We conducted a retrospective, descriptive study using routinely collected program data of UMC and AMC receiving medical, mental and social care at the Médecins sans Frontières clinic, in Belgrade, Serbia from January 2018 through January 2019. Results There were 3869 children who received medical care (1718 UMC, 2151 AMC). UMC were slightly older, mostly males (99%) from Afghanistan (82%). Skin conditions were the most prevalent among UMC (62%) and AMC (51%). Among the 66 mental health consultations (45 UMC, 21 AMC), most patients were from Afghanistan, with 98% of UMC and 67% of AMC being male. UMC as well as AMC were most likely to present with symptoms of anxiety (22 and 24%). There were 24 UMC (96% males and 88% from Afghanistan) that received social services. They had complex and differing case types. 83% of UMC required assistance with accommodation and 75% with accessing essential needs, food and non-food items. Several required administrative assistance (12.5%) and nearly a third (29%) legal assistance. 38% of beneficiaries needed medical care. Most frequently provided service was referral to a state Centre for social welfare. Conclusion Our study shows that unaccompanied and accompanied migrant children have a lot of physical, mental health and social needs. These needs are complex and meeting them in the context of migration is difficult. Services need to better adapt by improving access, flexibility, increasing accommodation capacity and training a qualified workforce.

scholarly journals Identifying unmet needs in long-term stroke care using in-depth assessment and the Post-Stroke Checklist – The Managing Aftercare for Stroke (MAS-I) study

2018 ◽  
Vol 3 (3) ◽  
pp. 237-245 ◽  
Author(s):  
Benjamin Hotter ◽  
Inken Padberg ◽  
Andrea Liebenau ◽  
Petra Knispel ◽  
Sabine Heel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Caregiver Burden ◽  
Unmet Needs ◽  
Community Dwelling ◽  
Social Needs ◽  
Interquartile Range ◽  
Stroke Patients ◽  
Post Stroke

Introduction Detailed data on the long-term consequences and treatment of stroke are scarce. We aimed to assess the needs and disease burden of community-dwelling stroke patients and their carers and to compare their treatment to evidence-based guidelines by a stroke neurologist. Methods We invited long-term stroke patients from two previous acute clinical studies ( n = 516) in Berlin, Germany to participate in an observational, cross-sectional study. Participants underwent a comprehensive interview and examination using the Post-Stroke Checklist and validated standard measures of: self-reported needs, quality of life, overall outcome, spasticity, pain, aphasia, cognition, depression, secondary prevention, social needs and caregiver burden. Results Fifty-seven participants (median initial National Institutes of Health Stroke Scale score 10 interquartile range 4–12.75) consented to assessment (median 41 months (interquartile range 36–50) after stroke. Modified Rankin Scale was 2 (median; interquartile range 1–3), EuroQoL index value was 0.81 (median; interquartile range 0.70–1.00). The frequencies for disabilities in the major domains were: spasticity 35%; cognition 61%; depression 20%; medication non-compliance 14%. Spasticity ( p = 0.008) and social needs ( p < 0.001) had the strongest impact on quality of life. The corresponding items in the Post-Stroke Checklist were predictive for low mood ( p < 0.001), impaired cognition ( p = 0.015), social needs ( p = 0.005) and caregiver burden ( p = 0.031). In the comprehensive interview, we identified the following needs: medical review (30%), optimization of pharmacotherapy (18%), outpatient therapy (47%) and social work input (33%). Conclusion These results suggest significant unmet needs and gaps in health and social care in long-term stroke patients. Further research to develop a comprehensive model for managing stroke aftercare is warranted. Clinical Trial Registration: clinicaltrials.gov NCT02320994.

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