scholarly journals Ethical dilemmas in old age psychiatry

1994 ◽  
Vol 18 (9) ◽  
pp. 541-544 ◽  
Author(s):  
Catherine Oppenheimer ◽  
Gwen Adshead ◽  
Jeanette Smith
Keyword(s):  
Old Age ◽  
Ethical Dilemmas ◽  
The Elderly ◽  
Health Needs ◽  
Financial Responsibility ◽  
Financial Interests ◽  
Old Age Psychiatry

Patients and their relatives sometimes make what to others appear to be unfortunate decisions. In this paper the ethical dilemmas raised by such decisions in the context of old age psychiatry are examined. The case also raises questions about financial responsibility for the care of the elderly and suggests that the health needs of patients can no longer be separated from their financial interests.

Is There a Need for Elderly Forensic Psychiatric Services?

2005 ◽  
Vol 45 (2) ◽  
pp. 154-160 ◽  
Author(s):  
I O Nnatu ◽  
F Mahomed ◽  
A Shah
Keyword(s):  
Mental Illness ◽  
Old Age ◽  
The Elderly ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Court Diversion ◽  
Mental Health Difficulties ◽  
Old Age Psychiatry ◽  
Forensic Psychiatric ◽  
Developed Nations

The population of the elderly in most developed nations is on the increase. Furthermore, the prevalence of mental disorder amongst elderly offenders is high. The true extent of `elderly' crime is unknown because much of it goes undetected and unreported. This leads to a failure to detect mental illness in such offenders. Court diversion schemes may improve recognition of mental illness but these schemes usually tend to deal with the more severe crimes. This may result in an overestimation of the amount of serious crime committed by the elderly and a failure to detect mental illness amongst those who commit less serious crimes. Efforts to service this hidden morbidity call for multi-agency collaboration. Improved detection and reporting of crimes is essential if mental health difficulties in the elderly are not to go unnoticed. The needs of elderly mentally-disordered offenders are complex and fall within the expertise of old age and forensic psychiatry, without being adequately met by either one. Therefore, consideration should be given to the development of a tertiary specialist forensic old-age psychiatry service.

scholarly journals The interface between old age psychiatry and the law

2002 ◽  
Vol 8 (4) ◽  
pp. 271-278 ◽  
Author(s):  
Brian Murray ◽  
Robin Jacoby
Keyword(s):  
Old Age ◽  
Psychiatric Care ◽  
Common Law ◽  
Civil Law ◽  
The Elderly ◽  
Legal Aspects ◽  
Northern Irish ◽  
Care For The Elderly ◽  
Old Age Psychiatry ◽  
The Uk

This article aims to provide a practical overview concentrating on civil legal aspects of psychiatric care for the elderly. We limit ourselves to English law (which also has jurisdiction in Wales; Scottish and Northern Irish law may be similar, but not identical). Civil law can, in turn, be divided into statute law (legislation provided by Parliament) and common law (the UK, unlike some European countries, has a strong tradition of law based on previous rulings by judges).

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 Physical illness associated with depression in the elderly in community based and hospital patients

1992 ◽  
Vol 16 (10) ◽  
pp. 612-613
Author(s):  
Stephen Dover ◽  
Christopher McWilliam
Keyword(s):  
Old Age ◽  
Psychiatric Illness ◽  
Geriatric Medicine ◽  
The Elderly ◽  
Physical Illness ◽  
Community Based ◽  
Senior Registrar ◽  
Hospital Patients ◽  
Old Age Psychiatry ◽  
Registrar Training

The co-existence of physical and psychiatric illness in so much of the elderly population poses diagnostic and therapeutic problems for psychiatrists, geriatricians and general practitioners alike, with the presence of physical illness strongly influencing and sometimes limiting the options for treatment of the psychiatric illness. Recognition of this has resulted in the Section of Old Age Psychiatry of the Royal College of Psychiatrists recommending that senior registrar training in old age psychiatry should include a one month attachment to an approved geriatric medicine unit.

scholarly journals 3. Old age psychiatry

1991 ◽  
Vol 15 (1) ◽  
pp. 15-16
Author(s):  
Dawn Black ◽  
Elspeth Guthrie ◽  
David Jolley
Keyword(s):  
Old Age ◽  
The Elderly ◽  
Old Age Psychiatry

The old age psychiatrist's role has been evocatively described as “physician to the soul of the elderly”. A more practical definition is psychiatrist to patients over the age of 65 with both functional and organic illnesses.

The Role of Electroconvulsive Therapy in the Treatment of Depressive Illness in Old Age

1989 ◽  
Vol 155 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Susan M. Benbow
Keyword(s):  
Old Age ◽  
Electroconvulsive Therapy ◽  
Age Groups ◽  
The Elderly ◽  
Depressive Illness ◽  
Electrode Placement ◽  
Physical Problems ◽  
Younger Age ◽  
Old Age Psychiatry ◽  
Temporary Memory

Electroconvulsive therapy is an important treatment in the depressive states of late life, and there is general agreement about the indications for its use in old age psychiatry. Indeed, old age may be associated with a better response to ECT than that in younger age groups. The additional risk involved through physical problems in the elderly is not great when compared with that of continuing depression and of the side-effects of alternative treatments. Temporary memory disorders and confusion may occur, but are minimised if unilateral electrode placement is used. Some patients treated with unilateral ECT do not respond, but will respond to bilateral treatment. Anxiety over unwanted treatment effects, which can lead to ineffective treatment of depressive illness, must be outweighed by knowledge of the dangers of leaving depression untreated in old age.

scholarly journals Recruitment into old age psychiatry

2019 ◽  
Vol 43 (3) ◽  
pp. 131-135 ◽  
Author(s):  
Lynsey McAlpine ◽  
Alex Bailey ◽  
Kate Milward ◽  
Charlotte Blewett
Keyword(s):  
Physical Health ◽  
Old Age ◽  
Thematic Analysis ◽  
Social Care ◽  
Health Needs ◽  
Recruitment Strategy ◽  
Factors Affecting ◽  
Qualitative Survey ◽  
Old Age Psychiatry ◽  
The Uk

This research aimed to explore the trainee perspective on factors affecting recruitment into old age psychiatry higher training in the UK. A qualitative survey was created by the Faculty of Old Age Psychiatry and distributed to current higher trainees in all psychiatric subspecialties. A total of 324 higher trainees responded to the survey, representing a broad demographic range. Thematic analysis was carried out, with sufficient responses to achieve saturation. Key themes included concerns about the future of the specialty, issues with social care, lack of support with patients’ physical health needs, issues with training posts, and workload. The need to improve core trainees’ experience of the specialty was highlighted. Many positive themes arose from the data; however, a number of barriers to recruitment were also identified. The findings have implications for recruitment to the specialty and should be used to inform recruitment strategy moving forward.Declaration of interestNone.

Ethics and old age psychiatry

2013 ◽  
Author(s):  
Julian C. Hughes
Keyword(s):  
Clinical Practice ◽  
Old Age ◽  
Final Section ◽  
Ethical Dilemmas ◽  
Ethical Reasoning ◽  
Assisted Dying ◽  
Ethical Theories ◽  
Ethical Concerns ◽  
Ethical Decisions ◽  
Old Age Psychiatry

This chapter starts by reviewing four of the main ethical theories – consequentialism, deontology, principlism, and virtue ethics – looking at their relevance to old age psychiatry. Next comes a practical framework, which can be used to deal with particular ethical dilemmas. The chapter goes on to consider the report on dementia produced by the Nuffield Council on Bioethics in 2009, with its emphasis on the importance of personhood and solidarity. In the final section arguments around assisted dying are discussed. Throughout the chapter the aim is to locate clinical practice in the broader field of ethical concerns, in which the person’s inter-relatedness with the broader social context is emphasized. Clinical decisions need to be seen as ethical decisions, which are either right or wrong, and which reflect the fundamental nature of ethical reasoning.

Teaching old age psychiatry to medical undergraduates

1998 ◽  
Vol 4 (3) ◽  
pp. 183-185 ◽  
Author(s):  
Stephen Curran ◽  
Peter C. W. Bowie
Keyword(s):  
Old Age ◽  
The Elderly ◽  
Undergraduate Curriculum ◽  
Core Knowledge ◽  
Undergraduate Training ◽  
Medical Undergraduates ◽  
Old Age Psychiatry

There are many different course designs for the teaching of old age psychiatry. It may be taught in blocks or spread over the undergraduate curriculum and/or integrated with either psychiatry or medicine for the elderly. Whichever approach is used, at the end of their undergraduate training, students should have the same core knowledge, skills and attitudes.

Topical issues in old age psychiatry

2005 ◽  
Vol 22 (3) ◽  
pp. 103-106 ◽  
Author(s):  
Sharon Foley ◽  
Aideen Freyne
Keyword(s):  
Old Age ◽  
Geriatric Medicine ◽  
Medical Science ◽  
The Elderly ◽  
Demographic Shift ◽  
Republic Of Ireland ◽  
Demographic Projections ◽  
Old Age Psychiatry ◽  
Ultimate Outcome ◽  
The Republic

AbstractWith advancements in medical science over past decades, our aging population has increased substantially. Census studies in 2001 showed that 429,100 of the population of the Republic of Ireland were aged 65yrs and older, making up 11.2% of the overall population. While the overall population of the Republic is expected to remain stable over the next ten years, the demographic projections for the elderly population is for significant growth: numbers of over 65yrs are expected to increase by nearly 108,000 people between 1996 - 2011, comprising over 14.1% of the overall population. In particular, our communities will contain a much higher proportion of octogenarians and nonagenarians: at present 21% of our over 65's are 80 yrs or older; by 2011, it is projected that this number will increase to 25%. In tandem, the prevalence of dementia will increase.In 2000, it was estimated that 31,000 people suffered with dementia in the Republic of Ireland, and this figure is expected to increase by 5000 cases per year between 2001-2011. The ultimate outcome of this demographic shift, will be higher demands on medical services for older people, especially geriatric medicine and old age psychiatry. This paper will focus on two particular aspects of management which will increasingly impact on the work of old age psychiatrists – medicolegal issues and management issues in dementia.

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