scholarly journals Should old age psychiatry develop memory clinics? A comparison with domiciliary work

2004 ◽  
Vol 28 (3) ◽  
pp. 78-82 ◽  
Author(s):  
S. Simpson ◽  
D. Beavis ◽  
J. Dyer ◽  
S. Ball
Keyword(s):  
Old Age ◽  
Clinical Implications ◽  
Memory Clinic ◽  
Retrospective Case ◽  
Memory Clinics ◽  
Old Age Psychiatry ◽  
Psychiatric Complications ◽  
To Receive ◽  
Case Note Review

Aims and MethodMemory clinics have become very popular in old age psychiatry and there is some pressure for them to be developed in old age services. However, there is little evidence to suggest that they are more advantageous over the traditional domiciliary visits or who should be seen in clinic. This was a naturalistic comparison of 76 consecutive new referrals to a memory clinic, with 74 consecutive new domiciliary requests within the same service over the same period of time. A retrospective case note review collected the clinical features and an 18-month prospective follow-up examined the subsequent clinical management.Clinical ImplicationsThe two groups were characterised more by their similarities than their differences. However, the domiciliary group had greater behavioural and psychological complications. The memory clinic patients were less likely to receive psychotropic medication and here more likely to be followed up.ResultsWe conclude that memory clinics might be less suitable for patients with prominent psychiatric complications. Memory clinics could complement the domiciliary model by providing early psychosocial/neuropsychiatric approaches, although this is likely to lead to an increased clinical case-load.

scholarly journals Sharing letters with patients and their carers: problems and outcomes in elderly and dementia care

2005 ◽  
Vol 29 (9) ◽  
pp. 330-333 ◽  
Author(s):  
Adrian Treloar ◽  
Dimitrios Adamis
Keyword(s):  
Old Age ◽  
Older Patients ◽  
Dementia Care ◽  
Care Plan ◽  
Clinical Implications ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Old Age Psychiatry ◽  
To Receive

Aims and MethodIn a cross-sectional survey, we assessed the attitudes of older patients and their carers towards receiving copies of letters about them and the effects upon outcomes of sharing letters. We also studied the opinions of consultants on letter-sharing.ResultsFew old age psychiatrists shared letters with patients or carers, and many had concerns about this practice. In contrast, letters were considered ‘very welcome’ by 87% of patients and carers who received them, and 81% of those who did not would be ‘very pleased’ to receive them. Patients and carers who had received letters had significantly better knowledge of their care plan, whom to contact and ways of making contact with services.Clinical ImplicationsDespite concerns expressed by psychiatrists, our findings support the sharing of letters with patients and carers of patients with dementia in old age psychiatry services.

scholarly journals A survey of memory clinic practice in Scotland

2008 ◽  
Vol 32 (12) ◽  
pp. 467-469 ◽  
Author(s):  
Jane Foy
Keyword(s):  
Memory Clinic ◽  
National Guidelines ◽  
Common Component ◽  
Prescribing Practice ◽  
Memory Clinics ◽  
Assessment Techniques ◽  
Old Age Psychiatry ◽  
Clinical Autonomy ◽  
Clinic Practice ◽  
The Cost

Aims and MethodA questionnaire survey of all memory clinics in Scotland to obtain information about clinic characteristics, assessment techniques and prescribing practice.ResultsMemory clinics are a common component of old age psychiatry services within Scotland. There is variability in clinic characteristics, assessment techniques and treatment approaches. Most clinicians appear to rely on their own clinical judgement rather than national guidelines when making decisions about investigations and the prescription of anti-dementia medications.Clinical ImplicationsThere is considerable variation in memory clinic practice across the country. Would standardisation of practice ensure equity in service provision/patient care? However, would such standardisation be at the cost of clinical autonomy?

scholarly journals Outcome of bilateral adrenalectomy in congenital adrenal hyperplasia: one unit’s experience

2006 ◽  
Vol 154 (3) ◽  
pp. 405-408 ◽  
Author(s):  
Cara Megan Ogilvie ◽  
Gill Rumsby ◽  
Tom Kurzawinski ◽  
Gerard S Conway
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Symptom Control ◽  
Clinic Visit ◽  
Bilateral Adrenalectomy ◽  
Successful Outcome ◽  
Management Problem ◽  
Adrenal Hyperplasia ◽  
Retrospective Case ◽  
Case Note Review

Objective: The use of bilateral adrenalectomy in the management of congenital adrenal hyperplasia (CAH) is controversial. We set out to review the outcome of 5 cases of CAH who have undergone adrenalectomy in our unit. Design: A retrospective case note review and subject interview of the experience of adrenalectomy in the setting of a tertiary adult CAH clinic. Methods: Subjects who had undergone adrenalectomy were reviewed at a routine clinic visit with particular reference to clinical and biochemical outcomes after adrenalectomy. Results: Two subjects underwent surgery for the sole indication of desire for fertility with successful outcome and without subsequent adrenal crises. Three women suffered from the common clinical management problem of unsuppressible hyperandrogenism and worsening obesity. Whilst the outcome of improved appearance and weight loss was achieved in these subjects, all three experienced significant complications including pigmentation and acute episodes of adrenal insufficiency. Conclusion: We present a mean follow-up of 4.2 patient years and conclude that this procedure may be suitable for selected women with CAH. Outcomes for those pursuing fertility were positive; however, complications were noted in those women for whom the procedure was performed for symptom control. Accepting that the number of subjects is small, it is clear that more data are required before widely recommending this procedure.

Oxford Textbook of Old Age Psychiatry

2013 ◽  
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Old Age ◽  
Mental Capacity ◽  
Global Approach ◽  
Additional Information ◽  
Memory Clinics ◽  
Old Age Psychiatry ◽  
The Common ◽  
Ethics Of Caring

Taking a global approach by highlighting both the common burdens and the differences in management from country to country, The Oxford Textbook of Old Age Psychiatry, Second Edition includes information on all the latest improvements and changes in the field. New chapters are included to reflect the development of old age care; covering palliative care, the ethics of caring, and living and dying with dementia. Existing chapters have also been revised and updated throughout and additional information is included on brain stimulation therapies, memory clinics and services, and capacity, which now includes all mental capacity and decision making.

scholarly journals A brief computerised discharge summary in old age psychiatry: general practitioner reactions

1990 ◽  
Vol 14 (6) ◽  
pp. 330-330 ◽  
Author(s):  
J. P. Wattis ◽  
David Protheroe
Keyword(s):  
General Practitioner ◽  
Old Age ◽  
Catchment Area ◽  
Discharge Summary ◽  
Medical Audit ◽  
Other Information ◽  
Old Age Psychiatry ◽  
Surgical Audit

In an attempt to provide data for medical audit, to standardise the information on discharge letters and to speed communication, a computerised discharge form was introduced for a catchment area of 20,000 people over 65 years. The programme, based on a surgical audit programme using DBASE II, was developed by one of us to run on an Amstrad PCW. This produced a discharge summary on a standard layout which gave the date of admission, the patient's name, date of birth and address as well as the consultant and GP's name. The patient's diagnosis (according to ICD-9), and a list of disciplines and facilities involved in follow-up preceded brief notes on history and progress. Date of discharge was followed by a list of medication and a space for ‘other information’. All this was contained on one side of A4 paper.

How do memory clinics compare with traditional old age psychiatry services?

2001 ◽  
Vol 16 (9) ◽  
pp. 837-845 ◽  
Author(s):  
Anna Luce ◽  
Ian McKeith ◽  
Alan Swann ◽  
Sarah Daniel ◽  
John O'Brien
Keyword(s):  
Old Age ◽  
Memory Clinics ◽  
Old Age Psychiatry

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.

scholarly journals Role and responsibility of the speciality tutor

1999 ◽  
Vol 23 (3) ◽  
pp. 170-172
Author(s):  
Jane Garner ◽  
Yong Lock Ong
Keyword(s):  
Old Age ◽  
Clinical Implications ◽  
Job Description ◽  
Old Age Psychiatry ◽  
Training Programmes

Aims and methodIn order to identify the role and responsibility of the speciality tutor, the tutors' post in old age psychiatry was compared across two regions.ResultsThe role was narrow; but different in the two regions depending on training programmes.Clinical implicationsTutors in all faculties should have an expanded and standardised job description, separate from the role of the regional representative, in order to strengthen the input of the specialisms to training at all levels.

scholarly journals Training and assessing independent nurse prescribers: a model for old age psychiatry

2009 ◽  
Vol 33 (9) ◽  
pp. 350-353 ◽  
Author(s):  
Sally Cubbin ◽  
Jane Pearce ◽  
Roger Bullock ◽  
Rupert McShane
Keyword(s):  
Patient Safety ◽  
Significant Contribution ◽  
Objective Structured Clinical Examination ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Nurse Prescribing ◽  
Memory Clinics ◽  
Old Age Psychiatry ◽  
High Standards ◽  
Better Than

Aims and MethodThe brevity of training and assessment for independent nurse prescribers has caused some concern. We aimed to validate an Objective Structured Clinical Examination (OSCE) for potential nurse prescribers in dementia. Nurses' performance after 12 days of training for potential prescribers was compared with that of doctors of different grades.ResultsThe performance of doctors, but not nurses, correlated with years of experience. Many nurses, especially those working in memory clinics, scored better than junior doctors.Clinical ImplicationsThis OSCE provides evidence of potential prescribers' competency for employers. This could make a significant contribution to maintaining high standards of patient safety with nurse prescribing. This may also be an appropriate addition to the assessment of specialty trainees as well as for revalidation.

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