scholarly journals Assessment of dependency level and community placement for the long-term mentally ill

1995 ◽  
Vol 19 (8) ◽  
pp. 467-469 ◽  
Author(s):  
C. E. Robson
Keyword(s):  
Mentally Ill ◽  
Rating Scale ◽  
Age Groups ◽  
The Elderly ◽  
Rehabilitation Service ◽  
Severely Mentally Ill ◽  
Behaviour Rating ◽  
Study Support ◽  
Assessment Procedures

The rehabilitation service for West Gloucestershire utilises a range of facilities to accommodate the long-term severely mentally ill. Group homes, supported lodgings, long-stay rehabilitation hostels and an inpatient slow stream rehabilitation ward provide increasing degrees of support according to levels of dependency. The findings of this study support the use of the Clifton Assessment Procedures for the Elderly Behaviour Rating Scale (CAPE BRS) as an aid to assessment of appropriate placement for the long-term severely mentally ill of all age groups in the community, both at the time of placement and to monitor ongoing need.

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 A cross-sectional evaluation of a community-orientated mental health service

1995 ◽  
Vol 19 (3) ◽  
pp. 151-154
Author(s):  
Jon Spear ◽  
Andrew Cole ◽  
Jan Scott
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Community Mental Health Services ◽  
Cross Sectional ◽  
Neurotic Disorders ◽  
Community Psychiatric ◽  
Severely Mentally Ill ◽  
Acute Distress ◽  
To Receive

Community mental health services have been criticised for seeing those with minor psychiatric disorders at the expense of those with severe and long-term illness. We report a cross-sectional evaluation of a UK service based entirely within the community. Most patients in contact with the service (66%) had a psychotic disorder or an affective disorder. Patients with greater impairment were likely to receive more intensive treatment. Only 20% of the community psychiatric nurse (CPN) case load focused on acute distress and neurotic disorders. Within this service careful operational planning and maintaining CPNs within the secondary care system appear to be critical factors in achieving the goal of giving priority to the severely mentally ill.

Further reliability and validity studies of a procedure to assess the needs for care of the chronically mentally ill

1994 ◽  
Vol 24 (1) ◽  
pp. 215-222 ◽  
Author(s):  
I. Van Haaster ◽  
A. D. Lesage ◽  
M. Cyr ◽  
J. Toupin
Keyword(s):  
Mentally Ill ◽  
Cultural Context ◽  
Reliability And Validity ◽  
Practical Experience ◽  
Needs For Care ◽  
Severely Mentally Ill ◽  
Care Assessment ◽  
Patient Groups ◽  
Validity Studies

SynopsisThe Needs for Care Assessment Schedule (NFCAS; Brewin et al. 1987) is an itemized and systematic procedure that aims to evaluate the needs for care of long-term mentally ill patients. The present study pursues reliability and validity related issues with the NFCAS in a different cultural context applying the procedure to 98 severely mentally ill patients belonging to different patient groups: short-term, long-term, in-patient and out-patient.Inter-rater reliability was found to be excellent. The results suggest that a clinician with little practical experience and adequate training may effectively use the procedure. The assessment of clinical relevance suggested that the procedure is both applicable and pertinent to all the patients in the study. Additional guidelines were developed for its use with long-term in-patients.

Making a reality of user involvement in community mental health services

1998 ◽  
Vol 22 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Kamaldeep Bhui ◽  
Anne Aubin ◽  
Geraldine Strathdee
Keyword(s):  
Mentally Ill ◽  
Service Management ◽  
User Involvement ◽  
Community Mental Health Services ◽  
Management Style ◽  
Rehabilitation Service ◽  
Community Based ◽  
Everyday Clinical Practice ◽  
Severely Mentally Ill ◽  
Community Based Rehabilitation

User centred services as an ideology have not become a reality of everyday clinical practice. In this paper we introduce a series of articles which describe user centred practice in a south London community-based rehabilitation service for the severely mentally ill. We emphasise the medical consultation style adopted, the service management style and specific initiatives allowing users to influence our practice and shape functional and structural components of the service.

scholarly journals Suicide in the elderly

2000 ◽  
Vol 6 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Howard Cattell
Keyword(s):  
Health Care ◽  
Mentally Ill ◽  
Risk Groups ◽  
The Elderly ◽  
Green Paper ◽  
Asian Women ◽  
Research Attention ◽  
Contentious Issue ◽  
Severely Mentally Ill ◽  
The Uk

Despite the fact that suicide and its prevention continues to be a priority area for health care in the UK, suicide in the elderly remains a neglected subject receiving little interest and research attention. The Green Paper Our Healthier Nation (Secretary of State for Health, 1998) maintained the concept of setting targets for suicide reduction originally proposed in The Health of the Nation strategy. The new target proposes that by the year 2010 the death rate from suicide and undetermined injury will be reduced by at least a further sixth (17%) from the baseline of 1996. The setting of such targets has always been a contentious issue among many psychiatrists, who have concerns that they may be used as a quality measure of psychiatric services, especially as some consider that social influences predominate over health care issues. The subsequent debate has focused on targeting specific at-risk groups, notably severely mentally ill young men, Asian women and those who deliberately harm themselves.

scholarly journals Efficacy of Citalopram in the prevention of recurrent depression in elderly patients: Placebo-controlled study of maintenance therapy

2002 ◽  
Vol 181 (1) ◽  
pp. 29-35 ◽  
Author(s):  
René Klysner ◽  
Jesper Bent-Hansen ◽  
Hanne L. Hansen ◽  
Marianne Lunde ◽  
Elisabeth Pleidrup ◽  
...  
Keyword(s):  
Major Depression ◽  
Elderly Patients ◽  
Rating Scale ◽  
The Elderly ◽  
Term Treatment ◽  
Fixed Dose ◽  
Controlled Study ◽  
Recurrence Time ◽  
Long Term Treatment

BackgroundThe highly recurrent nature of major depression in the young and the elderly warrants long-term antidepressant treatment.AimsTo compare the prophylactic efficacy of citalopram and placebo in elderly patients; to evaluate long-term tolerability of citalopram.MethodOut-patients, ⩾65 years, with unipolar major depression (DSM – IV: 296.2 x or 296.3 x) and Montgomery – Åsberg Depression Rating Scale score ⩾22 were treated with citalopram 20–40 mg for 8 weeks. Responders continued on their final fixed dose of citalopram for 16 weeks before randomisation to double-blind treatment with citalopram or placebo for at least 48 weeks.ResultsNineteen of the 60 patients using citalopram v. 41 of the 61 patients using placebo had recurrence. Time to recurrence was significantly different between citalopram— and placebo-patients, in favour of citalopram (log-rank test, P < 0.0001). Long-term treatment was well tolerated.ConclusionsLong-term treatment with citalopram is effective in preventing recurrence of depression in the elderly and is well tolerated.

scholarly journals The Portsmouth Care Consortium

1992 ◽  
Vol 16 (9) ◽  
pp. 550-551
Author(s):  
Rod Bale
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Residential Care ◽  
Social Service ◽  
Mentally Ill ◽  
The Elderly ◽  
Community Orientation ◽  
Homes For The Elderly ◽  
The City

The co-ordination of services for the long-term mentally ill in the community poses difficulties of organisation. Each country has its own health and social service structure which influences the development of such services. This paper outlines an approach to co-ordinating care in Portsmouth. The mental health services were well known in the ‘30s because of their community orientation due to the leadership of Thomas Beaton, the superintendent of St James' Hospital (Freeman, 1962). The city has a population of 210,000. Previous seaside holiday accommodation is now utilised for residential care homes for the elderly and the mentally ill.

scholarly journals Correlation of cardiovascular and respiratory comorbidities with motor functional independence in the elderly after hip fracture

2021 ◽  
Vol 74 (1-2) ◽  
pp. 20-24
Author(s):  
Natasa Radosavljevic ◽  
Dejan Nikolic ◽  
Sofija Radosavljevic ◽  
Mirko Grajic ◽  
Ksenija Boskovic
Keyword(s):  
Hip Fracture ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Severity Index ◽  
The Elderly ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Significant Difference ◽  
Different Levels

Introduction. The aim of the study was to evaluate the correlation between different levels of examined comorbidities using the Cumulative Illness Rating Scale for Geriatrics and motor Functional Independence Measure test in the elderly after hip fracture. Material and Methods. The study included 203 geriatric patients, 65 years of age and older, who were referred to a rehabilitation program at the Institute for Rehabilitation after hip fracture. The following comorbidities were analyzed: cardiac, vascular, and respiratory. The motor component of Functional Independence Measure was used to assess functional recovery. The Cumulative Illness Rating Scale for Geriatrics was used to calculate the comorbidity index. The patients were assessed on 4 different occasions: on admission, on discharge, 3 months after discharge, and 6 months after discharge. The short-term and long-term efficiency of rehabilitation treatment was measured. Results. There is a significant difference in motor Functional Independence Measure scores between different levels of vascular (p = 0.010) and respiratory (p = 0.047) comorbidities only on admission, while at other times of observation no significant difference (p > 0.05) was found. The highest level of correlation was found in level 3 comorbidity severity index for cardiac comorbidity (discharge/3 months) (Pearson?s correlation - R = 0.938) and vascular comorbidity (discharge/3 months) (R = 0.912), and level 2 comorbidity severity index for respiratory comorbidity (discharge/3 months) (R = 0.941). Conclusion. Rehabilitation treatment of the elderly after hip fracture plays a significant role both in short-term and long-term recovery, particularly in the functional domains even in persons with significant comorbidities. Early inclusion and an individually designed rehabilitation program with continuous monitoring of the elderly after hip fractures results in functional improvement and better quality of life.

scholarly journals Outcomes and Risks With Age in Spondylolisthesis: A Comparison of the Elderly From the Quality Outcomes Database

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Michael Karsy ◽  
Andrew Kai-Hong Chan ◽  
Michael S Virk ◽  
Praveen V Mummaneni ◽  
Mohamad Bydon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Rating Scale ◽  
Age Groups ◽  
The Elderly ◽  
Quality Outcomes ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Patient Reported ◽  
Lumbar Spondylolisthesis ◽  
The Impact

Abstract INTRODUCTION Degenerative lumbar spondylolisthesis affects 3% to 20% of the population with an increasing incidence of up to 30% in the elderly. The impact of age on surgical complication and patient reported outcomes (PRO) have yet to be evaluated in a modern, multicenter study. METHODS The Quality Outcomes Database (QOD) multicenter, prospective registry was used to evaluate patients from 12 US centers, including academic and private institutions, between July 2014 and June 2016 who underwent surgical treatment for grade 1 lumbar spondylolisthesis. All patients received at least 12 mo of follow-up RESULTS A total of 608 patients were divided into < 60 (n = 239), 60 to 70 (n = 209), 71 to 80 (n = 128), and > 80 (n = 32) categories. Older patients showed lower body mass index (BMI) (P = .00001), increased diabetes (P = .007), coronary artery disease (P = .0001), and osteoporosis (P = .005). A lower likelihood for home disposition was seen with the elderly (89.1% in < 60 yr olds vs 75% in > 80 yr olds), with more elderly patients discharged to skilled nursing facilities or rehabilitation (P = .002). No baseline differences in PROs (Oswestry Disability Index [ODI], EQ-5D [EuroQol healthy survey], Numeric Rating Scale for leg pain [NRS-LP] and back pain [NRS-BP]) were seen among age categories. A significant improvement for all QOLs was seen regardless of age (P < .05). Minimal clinically important differences (MCID) in QOLs were seen after surgery for all age groups. No differences in hospital readmissions (30-d, 3-mo) or reoperations (30-d, 1-yr, 2-yr, and 3-yr) were seen among age groups (P < .05). CONCLUSION Despite increased presurgical comorbidities and risk, well-selected elderly patients undergoing surgical treatment of grade 1 spondylolisthesis can achieve meaningful outcomes without increases in complications or readmission. However, PRO do not improve to the same degree in the elderly as in younger adults. This modern, multicenter US study reflects the current use and limitation of spondylolisthesis treatment in the elderly, which may be informative to patients and providers.

Assertive Community Treatment of the Mentally Ill: Service Model and Effectiveness

2005 ◽  
Vol 13 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Adaobi Udechuku ◽  
James Olver ◽  
Karen Hallam ◽  
Frances Blyth ◽  
Melissa Leslie ◽  
...  
Keyword(s):  
Assertive Community Treatment ◽  
Mentally Ill ◽  
Psychiatric Inpatient ◽  
Community Treatment ◽  
Inpatient Service ◽  
Clinical Environment ◽  
Global Assessment Of Functioning ◽  
Severely Mentally Ill ◽  
Before And After

Objective: To provide a description of the service delivery model of an assertive community treatment (ACT) team in the management of a group of severely mentally ill patients and examine the effectiveness of this team in reducing readmissions to a psychiatric inpatient service. Method: A clinical case audit was performed on a single day in September 2001. Admission episodes and duration were collected for patients registered with the team in the 12 month period prior to ACT and for a period of 12 months ending on the day of the audit. Forty-three patients were registered with the team at the time of data collection. The majority (79%) were diagnosed with schizophrenia and there were high rates of comorbidity (76%) and disability (mean Global Assessment of Functioning score 45.9). The main outcome measures were the number of readmissions and readmission days before and after the institution of ACT. Results: The mean number of readmission days reduced from 70.9 to 10.2 (p < 0.05) following the institution of ACT. Conclusion: Assertive community treatment conducted in a naturalistic clinical environment is effective in signi?cantly reducing the number of readmission days in a group of patients suffering from long-term and persistent severe mental illness.

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