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Psychogeriatric inpatient unit design: a literature review

Published online by Cambridge University Press:  19 November 2010

John T. Dobrohotoff  and
Robert H. Llewellyn-Jones
John T. Dobrohotoff*
Affiliation:
Central Coast Specialist Mental Health Service for Older People, Northern Sydney Central Coast Health, Gosford, New South Wales, Australia
Robert H. Llewellyn-Jones
Affiliation:
School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
*
Correspondence should be addressed to: Dr John T Dobrohotoff, Manager, Central Coast Mental Health Service for Older People, Northern Sydney Central Coast Health, PO Box 361, Gosford, NSW 2250, Australia. Phone: + 61 2 4320 2952; Fax: +61 2 4320 2715. Email: jdobrohotoff@nsccahs.health.nsw.gov.au.
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Abstract

Background: In many parts of the world the provision of psychogeriatric inpatient units (PGUs) remains limited. More units will be required over coming decades given rapid population aging.

Methods: Medline (1950–2010), psycINFO (1806–2009), EMBASE (1980–2009) and CINAHL (1982–2009) were searched for papers about PGU design. Selected non-peer reviewed literature such as government reports and unpublished academic dissertations were also reviewed. Data were also obtained from the literature related to general adult psychiatry inpatient units where there was limited information from studies of units designed for older people. Over 200 papers were reviewed and 130 were included.

Results: There are few good quality studies to guide the design of acute PGUs and much of the existing literature is based on opinion and anecdote or, at best, based on observational studies. Randomized controlled studies comparing different designs and assessing outcomes are virtually non-existent. Several studies have identified violence and trauma resulting from hospitalization as significant problems with current acute PGU care. Despite its limitations the available literature provides useful guidance on how PGU design can optimize patient and staff safety and improve clinical outcomes.

Conclusions: There are significant problems with current acute PGUs, and patient mix on existing units is an important issue. Future research should examine patient and staff perceptions of different PGU ward environments, the relationship between ward design and clinical outcomes, the effects of segregating patients with challenging behaviors in dementia and the benefits or otherwise of gender segregation.

Keywords

psychiatryfacilitywardenvironmentviolencegeriatricarchitectureold age
Type
Review Article
Information
International Psychogeriatrics , Volume 23 , Issue 2 , March 2011 , pp. 174 - 189
Copyright
Copyright © International Psychogeriatric Association 2010

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