Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-13T06:04:50.114Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric consultations for nursing home residents: a perspective from Turkey and the implications for comparable countries

Published online by Cambridge University Press:  01 August 2008

Eylem Sahin Cankurtaran ,
Ibrahim Kutluer ,
Murat Senturk ,
Gulten Bircan Erzin ,
Devrim Gursoy  and
Eray Tombak
Eylem Sahin Cankurtaran*
Affiliation:
Ankara Oncology Research and Training Hospital, Psychiatry Clinic, Ankara, Turkey
Ibrahim Kutluer
Affiliation:
Cubuk Hospital of Government, Neurology Clinic, Cubuk, Ankara, Turkey
Murat Senturk
Affiliation:
Çubuk Suleyman Demirel Home for the Elderly, Elderly Care and Rehabilitation Center, Ankara, Turkey
Gulten Bircan Erzin
Affiliation:
Umitkoy Home for the Elderly, Umitkoy, Ankara, Turkey
Devrim Gursoy
Affiliation:
Seyranbaglari Home for the Elderly, Elderly Care and Rehabilitation Center, Seyranbaglari, Ankara, Turkey
Eray Tombak
Affiliation:
Çubuk Suleyman Demirel Home for the Elderly, Elderly Care and Rehabilitation Center, Ankara, Turkey
*
Correspondence should be addressed to: Dr. Eylem Sahin Cankurtaran, Ankara Oncology Research and Training Hospital, Psychiatry Clinic, Ahmet Andiçen Hastane Birimi, Kolej, Ankara, Turkey. Phone: +90 312 4340990; Fax: +90 312 4342213. Email: eylemcankurtaran@yahoo.com.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: No specialized geriatric psychiatry consultation services are available for elderly people in the institutional care system in Turkey. Our aim was to evaluate psychiatric consultations among the residents of three homes for the elderly in a country with a rapidly aging population, and to investigate possible problems regarding psychiatric consultations.

Methods: The residents of three homes for the elderly, which served partially as “care and rehabilitation centers” (equivalent to nursing homes), were chosen for the study. Data on the use of psychiatric services (mainly patient consultations with a visiting psychiatrist) were collected and analyzed.

Results: The percentage of patients in the three homes for the elderly who had psychiatric consultations between 2005 and 2007 was 31.8% (172/540). The main reasons for referral were forgetfulness (61%), depressive symptoms (37.7%), agitation and disruptive behavior (29.6%), and psychotic symptoms (27.9%). Of these patients, 46.5% were diagnosed with dementia, 20.9% with depression, 20.5% with behavioral and psychotic symptoms of dementia, and 18.6 % with primary psychotic disorders such as schizophrenia.

Conclusion: Homes for the elderly in Turkey are not adequate in terms of consultations for psychiatric problems. Integration of these institutions with hospitals and organizing routine consultation visits from the psychiatry units would enhance the mental health of the elderly. Supporting the staff, maintaining good cooperation between them, and organizing educational programs in the field of mental health of the elderly are also required.

Keywords

elderlyinstitutional caredeveloping countriesgeriatric psychiatryconsultationsTurkey
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 4 , August 2008 , pp. 752 - 763
Copyright
© International Psychogeriatric Association 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albert, K. (2006). An investigation into the life conditions of schizophrenic and paranoid patients in the mental health care institution of city of Debrecen. Psychiatry Hungary, 21, 437–443.Google Scholar
American Geriatric Society and American Association for Geriatric Psychiatry (2003). The American Geriatrics Society and American Association for Geriatric Psychiatry recommendations for policies in support of quality mental health care in U.S. nursing homes. Journal of the American Geriatrics Society, 51, 1299–1304.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (Revised 4th edn). Washington, DC: American Psychiatric Association.Google Scholar
Arends, L. A. (2003). The legal position of psychogeriatrics patients in nursing homes. Tijdschrift voor Gerontologie en Geriatrie, 34, 65–73.Google Scholar
Bartels, S. J., Moak, G. S. and Dums, A. R. (2002). Models of mental health services in nursing homes: a review of the literature. Psychiatric Services, 53, 1390–1396.Google Scholar
Boggatz, T. and Dassen, T. (2005). Aging, care dependency, and care for older people in Egypt: a review of the literature. Journal of Clinical Nursing, 14 (8B), 56–63.Google Scholar
Callegari, M. T. C., Menchetti, M., Croici, G., Costantini, S. and Baranzini, F. (2006). Two years of psychogeriatric consultations in a nursing home: reasons for referral compared to psychiatrists' assessment. BMC Health Services Research, 6, 73–85.CrossRefGoogle Scholar
Cankurtaran, E. S. and Eker, E. (2007). Being elderly in a young country: geriatric psychiatry in Turkey. International Journal of Mental Health, 36, 66–72.Google Scholar
Chahine, L. M., Bijlsma, A., Hospers, A. P. N. and Chemali, Z. (2007). Dementia and depression among nursing home residents in Lebanon: a pilot study. International Journal of Geriatric Psychiatry, 22, 283–285.Google Scholar
Craig, E. and Pham, H. (2006). Consultation-liasion psychiatry services to nursing homes. Australasian Psychiatry, 14, 46–48.Google Scholar
De Boer, M. E., Leemrijse, C. J., Van Den Ende, C. H. M., Ribbe, M. W. and Dekker, J. (2007). The availability of allied health care in nursing homes. Disability and Rehabilitation, 29, 665–670.CrossRefGoogle ScholarPubMed
Directorate of Population Registry (2006). http://www.nvi.gov.tr (in Turkish). Last accessed 20 May 2007.Google Scholar
Directorate of Social Services and Child Protection (2007). http://www.shcek.gov.tr/hizmetler/yasli (in Turkish). Data obtained on 30 May 2007Google Scholar
Draper, B. (2000). The effectiveness of old age psychiatry services. International Journal of Geriatric Psychiatry, 15, 687–703.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Eker, E. and Ertan, T. (2005) The practice of dementia care: Turkey. In Burns, A. (ed.) Standards in Dementia Care: European Dementia Consensus Network (EDCON). Taylor and Francis: 105–111.Google Scholar
Fuller, K. and Lilquist, D. (1995). Geropsychiatric public sector nursing: placement challenges. Journal of Psychosocial Nursing and Mental Health Services, 33, 20–22.Google Scholar
GEBAM (2006). http://www.gebam.hacettepe.edu.tr/etkinlik/aras_files/frame.htm (in Turkish). Last accessed 20 May 2007.Google Scholar
Goldman, L. S. and Klugman, B. S. (1990). Psychiatric consultation in a teaching nursing home. Psychosomatics, 31, 277–281.Google Scholar
Katz, I. R., Lesher, E., Kleban, M., Jethanandani, V. and Parmelee, P. (1989). Clinical features of depression in the nursing home. International Psychogeriatrics, 1, 5–15.Google Scholar
Kotynia-English, R., McGowan, H. and Almeida, P. O. (2005). A randomized trial of early psychiatric intervention in residential care: impact on health outcomes. International Psychogeriatrics, 17, 475–485.Google Scholar
Lakey, S. L., Gray, S. L., Sales, A. E., Sullivan, J. and Hedrick, S. C. (2006). Psychotropic use in community residential care facilities: A prospective cohort study. American Journal of Pharmacotherapy, 4, 227–235.Google Scholar
Leo, J. R., Sherry, C., DiMartino, S. and Karuza, J. (2002). Psychiatric consultation in the nursing home: referral patterns and recognition of depression. Journal of Psychosomatic Research, 53, 783–787.Google Scholar
Meesters, P. D. (2002). Psychiatric consultation in the nursing home: an inquiry among Amsterdam nursing home physicians. Tijdschrift voor Gerontologie en Geriatrie, 33, 107–111.Google Scholar
Mizuno, Y. (2004). The long term care insurance system and geriatric psychiatry. Nippon Ronen Igakkai Zasshi, 41, 286–289.CrossRefGoogle Scholar
Proctor, R. et al. (1999). Behavioral management in nursing and residential homes: a randomised controlled trial. Lancet, 354, 26–29.Google Scholar
Rochon, P. A. et al. (2007). Variation in nursing home antipsychotic prescribing rates. Archives of Internal Medicine, 167, 676–683.Google Scholar
Rovner, B. W., German, P. S., Brant, L. J., Clark, R., Burton, L. and Folstein, M. F. (1991). Depression and mortality in nursing homes. JAMA, 265, 993–996.CrossRefGoogle ScholarPubMed
Snowdon, J., Day, S. and Baker, W. (2005). Why and how antipsychotic drugs are used in 40 Sydney nursing homes. International Journal of Geriatric Psychiatry, 20, 1146–1152.CrossRefGoogle ScholarPubMed
Snowdon, J., Day, S. and Baker, W. (2006). Current use of psychotropic medication in nursing homes. International Psychogeriatrics, 18, 241–250.Google Scholar
Yazgan, I. C., Kuscu, M. K., Fistikci, N., Keyvan, A. and Topcuoglu, V. (2005). Geriatric psychiatry consultations in a Turkish university hospital. International Psychogeriatrics, 18, 327–333.Google Scholar