Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T09:35:52.993Z Has data issue: false hasContentIssue false

Acute inpatient admissions in a community oriented old age psychiatry service

Published online by Cambridge University Press:  13 June 2014

Margo Wrigley
Affiliation:
Psychiatry, James Connolly Memorial Hospital, Blanchardstown, Dublin 15, Ireland

Abstract

Objective: This study reviewed all inpatient admissions in a community oriented old age psychiatry service with the aim of assessing the appropriateness of admission criteria, obtaining a profile of those admitted, and providing information about service utilisation.

Method: A retrospective chart review of all first inpatient admissions from 1989-1993 was carried out. Information concerning sociodemographic and clinical variables, and outcome measures in terms of discharge destination, was obtained.

Results: There were 205 first admissions in the study period. There were 37 patients (18%) admitted on an involuntary basis. One per cent of admissions were not assessed at home prior to admission. Six patients had no formal psychiatric disorder, of the remainder 53% had an organic, and 47% a functional psychiatric disorder. Of those admitted 68% were discharged to their original destination. Patients with dementia were more likely to be discharged to nursing homes. Other discharge destinations were also used.

Conclusions: The policy of initial domiciliary assessment of all referrals prior to admission is feasible in the majority of cases. Defined admission criteria clarify reasons for admission, and ensures appropriate use of beds. The range of discharge destinations highlights the need for maintaining close ongoing links with other service providers.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 1997

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

1. Working party on services for the elderly. The years ahead, a policy for the elderly. Stationary Office 1988.Google Scholar
2.Goldsmith, HF, Manderscheid, RW, Henderson, MJ, Sacks, AJ. Projections of inpatient admissions to specialty mental health organisations 1990 to 2010. Hosp Community Psychiatry 1993; 44: 478–83.Google ScholarPubMed
3.Rockwood, K, Stolee, P, Brahim, A. Outcome of admissions to a psychogeriatric Service. Can J Psychiatry 1991; 36: 275–9.CrossRefGoogle ScholarPubMed
4.Zubenko, GS, Rosen, J, Sweet, RA, Mulsant, BH, Rifai, AH. Impact of psychiatric hospitalisation on behavioural complications of Alzheimers disease. Am J Psychiatry 1992; 149: 1484–91.Google Scholar
5.Heinik, J, Popper, M, Hes, J, Avnon, M, Barak, Y. Psychiatric hospitalisation of senile, presenile and arteriosclerotic dementia patients in Israel. A psychiatric case register study. Int J Ger Psychiatry 1994; 9: 405–13.CrossRefGoogle Scholar
6.Wattis, JP, Butler, A, Martin, C, Sumner, T. Outcome of admission to an acute psychiatric facility for older people: a pluralistic evaluation. Int J Ger Psychiatry 1994; 9: 835–40.CrossRefGoogle Scholar
7.Shaping a healthier future. A strategy for effective healthcare in the 1990s. Irish Department of Health. Stationary Office 1994.Google Scholar
8.Folstein, MF, Folstein, SE, McHugh, PR. ‘Mini Mental State’ A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.CrossRefGoogle Scholar
9.Pattie, AM. A survey version of the Clifton Assessment Procedure for the Elderly (CAPE). Br J Clin Psychol 1981; 20: 173–8.CrossRefGoogle ScholarPubMed
10. Data desk data description Inc. PO Box 4555, Ithaca, NY.Google Scholar
11.O'Hare, A, Walsh, D. Activities of Irish psychiatric hospitals and units. Dublin Medico Social Research Board, 1992.Google Scholar
12.Carey, TG, Owens, JM. Involuntary admissions to a district mental health service, implications for a new mental treatment act. Ir J Psych Med 1993; 10:139–44.CrossRefGoogle Scholar
13.Feehan, CJ. Audit of the use of the Mental Health Act in a psychogeriatric hospital. Int J Ger Psychiatry 1994; 9: 563–5.CrossRefGoogle Scholar
14.Gilmore, C, Wood, GC, Rigby, JC. Elderly patients and the Mental Health Act 1983. Int J Ger Psychiatry 1994; 9: 809–18.CrossRefGoogle Scholar
15.Doyle, H, Varian, J. Crisis intervention in psychogeriatrics: a round-the-clock commitment. Int J Ger Psychiatry 1994; 9: 6572.CrossRefGoogle Scholar
16.Rovner, BW, Katz, IR, Psychiatric disorders in the nursing home: a selective review of studies related to clinical care. Int J Ger Psychiatry 1993; 8: 7587.CrossRefGoogle Scholar