Problems of a geriatric mental health service

The origins of old age psychiatry in Britain in the 1940s

In the 1940s, some of the most influential psychiatrists of their day such as David K. Henderson and Aubrey Lewis were taking an active interest in the well-being of older people. Spurred on by the fears of a rising population of older people, overcrowding in mental hospitals, social changes and an awareness of the lack of knowledge of older people's mental illnesses, they and others began to explore further the mental health needs of older people. There was a marked change from a predominant interest in neuropathology in older mental hospital patients to emphasis on the need to provide clinical care and treatment for people in the community. The establishment of the new specialty of geriatric medicine and the inception of the National Health Service gave further impetus to service development.

Impact of psychogeriatric day hospital care on the patient's family

The supporters of 129 patients referred for psychogeriatric day hospital care were interviewed and followed-up after three and six months. The majority of their dependents suffered from dementia. Thirty-one per cent were still attending six months later, while 37% had been admitted to institutional care. The most positive effects of day hospital were associated with continued patient attendance, the number of distinct advantages foreseen by the supporter, and the lack of any negative expectations concerning their dependents' adjustment to day care. Positive benefits were also closely associated with reductions in the number of problems faced by the supporter.

Intervention in psychosocial decompensation of the elderly in poor neighbourhoods in Jerusalem

In learning to understand the particular problems of old age, in focusing our attention on losses and decompensation, we developed an approach which was concrete and situational rather than (life-long) developmental. In most cases, brief crisis-orientated interventions were sufficient to reduce symptomatology and restore the patient to a healthier level of functioning. Such interventions involved not only the psychogeriatric team but other health and social agencies as well. More so than in other fields of psychiatry, psychogeriatrics concerns itself with a wide spectrum of psychosocial factors; thus the integration of the pyschogeriatric unit into the existing network of community services becomes and important concern.

Individual psychotherapy with the aged: a selective review

While elderly individuals are still markedly underrepresented in facilities providing outpatient psychological services, clinical interest in individual psychotherapeutic intervention with the aged mentally ill has gradually risen during the past several decades. A broad review of the literature suggests that published descriptions of such interventions have generally been global and vague and that research reports, while collectively pointing to the feasibility of individual psychotherapy, have been infrequent and methodologically weak. In view of the rising numbers of elderly persons potentially requiring psychological services and a probable decrease in the mutual avoidance of therapists and the aged, the need for further theoretical development and empirical research is indicated.