Geropsychiatric Public Sector Nursing: Placement Challenges

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

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.

Consultation-liaison psychiatry services to nursing homes

OBJECTIVE

The aim of the present paper is to review current opinion relating to the provision of mental health consultation to nursing homes, and to provide recommendations for future research.

METHOD

The current literature pertaining to consultation-liaison psychiatry within nursing homes was reviewed.

RESULTS

There is a paucity of well-designed empirical studies of mental health service provision to Australian nursing homes. This is of particular concern given the ageing Australian population and the prevalence of psychiatric symptoms in nursing home residents. Psychiatric consultation and liaison to nursing homes may result in reduced need for crisis intervention, improved use of behavioural management strategies for the symptoms associated with dementia, and reduced nursing home staff stress and burnout.

CONCLUSIONS

Further research is required to evaluate the costs and benefits of providing regular mental health services to nursing homes in Australia, particularly in rural areas. Future service development should be complemented by methodologically sound evaluation.