Asunto(s)
Anciano , Capacitación de Usuario de Computador , Enseñanza/métodos , Anciano/psicología , Cuidadores , Humanos , AprendizajeRESUMEN
The authors examined availability, characteristics, and perceived adequacy of psychiatric consultation in nursing homes, as reported by directors of nursing, who returned 899 questionnaires. Thirty-eight percent of nursing home residents were judged to need a psychiatric evaluation; current frequency of consultation was rated as adequate by half of nursing directors. Nearly two-thirds reported that psychiatrists adequately provided diagnostic and medication recommendations; however, advice on nonpharmacologic management techniques, staff support, and dealing with staff stress and family conflicts was largely viewed as inadequate. Findings suggest that perceived need for psychiatric services is far greater than the level actually provided. Overall, more attention must be directed to identifying incentives for psychiatrists to practice in nursing homes, determining clinical effectiveness of mental health services, and examining effects of alternative payment mechanisms on level of care.
Asunto(s)
Casas de Salud , Psiquiatría , Derivación y Consulta , Humanos , Servicios de Salud Mental/economía , Evaluación de NecesidadesRESUMEN
A consultation-liaison psychiatry program in a teaching nursing home helped implement six guiding principles including: make the patient human to the staff; assume no behavior is random; look for depression of psychosis as a source of problems; reduce medications and medication doses; create a more homelike environment; and use conditions in which learning still occurs in dementia.