Mental health problems are very common among older people in general hospitals. They are independent predictors of poor outcomes. Research indicates that appropriate interventions can improve outcomes. It is increasingly recognized that liaison mental health services have a key role in meeting the needs of older people in the general hospitals and educating and supporting staff. This paper describes aspects of the developmental and clinical work of a consultant nurse in developing a nurse-led liaison mental health service for older people in Chesterfield, Derbyshire, UK. It describes the impact of this service on referral rates. It also details the results of an audit of 206 referrals assessed by the consultant nurse in the second year of the service. The analysis of data collected provides a profile of aspects of the role of a liaison nurse including reasons for referral, psychiatric diagnosis and interventions recommended. This paper also, uniquely, documents mental health liaison into a community hospital. Implications for the development of services are discussed.
This paper examines whether the literature suggests that Beck's cognitive therapy is a treatment helpful to depressed elderly people, and highlights the issues and adaptations which are considered in its use with this client group. Evidence from outcome studies and case studies is presented which does suggest that it is helpful. A number of issues are raised which require certain special sensitivities on the part of the therapist. Evidence is discussed which suggests that certain adaptations to style and content of therapy may be needed for it to be maximally effective. It is argued that the use of cognitive therapy by community psychiatric nurses (CPNs) could contribute to making the service to depressed elderly people more comprehensive.
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