In recent years increasing interest has centered on the elderly psychogeriatric patient living in the community and the part played by relatives in supporting these patients. There is a need, however, for ways of assessing the behavioural disturbance shown by such patients at home and the effect this behaviour has on relatives. Ratings by relatives of the behaviour at home of elderly dementing patients attending a geriatric psychiatry day hospital, together with the relatives' own ratings of the degree of stress and upset being experienced were obtained. Using the technique of factor analysis was shown that the patient's behaviour and the relative's reaction could be analysed into a number of separate categories and that these were differentially related to each other. Thus, for example, personal distress in the relative was related mainly to the amount of apathetic and withdrawn behaviour shown by the patient, whereas negative feelings held by the relative towards the patient were related only to the degree of disturbance of the patient's mood. The construction of scales measuring these different aspects of patient's behaviour and relative's reaction is described.
“What's the use of their having names” the Gnat said, “if they won't answer to them?” “No use to them“, said Alice, “but it's useful to the people that name them, I suppose. If not, why do things have names at all?”
Psychiatric day hospitals for the elderly have been regarded either as an alternative to in-patient care or as a long-term supportive facility for patients with chronic psychiatric disabilities. In a five-year review of such a unit it was found that the unit's main function had become that of providing an immediate short-term supportive facility to demented patients, mainly in the 75-years-and-over age group, and to their relatives, until such time as beds in the long-stay psychogeriatric wards of the hospital became available. The implications of this change in role of day hospitals are discussed in the light of present facilities and the predicted increase in the size of this section of the population.
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