Obstacles in Coordinating Services for the Care of the Psychiatrically Ill Aged*

Abstract

A coordinated program for comprehensive care is a good approach to the management of the psychiatrically ill aged. Nevertheless, the patients, their families, community professionals, and the organizational patterns of many facilities and agencies offer a variety of obstacles to comprehensive care. These obstacles are discussed under the headings: 1) attributes of the patients, 2) patient‐family interactions, 3) attributes of professional caregivers, 4) adequacy of community resources and organization, 5) multidisciplinary interactions, and 6) attributes of the case coordinator. These categories are not mutually exclusive, nor do they exhaust the full range of the problems. Such a classification, however, helps to determine some of the major difficulties encountered by coordinators in implementing programs for comprehensive care.

Opinions about Geriatric Patients in Public Mental Hospitals: Administrators of 269 Public Mental Hospitals and 53 Officials of State or Territorial Mental Hygiene Agencies Were Surveyed to Ascertain Their Opinions about the Potential for Rehabilitation of Older Patients

“…Studies focusing on the discharge and place-ment processes have revealed a number of hospital administrative and community problems relating to older patients (65). More expeditious discharging of these patients has been highly'correlated with periodic reevaluations of their diagnostic status and more accurate reporting of their competencies (66,67).…”

“…Because the literature characterizes as geriatric the mentally ill patient who is 60 years or older (19), we sought information on all mentally ill patients at or over this age level. However, most State agency heads and most hospital directors pointed out that their estimates were based on the numbers of patients aged 65 and over. The tabled estimates therefore reflect only the proportion of mentally ill persons aged 65 and over who currently were patients in public mental hospitals.…”