Psychiatric care needs of elderly graduates-unanswered questions

Abdul-Hamid, Walid; Holloway, Frank; Silverman, Marisa

doi:10.1080/13607869856632

Cited by 8 publications

(5 citation statements)

References 27 publications

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“…The document 'Towards a model plan for a comprehensive community based mental health system ' (1987) recognized that patients with severe mental illnesses have a wide range of needs but unfortunately the needs of elderly patients is a neglected area of research (Abdul-Hamid, Holloway, Silverman, 1998;Campbell and Aneth, 1997) and has never been addressed in policy documents (The Royal College of Psychiatrists Council Report, 2002). Thornicroft, Strathdee and Phelan (1998) studied the needs of 23 elderly patients of schizophrenia and compared them with those of 160 patients from a younger age group.…”

Section: Patients' Needsmentioning

confidence: 99%

Older people with chronic schizophrenia

Karim

Overshott

Burns

2005

Aging & Mental Health

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Older people with chronic schizophrenia are a numerically small but important group with complex clinical and service needs. Along with a reduction in positive schizophrenic symptoms with increasing age, a majority suffer from negative symptoms, cognitive deficits, depression, side effects due to long-term use of antipsychotics and co-morbid medical problems. They may have social disabilities making them vulnerable to poverty, isolation and poor quality of life. Evidence suggests that judicious use of antipsychotics combined with psychotherapy and psychosocial interventions are effective. There are shortcomings in the standard of both hospital and community care, and the cost implications of providing adequate services are high.

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Section: Patients' Needsmentioning

confidence: 99%

Older people with chronic schizophrenia

Karim

Overshott

Burns

2005

Aging & Mental Health

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“…More specifically related to the content of clinical services, Andersen et al 88 recommended screening for traumatic brain injury after finding that this seemed to explain the poor performance in cognitive testing among a sample of 34 homeless people in Canada, whose average age was 58.8 years. Further related to health services, Abdul-Hamid et al 89 had earlier raised questions about whether clinical services for older homeless people should be under the responsibility of geriatricians or psychogeriatricians.…”

Section: Servicesmentioning

confidence: 99%

Service provision for older homeless people with memory problems: a mixed-methods study

Manthorpe

Samsi

Joly

et al. 2019

Health Serv Deliv Res

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Background Early or timely recognition of dementia is a key policy goal of the National Dementia Strategy. However, older people who are homeless are not considered in this policy and practice imperative, despite their high risk of developing dementia. Objectives and study design This 24-month study was designed to (1) determine the prevalence of memory problems among hostel-dwelling homeless older people and the extent to which staff are aware of these problems; (2) identify help and support received, current care and support pathways; (3) explore quality of life among older homeless people with memory problems; (4) investigate service costs for older homeless people with memory problems, compared with services costs for those without; and (5) identify unmet needs or gaps in services. Participants Following two literature reviews to help study development, we recruited eight hostels – four in London and four in North England. From these, we first interviewed 62 older homeless people, exploring current health, lifestyle and memory. Memory assessment was also conducted with these participants. Of these participants, 47 were included in the case study groups – 23 had ‘memory problems’, 17 had ‘no memory problems’ and 7 were ‘borderline’. We interviewed 43 hostel staff who were participants’ key workers. We went back 3 and 6 months later to ask further about residents’ support, service costs and any unmet needs. Findings Overall, the general system of memory assessment for this group was found to be difficult to access and not patient-centred. Older people living in hostels are likely to have several long-term conditions including mental health needs, which remain largely unacknowledged. Participants frequently reported experiences of declining abilities and hostel staff were often undertaking substantial care for residents. Limitations The hostels that were accessed were mainly in urban areas, and the needs of homeless people in rural areas were not specifically captured. For many residents, we were unable to access NHS data. Many hostel staff referred to this study as ‘dementia’ focused when introducing it to residents, which may have deterred recruitment. Conclusions To the best of our knowledge, no other study and no policy acknowledges hostels as ‘dementia communities’ or questions the appropriateness of hostel accommodation for people with dementia. Given the declining number of hostels in England, the limits of NHS engagement with this sector and growing homelessness, this group of people with dementia are under-recognised and excluded from other initiatives. Future work A longitudinal study could follow hostel dwellers and outcomes. Ways of improving clinical assessment, record-keeping and treatment could be investigated. A dementia diagnosis could trigger sustained care co-ordination for this vulnerable group. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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“…The needs of elderly graduates for services is an important though neglected area of research (Campbell, 1997;Abdul-Hamid et al, 1998). We would like to report the ®ndings of an analysis of the service needs of elderly graduates from a survey of a representative sample of people with psychosis in two de®ned geographic areas.…”

Section: The Needs Of Elderly Graduates Dear Editormentioning

confidence: 99%