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The Act one year on - a mental health officer's perspective
- Author:
- LOCKERBIE Gordon
- Journal article citation:
- Rostrum Magazine, 86, October 2006, pp.12-13.
- Publisher:
- British Association of Social Workers (Scotland)
The author, a Mental Health Officer, discusses the impact of the new Mental Health (Care and Treatment) (Scotland) Act 2003 on managing work for older people. Although it has increased workloads, he argues it is more professional rewarding, improves patients rights and will improve services for people with mental health problems.
Delirium subtype identification and the validation of the Delirium Rating Scale - Revised-98 (Dutch version) in hospitalized elderly patients
- Authors:
- DE ROOIJ Sophia E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(9), September 2006, pp.876-882.
- Publisher:
- Wiley
Delirium is the most common acute neuropsychiatric disorder in hospitalized elderly. The Dutch version of the Delirium Rating Scale - Revised-98 (DRS-R-98) appears to be a reliable method to classify delirium. The aim of this study was to determine the validity and reliability of the DRS-R-98 and to study clinical subtypes of delirium using the DRS-R-98. Patients received the Dutch version of the DRS-R-98, the Mini-Mental State Examination, the Confusion Assessment Method, and a clinical diagnosis of delirium according to DSM-IV criteria, and their relatives the Informant Questionnaire Cognitive Decline in the Elderly. The DRS-R-98 validation cohort (n = 65) consisted of 23 patients with delirium, 22 patients with dementia, and 20 non-psychiatric comparison patients. For the delirium subtype study, a second cohort comprising 54 delirious patients was investigated. Median DRS-R-98 scores significantly distinguished delirium from dementia and no psychiatric disorder. Inter-rater reliability (intra-class correlation 0.97) and internal consistency (Crohnbach's alpha 0.94) were high. Positive scores of DRS-R-98 item 4 (affect liability) and item 7 (motor agitation) predicted the presence of non-hypoactive delirium, with a specificity of 89% and a sensitivity of 57%. The results show that the Dutch version of the DRS-R-98 is a valid and reliable measure of delirium severity and distinguishes patients with delirium from patients with dementia and comparison patients.
The utility of the clock drawing test in detection of delirium in elderly hospitalised patients
- Authors:
- ADAMIS Dimitrios, et al
- Journal article citation:
- Aging and Mental Health, 20(9), 2016, pp.981-986.
- Publisher:
- Taylor and Francis
Objectives: Delirium is common neuropsychiatric condition among elderly inpatients. The clock drawing test (CDT) has been used widely as bedside screening tool in assessing cognitive impairment in elderly people. Previous studies which evaluate its usefulness in delirium reported conflicting results. The objective of this study was to evaluate the utility of CDT to detect delirium in elderly medical patients. Method: Prospective, observational, longitudinal study. All acute medical admissions 70 years of age and above were approached within 72 hours of admission for recruitment. Patients eligible for inclusion were assessed four times, twice weekly during admission. Assessment included Confusion Assessment Method (CAM), Delirium Rating Scale (DRS-98R), Montreal Cognitive Assessment (MoCA), Acute Physiology and Chronic Health Evaluation II (APACHE) II, and CDT. Data was analysed using a linear mixed effect model. Results: Three hundred and twenty-three assessments with the CDT were performed on 200 subjects (50% male, mean age 81.13; standard deviation: 6.45). The overall rate of delirium (CAM+) during hospitalisation was 23%. There was a significant negative correlation between the CDT and DRS-R98 scores (Pearson correlation r = −0.618, p < 0.001), CDT and CAM (Spearman's rho = −0.402, p < 0.001) and CDT and total MoCA score (Pearson's r = 0.767, p < 0.001). However, when the data were analysed longitudinally controlling for all the factors, we found that cognitive function and age were significant factors associated with CDT scores (p < .0001): neither the presence nor the severity of delirium had an additional significant effect on the CDT. Conclusion: CDT score reflects cognitive impairment, independently of the presence or severity of delirium. The CDT is not a suitable test for delirium in hospitalised elderly patients. (Publisher abstract)
Assessing hand hygiene in older people's care settings
- Authors:
- MacKENZIE Lorna, et al
- Journal article citation:
- Nursing Times, 12.8.08, 2008, pp.30-31.
- Publisher:
- Nursing Times
This study aimed to evaluate whether sufficient attention is paid to patient hand hygiene in older people's care settings. One hundred and fourteen staff in mental health care settings for older people - two NHS inpatient units and five private care facilities in the north of England. An eight-item questionnaire was used. The findings indicated staff believe that good patient hand hygiene is important but do not frequently assist patients who have physical and cognitive impairment to wash their hands after visits to the toilet or before meals. While the study was set in the north of England, the authors found evidence that these findings could be generalised across the UK.
Chronic pain and depression among geriatric psychiatry inpatients
- Authors:
- MEEKS Thomas W., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(6), June 2008, pp.637-642.
- Publisher:
- Wiley
The authors examined whether chronic pain among depressed geriatric inpatients was associated with several clinical variables - comorbid psychiatric and medical diagnoses, length of hospitalisation, suicidal ideation, and sleep duration. Medical charts of in-patients admitted to a geriatric psychiatry unit over two years were examined retrospectively and 148 patients with a depressive disorder were identified. Admission pain assessments were used to classify whether patients had chronic pain. Other variables of interest were collected from charts. The results showed that 62% of patients reported chronic pain. In multivariate regression analysis, depressed older adults with chronic pain were more likely to report suicidal ideation, be diagnosed with personality disorder, have higher medical burden and experience decreased total sleep time compared to depressed older adults without chronic pain. It was concluded that chronic pain - common in depressed older adults - may influence clinical features of depression and should be assessed as a possible suicide risk factor. Prospective studies should examine causal relationships and determine the effects of adequate pain treatment on depression course and suicide risk in older adults.
Spiritual advisors and old age psychiatry in the United Kingdom
- Authors:
- LAWRENCE Robert M., et al
- Journal article citation:
- Mental Health Religion and Culture, 11(3), April 2008, pp.273-286.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This survey investigates the role and views of NHS spiritual advisors across the United Kingdom on the provision of pastoral care for elderly people with mental health needs. The College of Health Care Chaplains provided a database, and questionnaires were sent to 405 registered NHS chaplains/spiritual advisors. The response rate was 59%. Quantitative and qualitative analyses were carried out. Spiritual advisors describe their working patterns and understanding of their roles within the modern NHS, and their observations of the level of NHS staff awareness of the importance of spiritual issues in the mental health care of older adults. They provide insights into possible negative and positive perceptions of their roles at a service level, and contribute suggestions of topics relevant to shared education between pastoral care and clinical services. This survey further highlights ethical and operational dimensions at the point of integration of the work of spiritual advisors and multidisciplinary teams.
Holistic care for older inpatients
- Author:
- SMY Janis
- Journal article citation:
- Nursing Times, 16.05.06, 2006, pp.16-17.
- Publisher:
- Nursing Times
This article reports on a team of nurses from Bradford who won a Nursing Times Award for training 'older people's champions' to ensure patients' mental health needs, as well as physical needs, are met.
Moving on: key learning from Rowan Ward: working to improve in patient services for older people with mental health problems
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2005
- Pagination:
- 8p.
- Place of publication:
- London
The Care Services Improvement Partnership has produced this leaflet to share learning, provide information and useful contacts to colleagues in development centres, strategic health authorities, primary care trusts, local authorities and all organisations working to improve in patient services for older people with mental health problems.
Support from hospital to home
- Author:
- PATON Nic
- Journal article citation:
- Nursing Times, 16.11.04, 2004, pp.24-15.
- Publisher:
- Nursing Times
Looks at how an outreach settlement scheme run by ward nurses at Julian Hospital, Norwich, is ensuring that leaving hospital is less traumatic for older people with mental health needs. Hospital can quickly become a secure haven from the world, and discharge daunting and frightening after the safe routine of a ward. A checklist for setting up an outreach settlement scheme is given.
A comparison of self-reported function assessed before and after depression treatment among depressed geriatric inpatients
- Authors:
- CASTEN Robin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 15(9), September 2000, pp.813-818.
- Publisher:
- Wiley
The purpose of this study was to determine whether self-perceptions of function among depressed, geriatric psychiatry inpatients improved as their depression resolved. Self-perceptions of function improved over time, while caregivers' perceptions remained stable, suggesting that patients' perceptions of function is in part influenced by their depression. Further, correlations between patient and caregiver perceptions of function were higher at 3 months post discharge (when patients were not depressed) than they were at admission. The implication is that self-perceptions of function are more accurate when not depressed.