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Treatment of patients with Alzheimer's disease: a national survey following release of the NICE guidance
- Authors:
- CONNOLLY Claire M., BULLOCK Roger
- Journal article citation:
- Psychiatric Bulletin, 27(1), January 2003, pp.11-13.
- Publisher:
- Royal College of Psychiatrists
The National Institute for Clinical Excellence (NICE) has issued guidance regarding the treatment of Alzheimer's disease. A postal survey of old age psychiatrists, geriatricians and neurologists was conducted to establish working practice pre-NICE and investigate expectations about the effect of this guidance. The overall response rate was 26.3%. Old age psychiatrists prescribe the majority of drugs for the treatment of Alzheimer's disease. There was variation in the annual expenditure on such treatment. The main reason for non-prescription was a lack of funding. Over 80% of doctors thought that patients with mild disease should now be targeted for treatment. In order to implement the guidance it will be necessary to address the issue of funding and have clear role allocation between local services.
Old age mental disorders in Newcastle upon Tyne: Part 1 a study of prevalence
- Authors:
- BURNS Alistair, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(3), March 1996, pp.193-199.
- Publisher:
- Wiley
This paper forms part of a series in which key papers in old age psychiatry are presented with an Introduction, commentary by the original author and current update by someone working in the field. This study was part of the academic onslaught on old age psychiatry from the Newcastle Group, starting in the 1950s and continuing today. The accompanying commentaries review the paper in detail and a summary and conclusions are included.
Audit of the use of the Mental Health Act in a psychogeriatric hospital
- Author:
- FEEHAN C.J.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 9(7), July 1994, pp.563-565.
- Publisher:
- Wiley
The question of detaining elderly mentally ill patients against their wishes raises many ethically difficult questions. Provides details of a survey of the extent and purpose of the use the Mental Health Act (1983) in a particular psychogeriatric hospital.
Perceived mental health needs and adequacy of service provision to older people in care homes in the UK: a national survey
- Authors:
- PURANDARE Nitin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(6), June 2004, pp.549-553.
- Publisher:
- Wiley
A postal survey of managers of a stratified random sample of 2638 (14% of 18,698) care homes in the UK caring for older residents. Reminders were sent to those not returning the questionnaires. The response rate was 64% (n = 1689). Forty-one percent of care home managers felt that at least 50% of their residents needed psychiatric evaluation. Cognitive impairment, depressive symptoms and challenging behaviour was thought to be present in at least a quarter of residents by 78%, 29% and 17% respectively. Thirty-eight percent of managers reported that their homes never received any visits from OAPs and only a half described the current frequency of visits as adequate. Pharmacological advice was perceived to be adequate by about three-quarters but less than a half perceived non-pharmacological advice as adequate. Eighty percent wanted more input for staff education and training. Perceived need ( p < 0.001), frequency of visits by OAPs ( p = 0.001), availability of geriatrician ( p = 0.001), amount of non-pharmacological advice ( p = 0.014) and direct referral access to OAPs for known patients ( p = 0.036) were found to be independent predictors of perceived inadequacy of service provision by OAPs. The survey highlights the perception of unmet need and inadequacy of service provision by OAPs amongst managers of care homes in the UK. The study findings, if confirmed by direct observational studies, may have a considerable impact on already sparse resources with a need to explore efficacy of different models of care in meeting this need.
Do patients really want copies of their GP letters?: a questionnaire survey of older adults and their carers
- Authors:
- DALE Jenny, et al
- Journal article citation:
- Psychiatric Bulletin, 28(6), June 2004, pp.199-200.
- Publisher:
- Royal College of Psychiatrists
The National Health Service Plan stated that all correspondence between clinicians would be copied to patients by April 2004. We wanted to find out whether this practice reflected the true desires of their patients. A questionnaire survey was therefore performed in older adults and their carers attending a psychiatric out-patient clinic. A total of 88 participants were recruited; 50 patients and 38 carers. The majority of patients and carers wanted a letter about their care but most preferred a separate, simple letter rather than a copy of the letter sent to their general practitioner. Although this study supports the existing evidence that patients would like written information about their care, it indicates that certain patient groups might not want this in the form of copies of their medical correspondence. Further research into patient and carer preference is needed before the implementation of this policy.
The elderly homeless men in Bloomsbury hostels: their needs for services
- Author:
- ABDUL-HAMID Walid
- Journal article citation:
- International Journal of Geriatric Psychiatry, 12(7), 1997, pp.724-727.
- Publisher:
- Wiley
This article analyses the needs of a subsample of elderly residents in four inner London hostels for homeless people. Their needs were compared with those of 64 younger residents within the same hostels. The data related to demographic characteristics and health problems showed that the elderly homeless were physically frail and socially isolated. This group demonstrated more need for physical health services than the younger sample. However, the needs assessment method used in this study failed to show significant differences between the needs of these elderly and those of the younger residents. Discusses ways of improving the assessment of needs for services in the elderly homeless and the way forward in meeting the needs of this disadvantaged group.
Personality change in dementia of the Alzheimer type
- Authors:
- JACOMB P.A., JORM A.F.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(3), March 1996, pp.201-207.
- Publisher:
- Wiley
Although cognitive impairment is the predominant feature of dementia, personality changes are also frequently reported. This study aimed to describe the nature of personality change in dementia of the Alzheimer type and the relationship of this change to cognitive decline. The significance of the results are discussed.
Caring for someone with Parkinson's Disease: factors that contribute to distress
- Authors:
- MILLER E., BERRIOS G.E., POLITYNSKA B.E.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(3), 1996, pp.263-268.
- Publisher:
- Wiley
An investigation into the impact of caring for someone with Parkinson's disease is described. Informal carers, in this case spouses, were found to have raised levels of distress as indicated by a number of instruments. Levels of depression in the sufferer emerged as offering the best prediction of distress in the carer, which raises the potential importance of treating depression in those with Parkinson's disease. Contrary to expectations, an index of potential social support did not predict carer distress and this may have been because the extent of social contact with others was so low as to not allow it to be a differentiating factor.
A prevalence study of suicide ideation among older adults in Hong Kong SAR
- Authors:
- YIP Paul S. F., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(11), November 2003, pp.1056-1062.
- Publisher:
- Wiley
The objective of this paper is to ascertain estimates of the prevalence, and associated risk factors for, suicidal ideation among community-dwelling older adults in Hong Kong. The study was conducted as part of the General Household Survey (GHS), using face to face interviews of ethnic Chinese people aged 60 or above living in the community. Elders living in institutions or elderly homes were excluded from the study. Six percent of the sample was found to have ever had suicide ideation. The results showed that poor physical health, including poor vision, hearing problems, and a greater number of diseases; and poor mental health, especially in the form of depression, are predictors of suicidal ideation in the elderly population. Also, statistical analysis by linking individual factors to depression showed that financial and relationship problems are significant risk factors as well. Older adults who engaged in active coping, that is, those who actively seek to manage or control the negative events in their lives, fare better with lower levels of suicidal ideation than those who use passive coping styles. The prevalence of suicidal ideation is similar among elders in Hong Kong and western countries. Factors that contribute to risk for suicidal ideation span physical and mental health, social, and psychological domains. Although the association of suicidal ideation to self-destructive acts remains to be determined, these findings indicate a variety of potential foci for late life suicide prevention efforts.
Language impairment and aggression in Alzheimer's Disease
- Authors:
- WELSH Steven W., CORRIGAN Frank M., SCOTT Marian
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(3), 1996, pp.257-261.
- Publisher:
- Wiley
With an increasingly aged population, age-related conditions become important for patients, relatives and other carers. Problems for carers result from both the cognitive impairment and the behavioural change. This article considers the association of aggressive behaviour with language impairment and other cognitive impairment.