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The day hospital in psychiatry of old age – what difference does it make?

Published online by Cambridge University Press:  13 June 2014

Eleanor Corcoran ,
Alice Guerandel  and
Margo Wrigley
Eleanor Corcoran
Affiliation:
St. Vincent's Hospital, Elm Park, Dublin 4, Ireland
Margo Wrigley
Affiliation:
Department of Old Age Psychiatry, James Connolly Memorial Hospital, Blanchardstown, Dublin 16, Ireland
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Abstract

Objective: Two day hospitals were established in North Dublin in 1989 to play a key role in the first old age psychiatry service in the Republic of Ireland. The purpose of this study was to identify the characteristics and needs of day hospital attenders, to carry out a preliminary evaluation of the role of the day hospitals in meeting these needs, and make recommendations for future developments. Method: All 237 regular attenders between March 1989 and 1992 were included. Demographic, social, medical and psychiatric data including CAGE questionnaire, Folstein mini-mental state, and Clifton Assessment Procedures for the Elderly survey version, were recorded at initial assessment. Data on duration and outcome of attendance, use of inpatient, general hospital and community care services were collected from a retrospective study of records and subjected to statistical analysis. Results: The average age was 78 years (SD 6yrs); 139 (59%) patients had organic and 98 (41%) had functional psychiatric disorders; 198 (84%) patients had a medical problem. In the functional group, 24 (25%) required acute admission; 70 (71%) patients were managed in the community. Twenty eight (29%) patients required residential care or had died on average 8 months after initial contact. In the group with dementia 104 (75%) had CAPE scores C/D/E at initial assessment, indicating high dependency. Eighty eight (63%) patients were in residential care or dead on average 8 months later. Conclusions: Day hospital treatment enabled elderly patients with functional psychiatric illness to be treated in the community with low usage of beds. It provided only short/medium term care for patients with dementia, who had little support from statutory services. A comprehensive network of services is necessary to support highly dependent patients in the community.

Keywords

Community psychiatryDay careDementia servicesGeriatric psychiatryPsychiatry of old age
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 11 , Issue 3 , September 1994 , pp. 110 - 115
Copyright
Copyright © Cambridge University Press 1994

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