The long-term care needs of geriatric patients in a psychiatric unit
Date
2015-09-23
Authors
Horton, Cecilia
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Abstract
The length of hospital stay varies widely between geriatric patients, particularly those waiting for long-term care placement. A number of studies attempt to predict which hospitalized older adults are likely to require long-term care placement, but few studies examine the factors that affect the length of time for geriatric patients with psychiatric diagnoses to be discharged from hospital to long-term care. This retrospective chart review examines the characteristics of 925 geriatric patients discharged to long-term care over a 3 year period from a Vancouver Island urban hospital. This paper compares geriatric patients from general units versus those in psychiatric units who are discharged to long-term care. Analyses focus on: 1) describing differences in physical function and mental status between the 2 groups of geriatric patients (i.e. general versus psychiatric); and 2) identifying factors that may affect the length of time for discharge from hospital to nursing home. Findings indicate that frail, elderly women are discharged relatively quickly from hospital to long-term care facilities. However, geriatric patients in psychiatric units are a distinct subset which is more likely to be male and to have behavioural and psychological symptoms of dementia (BPSD) that present challenges to long-term care placement and contribute to delays in discharge. Recommendations include providing long-term care staff the necessary education and training to care for those with dual mental health and geriatric diagnoses who have more challenging care needs as well as increasing the availability of long-term care facilities with the necessary design features (e.g., single occupancy rooms, secure units) for this population.
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Keywords
geriatric psychiatry, long-term care needs, length of stay, mental health