Community psychological services address a range of emotional and behavioral needs. For the elderly, these services are especially critical because geriatric inpatient mental health care is limited. Therefore, it is imperative that the risk factors that lead to inpatient care and lengthen time of stay be identified and attended to as early as possible. Zahinoor Ismail, Assistant Professor of the Department of Psychiatry at the University of Toronto in Canada led a study that explored what factors increased length of stay (LOS) for geriatric clients compared with adult psychiatric clients.
In a recent study, Ismail assessed 570 adult patients with mood problems and 199 geriatric patients with similar psychological issues. Demographic and medical information were collected during the first 3 days the clients were in the hospital. Ismail found that some factors contributed to lengthier stays for both groups, including negative symptoms, needing assistance with daily living activities, and overall disability. However, the length of stay was longer for the geriatric participants when they had voluntarily admitted themselves or if they lived alone. In addition, the elderly participants who needed high levels of supervision were also admitted for longer periods of time than those who needed less observation.
Ismail believes that early identification of mood disorders, such as depression, is critical for elderly individuals. Many of the participants in this study, and many of those who receive hospitalization, may have psychological problems long before they ever enter the hospital. Experiencing the death of a loved one or a significant physical health problem could exacerbate symptoms that were otherwise minimal. Primary care physicians, family members, and friends should work together to recognize signs of mental illness in order to provide care at the community level before inpatient care is warranted. Clinicians can help clients develop tools to maintain independence and overcome the challenges of living alone in ways that can prevent further progression of symptoms. “Addressing these predictive factors early on during admission and in the community may result in shorter hospital LOS and more optimal use of resources,” Ismail said.
Ismail, Zahinoor, Tamara Arenovich, Charlotte Grieve, Peggie Willett, Gautam Sajeev, David C. Mamo, Glenda M. MacQueen, and Benoit H. Mulsant. Predicting hospital length of stay for geriatric patients with mood disorders. Canadian Journal of Psychiatry 57.11 (2012): 696-703. Print.
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