title: Unexpected consequences of deinstitutionalization of the mentally disabled elderly.
abstract: An unexpected consequence of the rapid deinstitutionalization of state mental hospital patients has been a sharp rise in posttransfer mortality among the elderly. Considerable evidence suggests that outcome is mediated by two factors. Elderly patients with certain characteristics - especially physical frailty and severe cognitive impairement - comprise a high-risk subgroup for whom relocation is likely to be fatal. Among other elderly persons, environmental, personality and personality-environment congruence are associated with posttransfer prognosis. The studies reviewed indicate that the therapeutic value of deinstitutionalization for mentally disabled elderly persons is problematic.
mesh_terms: D000368:Aged; D003688:Deinstitutionalization; D003704:Dementia / Q000401:mortality / Q000523:psychology*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D012917:Social Adjustment; D012931:Social Environment; D013315:Stress, Psychological / Q000523:psychology