["Turning trouble into virtue"--5 years of cooperation of a psychiatric department with a center for the elderly and home for the aged].
The article describes the cooperation of a Department of Psychiatry with an old people's center or a home for the aged, and the possibilities and difficulties experienced during such cooperation over a period of five years. The starting point of this co-operation was that both institutions required one another for coping with their work. We tried to make a virtue of necessity. Of course it would not be easy to transfer our kind of cooperation to any other institution. However, we would point out the following problems of cooperation and the developments experienced by us: An old people's home with care facilities is suitable as a complementary to a psychiatric hospital for the continuing treatment of very aged patients who are severely psychotic. In an old people's home with nursing facilities it should certainly be possible to translate into reality a comprehensive psychiatric care programme besides drug therapy, if the personnel is properly instructed and the ensuing conflicts are mastered, although the scope is bound to be limited by shortage of personnel. Instructions can consist of team discussions on individual cases, consultation hours, and emergency services; time must be allowed to help the patients as well as to advise the nurses. Such cooperation can be financed (in the Federal Republic of Germany) on the one hand by sickness insurance payments of medical services rendered to the patients, and on the other hand by a lumpsum to be included in the fees charged by the home, although such lumpsums cannot unfortunately cover all the activities and therapy group costs in a satisfactory way. Almost all the inmates of an old people's nursing home display some psychiatric abnormalities, although only about one-half of them require direct psychiatric treatment. The remaining patients can be stabilised by means of comprehensive psychiatric care based on an understanding of their conflicts and difficulties. Development of such cooperation between psychiatric hospital and old people's nursing home is not continuous. It takes place phasewise, frustration alternating with effectivity. The article describes the course of such development in detail.(ABSTRACT TRUNCATED AT 400 WORDS)
D000368:Aged; D003131:Combined Modality Therapy; D003704:Dementia / Q000628:therapy; D003866:Depressive Disorder / Q000628:therapy; D004630:Emergencies; D005859:Germany, East; D006707:Homes for the Aged / Q000458:organization & administration; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D009497:Neurotic Disorders / Q000628:therapy; D010347:Patient Care Planning / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D011567:Psychiatric Department, Hospital / Q000458:organization & administration; D011575:Psychoanalytic Therapy; D011615:Psychotherapy, Group; D012017:Referral and Consultation; D012559:Schizophrenia / Q000628:therapy
"Aus der Not eine Tugend machen"--Fünf Jahre Kooperation einer psychiatrischen Abteilung mit einem Altenzentrum bzw. Altenpflegeheim.