The frequency, nature, context, and caregivers' reactions to aggressive behavior in 213 dementia patients residing in the community was studied. Aggression was reported in 57.2% of the patients and in 10.6% of the caregivers. Predictors of patient aggression were greater frequency of behavior and memory problems, premorbid aggression, and a more troubled premorbid social relationship between patient and caregiver. Patient aggression predicted the decision to discontinue home care.

This study was carried out to validate a rating scale which could serve as a guide in determining the need for institutional care. The scale assesses the subject's physical and mental disability, balanced against his ability to function and the support available from relatives and community resources. Cut-off points were tested by the use of an 18-month follow-up interval. Initially, 130 aged men and women from three different settings were rated. At the time of follow-up eighteen months later, 83 per cent of the subjects who had obtained an initial score indicative of their inability to function in the community were either dead or in an institution. In contrast, 90 per cent of those who obtained an initial score indicating that they were able to continue in the community, were not in an institution at the time of follow-up. The rating scale can be used not only to help decide the need for institutional care, but also to help determine the most suitable setting for the patient if placement is necessary.

The attitude of physicians toward retirement was studied using a questionnaire sent to physicians aged 65 and older. The information obtained was supplemented by organizing a study group of interested doctors. Of the 58 respondents whose average age was 71, 54 were still in practice and 65% had no plans for retirement. There was a strong urge to maintain the status quo. The group discussion centered around the loss of control over one's declining practice and the fear of diminishing competence with advancing age. The dedicated lifetime pursuit of a medical practice makes retirement extremely difficult for today's older physician. This study supports surveys on the working life span, longevity and mortality of North American physicians.

This study reports the 12 month experience of a hospital-based, multidisciplinary psychogeriatric community team. The patients evaluated were unable to come to the hospital clinics because of a psychiatric and/or physical disability. The group included some patients rarely seen in psychiatric office practice and outpatient facilities, but who posed problems for their families and the community. Some required referral to a clinic, crisis management or emergency hospitalization. Others however, required only minimal intervention. A total of 151 patients (119 females and 32 males) whose average age was 78.2, were seen. Seventy percent were widowed, single, divorced or separated; 43% lived alone. The patients were grouped according to the method of intervention used: psychiatric and social intervention—55%; social and nursing intervention — 28%; no follow-up —11% and; emergency hospitalization — 6%. Seventeen patients were left “untreated”. These patients usually had more adequate family or community support than was initially apparent. They were referred for a crisis which was resolved quickly. An attempt is made to explain our approach, and several case examples are given.