With populations aging there have been some concerns on elderly offending. We compared elderly homicide offenders with a younger comparison group with special emphasis on psychopathy. We analyzed nationwide register-based material on all homicide offenders aged 60 or older who were in a forensic psychiatric examination in Finland 1995-2004 and their gender-matched comparison group of younger homicide offenders. The offenders 60 years or older were diagnosed less often than the younger ones with drug dependence and personality disorders and more often with dementia and physical illnesses. The mean Psychopathy Checklist--Revised total scores as well as factor and facet scores were lower in the 60 or older age group. The group 60 years or older had significantly lower scores on eight individual items of social deviance. The interpersonal/affective factor 1 scores did not differ. Understanding the possible underlying phenomena of violent behavior may provide help for developing services for the elderly.
Identifying management differences seems to benefit the professional development of both groups. Exploring and discussing the underlying reasoning leading to management differences may be a productive format for primary care doctors and psychiatric specialists to teach and learn together. It may also promote collaboration in caring for the depressed elderly.
Schizophrenia guidelines list family interventions as an efficient means in reducing relapses. Interventions aim to help families cope with their relative's problems more effectively, provide support and education, and reduce levels of distress and improve the family communication (see deHaan et al., 2002).
This study is a comparative analysis of long-term psychogeriatric and mixed-care unit patient characteristics in nursing homes and hospitals in Helsinki. The role of the so-called psychogeriatric nursing homes is still under question and not well developed. The aims of the study were to identify and survey psychogeriatric wards and analyze whether these units differ from the rest of the long-term units/wards in terms of patients' characteristics. Participants studied were a total of 2828 elderly long-term care residents, of which 372 were living in long-term psychogeriatric and 2456 in ordinary long-term care units. Data were drawn from the Resident Assessment Instrument (RAI) database and had been collected in the project "Benchmarking and implementation of RAI in Elderly Care in Finland". Scales and items based on Minimum Data Set were used for the comparisons. Resident groups in psychogeriatric units and in ordinary, mixed-client settings were clearly distinguishable. The psychogeriatric residents were younger, had more comorbidity as to psychiatric diseases, and had more often psychiatric symptoms and psychotropic medications. The residents in psychogeriatric units did not differ in cognitive and functional status from those in mixed-client units and had similar comorbidity as to somatic diseases. This study shows that psychiatric symptoms that need to be addressed are common in long-care facilities. The results emphasize the importance of recognition of the multiple care needs of elderly with severe mental symptoms or illness.
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