Comparing psychogeriatric units to ordinary long-term care units—Are there differences in case-mix or clinical symptoms?

Abstract

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.

Psychotropic Drug Prescription in Nursing Homes During the COVID-19 Pandemic

“…However, PSUs and GUs in nursing homes show a differential prescription pattern, as sociodemographic characteristics, cognitive and frailty factors, and psychotropic drug utilization differ between the units. This observation agrees with the previously cited studies by Saarela et al [ 11 ] and Tordoff et al [ 29 ]. The findings reported in this paper demonstrate, for the first time, that prescription dynamics for psychotropic drugs during the pandemic differed in PSUs and GUs, indicating a differential profile that could be important when designing specific protocols for caring for and addressing BPSD.…”

“…Consequently, psychotropic drugs such as antipsychotics, antidepressants, hypnotics/anxiolytics, and antiepileptic drugs are frequently used; these drugs often pose safety issues [ 10 ]. This fact is especially important in the psychogeriatric units (PSUs) of nursing homes, where a greater use of psychotropic drugs is directly related to the clinical profile of the person admitted to these units; they tend to be younger and to have greater comorbidities of pathology and psychiatric symptomatology [ 11 ]. The present study compares prescription patterns of psychotropic medications between PSUs and geriatric units (GUs) to identify differences between both units.…”

Predictors of Healthcare Service Utilization for Mental Health Reasons

“…Finally, the only enabling factor that predicts healthcare service utilization for mental health reasons was low quality of life. In fact, according to numerous authors, low quality of life appeared to be a powerful indicator for healthcare service utilization for mental health reasons [ 120 , 121 , 122 ] and has been found to be a significant predictor of 30-day and one-year hospitalization [ 123 ].…”