Interface between general adult and old age psychiatry

Abstract

SUMMARYOlder people with mental health problems are entitled to the same level and quality of care as younger people. Several factors continue to influence policy and delivery of older adults' mental health services in the UK. Following the introduction of the Equality Act 2010, there has been a drive to create an ‘ageless’ National Health Service. This has opened up the debate about whether such a service is best equipped to meet the specific needs of older adults. In this contribution we consider the concepts of ‘old age’ and ‘frailty’ and their clinical and service provision implications in psychiatry. The management of late-life depression and early-onset dementia, advance care planning and palliation in dementia are also considered.LEARNING OBJECTIVES•Appreciate how old age psychiatric services and the concept of ‘old age’ have evolved over time•Gain an understanding of issues at the interface between old age and general adult psychiatry and those specific to old age psychiatry•Gain an overview of procedures involved in transferring care between general adult and old age psychiatric services and the need for a separate old age psychiatry subspecialtyDECLARATION OF INTERESTNone.

Old age mental health services in Southern Balkans: Features, geospatial distribution, current needs, and future perspectives

“…Such imbalances have been observed in geriatric mental health services in other European countries too [33], as well as in memory clinics [30]. Despite these imbalances and the international trends of developing specialized old age mental health care services [6,13,15], new psychogeriatric units in the studied region are being planned and inaugurated in a relatively slow rhythm. This reluctance can be attributed to a certain extent to the negative effects of the deep socioeconomic crises and dearth of financial resources that have scourged the region of Southern Balkans.…”

“…Old age mental health services are more effective in looking after elderly people suffering from mental disorders in comparison to general adult psychiatric services. They are dedicated to people in later life living with (a) a recurrent, persistent, or chronic mental illness, (b) a late-onset mental illness, (c) behavioral and psychological symptoms related to neurocognitive disorders, or (d) old age medical diseases linked to psychiatric symptoms, for example, chronic obstructive lung disease [13][14][15][16][17][18][19][20]. Of note, elderly individuals, suffering from mental disorders, treated at psychogeriatric units, have less unmet needs (e.g.…”

Factors that influence psychiatric trainees’ choice of higher training specialty: mixed-methods study

“…Some trainees chose to dual-train to maximise career opportunities. Discussions about ʻageless services’ 15 , 16 may have affected trainees’ attitudes towards old age psychiatry as a career, leading to consideration of dual training or other subspecialties, with a negative knock-on effect on recruitment.…”