Time for change—psychiatric morbidity in residential homes for the elderly

Abstract

Previous studies of psychiatric morbidity in Local Authority Social Services Part 111 homes have shown high rates of depression and dementia. Our study of Part 111 homes in Leicester city shows higher rates and greater severity of dementia than these studies. Eighty-two per cent were diagnosed as suffering from dementia to some degree and 53% showed severe levels of cognitive impairment and dependency. A rate of depression (17%) was found, lower than in previously reported studies. These results seem to reflect the changing role of Part 111 homes in service provision for the elderly population.

A comparison of five pain assessment scales for nursing home residents with varying degrees of cognitive impairment

“…Two UK studies have indicated that 38-57% of nursing home residents had moderate to severe dementia. 12,13 The prevalence of chronic pain in older people has been estimated to be 37% among 65-75 year olds, rising to 43%-60% of those aged 75 or more 14,15 and 37% in a sample of 68 nursing homes. 16 It is highly likely, therefore, that many nursing home residents in the UK suffer both cognitive impairment and chronic pain.…”

A Survey of the Relationship Between Community Mental Health Teams and Residential Homes for the Elderly

“…Levels of dementia have been reported between 67% (Mann et al, 1984a) and 87% (Harrison et al, 1990). In a study of four Part I11 homes, Neville et al (1995) confirmed that this is also the case in Leicester, when they found 53% of the residents to be suffering from severe dementia and 29% from mild to moderate dementia.…”

“…Although, as previous research has found, care staff are not unwilling to care for demented residents (Wilkin et al, 1982;Mann et al, 1984b), they are now often having to care for groups of residents of whom over 80% are suffering from some degree of dementia (Harrison et al, 1990;Neville et al, 1995), yet policy and resources in these homes have not responded to the changing needs of the resident population (Mann, 1987;Norman, 1987). Staffing levels have not increased and the majority of care staff have little formal training in the management of mental health and behavioural problems (Ghosh et a/., 1987).…”

Local population differences and the needs of people with cognitive impairment

“…Less well explored, however, are the large dierences in the demography of local populations. Cognitive impairment aects over 80% of those in residential settings (Wattis et al, 1992;Darton, 1994;Neville et al, 1995) and thus provides an important focus for examining the service consequences of local demography.…”