Specialized partial hospitalization for older adults: a clinical description of an intermediate-term program.

Abstract

The field of geriatric mental health is confronted with the dilemma of a sharp rise in the elderly segment of the population and a concomitant shortage of age-appropriate psychiatric intervention services. There is tremendous need for specialized hospital-based intervention for older adults with mental health problems. A creative and rapid response is imperative and should be based on a continuum of geropsychiatric services that includes acute inpatient, partial hospitalization, and outpatient services. Because Medicare reimbursement for partial hospitalization is restricted to hospital-based programs, private psychiatric hospitals are uniquely positioned to assume a dominant role in the geriatric mental health service delivery system. This article details one hospital's specialized, intermediate-term partial-hospital program for older adults. Partial hospitalization is demonstrated to be an essential component of comprehensive geropsychiatric services that can overcome problems of cost-effectiveness, accessibility, and acceptability to consumers--all factors that presently restrict the development and use of such programs. Based on empirical findings, clinical adaptations to assessment and treatment procedures specific to older adults are presented.