Criteria for admission of the elderly to geriatric and psychiatric units.

Abstract

A method of assessing physical and psychological disturbances in old people admitted to geriatric or mental hospitals is described. A sample of admissions aged 60 years and over to Wakehurst House (geriatric) and Purdysburn Hospital (mental) in Belfast were so assessed. By grading his disabilities, each patient was assigned to one of four groups ranging from entirely mental illness to entirely physical illness. In this way it was found that 24 per cent. Of the patients in the mental hospital group and 34 per cent. of patients in the geriatric hospital group were misplaced, and ought to have been in the other type of hospital. Factors associated with misplacement in both units were: age 75 and over, being single or widowed, and low socio-economic status. In addition, many of those misplaced into the geriatric hospital had been admitted from welfare institutions or lodgings. Clinical features of misplacement here were restlessness, disorientation, and impaired ability to communicate. In the mental hospital many misplaced patients were transfers from acute medical wards. Impaired physical mobility and incontinence of urine were conspicuous. Recognition of the amount of misplacement now occurring and knowledge of the clinical and social factors associated with this can aid better disposal of patients, and a schema for this has been drawn up.