{"title":"Psychiatry in the geriatric hospital: its goals and limitations.","authors":"M Feder, J P Junod","doi":"10.1159/000245557","DOIUrl":"https://doi.org/10.1159/000245557","url":null,"abstract":"Dr. M. Feder, Hôpital de Gériatrie, CH-1200 Geneva (Switzerland) It is widely accepted that pathology in the aged nearly always comprises a considerable psychiatric component. It is paradoxical that despite an acknowledged interdependence of the physical and psychiatric aspects of care most geriatric facilities separate the two disciplines. At the Geriatric Hospital in Geneva, Switzerland, to reach the major goal of offering comprehensive medical service to the aged, the medical staff consists of internists and psychiatrists sharing equal responsability and enjoying equal status. This principle is personified in the medical director of the hospital who has training in both internal medicine and psychiatry. In the Hospital opened 3 years ago only 200 of the 320 beds are occupied due to the difficulty of recruiting nursing personnel. We admit all aged patients with both physical and psychiatric disorders placed on mixed floors. The average age of the patient is 79. The patients are admitted for diagnosis, treatment and rehabilitation – with the exception of those needing surgery or the agitated, ambulatory patient in need of protection (i.e. closed facilities) 20–25 patients are admitted weekly while the average length of stay is 46 days. 2 years ago we opened a Day Hospital which offers ongoing treatment for over 80 patients. Recently the Day Hospital is also being used as a rapid diagnostic centre. Closely connected with the Hospital is the Geriatric Centre assuring the coordination of all geriatric services in the Canton of Geneva as well as providing direct extramural psychogeriatric care. This Centre refers patients to the Hospital, but the majority, 60%, of the hospital patients come from 1 This paper has been read at the meeting of the European Clinical Section of the International Association of Gerontology, held in Manchester, 1974. Feder 59 referrals by private physicians. For 3 years, internists and psychiatrists have worked closely together sharing in decision-making and aiming at total care. We think that the patients benefit from the fact that the psychiatrist is fully integrated in the therapeutic team and does not function only as a consultant in psychiatry. His intervention is more natural and he is accepted easily by the patients. We hardly ever encounter the well-known misgivings of the aged toward psychiatry. The psychiatrist has an important preventive role in the early discovery of psychiatric illness. All too often the patient, his family and even the treating physician have a tendency to focus on the physical symptoms. The patient does not merely need a diagnosis, but above all, an emphatic attitude on the part of all toward his psychosocial or psychiatric problems, the latter frequently underrated in favour of the somatic manifestations, a priority considered more important.","PeriodicalId":75882,"journal":{"name":"Gerontologia clinica","volume":"17 2","pages":"58-60"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245557","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12360076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vitamin C supplementation of old people with low blood levels.","authors":"M L Burr, R J Hurley, P M Sweetnam","doi":"10.1159/000245583","DOIUrl":"https://doi.org/10.1159/000245583","url":null,"abstract":"<p><p>Ascorbic acid blood levels were estimated in 828 elderly people living in the community. 297 subjects with low blood levels were admitted to a 2-year controlled trial of vitamin C. Despite a rise in plasma and leucocyte levels, vitamin C produced no apparent benefit in terms of mortality, morbidity or mental senescence. On following up all those who were originally seen, it was found that a higher proportion of deaths occurred among subjects whose leucocyte levels were below 15 mug/10(8) cells than among the rest. This association was especially marked in the men; it was not due to smoking and was probably attributable to an effect of ill-health on blood levels, either directly or through impairment of appetite.</p>","PeriodicalId":75882,"journal":{"name":"Gerontologia clinica","volume":"17 4","pages":"236-43"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245583","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12393742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Continuous combined assessment in rehabilitation of strokes.","authors":"J Pathy","doi":"10.1159/000245558","DOIUrl":"https://doi.org/10.1159/000245558","url":null,"abstract":"<p><p>Treatment of strokes by the method of continuous combined assessment and management is described. It is suggested that stroke patients can only obtain rational and comprehensive assistance when the multiple agencies available use their skills in a multi-disciplinary team situation. A simple scoring system was devised to evaluate the continuous combined assessment and management method of treating a defined group of 454 patients aged 60-85 with strokes. Data on comparative recovery rates in reported series of strokes is confounded by varying criteria for recording disability, evaluating recovery and age patterns. The importance of an internationally acceptable system of scoring disability is emphasised.</p>","PeriodicalId":75882,"journal":{"name":"Gerontologia clinica","volume":"17 2","pages":"61-6"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245558","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12360077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Day care and social needs.","authors":"M K Bagnall","doi":"10.1159/000245532","DOIUrl":"https://doi.org/10.1159/000245532","url":null,"abstract":"","PeriodicalId":75882,"journal":{"name":"Gerontologia clinica","volume":"16 5-6","pages":"253-7"},"PeriodicalIF":0.0,"publicationDate":"1974-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245532","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15391560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Haemoglobin levels in a group of over 75-year-old patients studied in general practice.","authors":"E I Williams, J V Nixon","doi":"10.1159/000245524","DOIUrl":"https://doi.org/10.1159/000245524","url":null,"abstract":"In a survey carried out in general practice, 297 patients over 75 years of age were seen and examined. The haemoglobin levels of 282 of these patients were estimated. The overall mean haemoglobin level was 89% (100% = 14.8 g/l00 ml blood); 6% of men and 19 % of the women had haemoglobin levels under 80 %. Defining anaemia as a haemoglobin of less than 85 %, those who were anaemic were looked at from the point of view of age, sex, marital state and social class, whether they were living alone and what effect their anaemia had on their overall health. Social class seemed to have no effect on the level of anaemia but the percentage is much higher in women than in men. Anaemia was more common in single and widowed persons of both sexes. There was a marked number of patients living alone who were anaemic and this group is particularly vulnerable. As was to be expected, there was an increased degree of anaemia amongst patients in the poorer health groups.","PeriodicalId":75882,"journal":{"name":"Gerontologia clinica","volume":"16 4","pages":"210-8"},"PeriodicalIF":0.0,"publicationDate":"1974-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245524","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15537471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The problem of postural hypotension.","authors":"J A Grunstein","doi":"10.1159/000245502","DOIUrl":"https://doi.org/10.1159/000245502","url":null,"abstract":"","PeriodicalId":75882,"journal":{"name":"Gerontologia clinica","volume":"16 1","pages":"171-4"},"PeriodicalIF":0.0,"publicationDate":"1974-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15263534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prescribing for the elderly in general practice and the problems of record keeping.","authors":"J A Forbes","doi":"10.1159/000245480","DOIUrl":"https://doi.org/10.1159/000245480","url":null,"abstract":"","PeriodicalId":75882,"journal":{"name":"Gerontologia clinica","volume":"16 1","pages":"14-7"},"PeriodicalIF":0.0,"publicationDate":"1974-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15948834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Day care and society.","authors":"M R Hall","doi":"10.1159/000245541","DOIUrl":"https://doi.org/10.1159/000245541","url":null,"abstract":"","PeriodicalId":75882,"journal":{"name":"Gerontologia clinica","volume":"16 5-6","pages":"300-6"},"PeriodicalIF":0.0,"publicationDate":"1974-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245541","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15561817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Steroid therapy in the elderly.","authors":"H D Eastwood","doi":"10.1159/000245501","DOIUrl":"https://doi.org/10.1159/000245501","url":null,"abstract":"","PeriodicalId":75882,"journal":{"name":"Gerontologia clinica","volume":"16 1","pages":"163-70"},"PeriodicalIF":0.0,"publicationDate":"1974-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15649816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}