[Interest of extrahospital multidisciplinary unit of neuro-psycho-geriatric intervened in nursing home: Analysis of 288 interventions]

Encephale. 2019 Sep;45(4):327-332. doi: 10.1016/j.encep.2018.09.001. Epub 2019 Mar 14.
[Article in French]

Abstract

Introduction: Geriatrics Mobile Units are a new organisation operating in nursing homes. Their mission is to propose globally oriented neuro-psychiatric and geriatric care. The purpose of the study is to assess their activity and impact over a 21-month period.

Method: A prospective single center study of UMNPG's data including intervention characteristics, patient characteristics, recommendations and reassessment after intervention. The Neuropsychiatric Inventory Nursing Home version (NPI-NH) was measured during intervention and reassessed after 30 days (Student's t-test).

Results: From March 2014 to December 2015, UMNPG conducted 288 interventions mainly for medical advices (81%), clinical assessments (54%) and health care team support (46%). The average age was 84.6±7.3years, 73.3% of whom were women. The patients were dependent (62% of GIR 1 or 2) with dementia (60%) and under several medications (83.7%). The symptoms were mainly agitation/aggression (76.4%), anxiety (75%), depression (66.7%), irritability (60.4%), aberrant motor behaviour (55.9%) and delusions (48.6%). The main proposals of UMNPG were a change in treatment (79.5%), a health care team support (85.4%) and hospitalization (8.4%). The rate of follow-up on recommendation was 83% on the 15th day and 80% on the 30th day. The rate of avoided hospitalizations was 16%. The average NPI-NH decreased (on day 0 NPI=50±19.2; on day 30 NPI=33.9±19.6, p<0.001).

Conclusion: UMNPG-EHPAD intervenes for frail elderly residents with multiple disorders in crisis situations. Medical recommendations help to support people in nursing homes and decrease NPI-NH. UMNPG-EHPAD is part of geriatric network strengthening the city/hospital connection.

Keywords: Elderly; Filière de soins; Institution; Network; Nursing home; Public health; Santé publique; Sujets âgés.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Critical Pathways
  • Dementia / diagnosis
  • Dementia / psychology
  • Dementia / therapy
  • Female
  • France
  • Geriatric Assessment / methods
  • Geriatric Psychiatry / methods*
  • Geriatric Psychiatry / organization & administration*
  • Geriatric Psychiatry / standards
  • Home Care Services, Hospital-Based* / organization & administration
  • Home Care Services, Hospital-Based* / standards
  • Humans
  • Interdisciplinary Communication
  • Male
  • Mobile Health Units* / organization & administration
  • Mobile Health Units* / standards
  • Neuropsychiatry / methods
  • Neuropsychiatry / organization & administration
  • Neuropsychiatry / standards
  • Neuropsychological Tests
  • Nursing Homes* / organization & administration
  • Nursing Homes* / standards
  • Patient Care Team* / organization & administration
  • Patient Care Team* / standards
  • Prospective Studies
  • Surveys and Questionnaires