The benefits of psychiatric hospitalization for older nursing home residents

J Am Geriatr Soc. 1996 Sep;44(9):1062-5. doi: 10.1111/j.1532-5415.1996.tb02938.x.

Abstract

Objective: To examine the demographic characteristics and treatment outcomes of nursing home residents admitted to a geropsychiatric inpatient unit.

Design: A retrospective cohort design based on an ongoing data base effort.

Setting: The geropsychiatric inpatient unit of the Houston Veterans Affairs Medical Center Hospital.

Participants: All admissions to the unit from nursing homes during an 18-month period.

Measurements: Mini-Mental State Examination, Brief Psychiatric Rating Scale, Hamilton Rating Scale for Depression, Cohen-Mansfield Agitation Inventory, Rating Scale for Side Effects, and Global Assessment of Functioning were administered on admission and discharge.

Results: Paired t tests comparing change scores revealed significant decreases in general psychiatric symptoms (P < .001), depression (P < .001), and agitation (P < .001); significant improvement in global functioning (P < .001); with no significant changes in cognitive status (P = .485) or side effects (P = .120). When the patients were subgrouped according to reasons for admission, paired t tests revealed decreases in violence (CMAI Factor 1; P = .000), psychosis (BPRS thought disorder scale; P = .000 and hostility subscale; P < .008), and depression (HAM-D; P = .002). Four patients were discharged to less restrictive environments, all with chronic mental illnesses.

Conclusion: Inpatient psychiatric hospitalization significantly benefits nursing home residents with and without dementia who are admitted for severe behavior problems.

MeSH terms

  • Aged
  • Dementia / diagnosis
  • Dementia / therapy*
  • Female
  • Geriatric Psychiatry
  • Hospitalization*
  • Hospitals, Psychiatric*
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / therapy*
  • Nursing Homes*
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome