TOWARDS A CONSENSUS ON CONTINUING CARE FOR OLDER ADULTS WITH PSYCHIATRIC-DISORDER - REPORT OF A MEETING ON 27 MARCH 1995 AT THE ROYAL-COLLEGE OF PSYCHIATRISTS

This meeting explored the role of the NHS in providing long-term care for older people with mental illness, principally those with dementia. NHS continuing care units medically supervised by a specialist consul tant were an essential part of a system of assessment, treatment and c are that must be sensitive to the needs of patients and carers. This s ystem also involved family and friends, the independent sector, genera l practitioners, social services and other NHS providers. NHS long-sta y units should be training centres and models of quality care linked t o consultant-led multidisciplinary community mental health teams for o lder adults. Characteristics of patients likely to need admission to N HS units included: (a) sustained or frequently recurrent difficult beh aviour arising from dementia or other serious psychiatric disorder whi ch could not be mana ed elsewhere except with inappropriate sedation: (b) physical illness and sensory problems associated with the problems above if the needs of the patient could not better be met in another setting; (c) dementia or other serious psychiatric disorder with failu re to cope or more rapid deterioration in other care settings. The ext ent and impact of the current wide local variations in NHS long-stay p rovision and the feasibility and benefits of general practice register s of patients with dementia were identified as areas for further inves tigation.