HIDDEN GEROPSYCHIATRY - WHO HELPS THE HOM ES IN CARING FOR THE MENTALILL ELDERLY PATIENT - STUDY ON NURSING-HOMES IN GUTERSLOH 1991

In 1991, there existed 20 homes and nursing homes for the elderly in t he district of Gutersloh (Nordrhein-Westfalen, Federal Republic of Ger many) with a total of 1518 beds. 56 000 persons aged 60 years and more rsp. 41 000 persons aged 65 years and more are living in this area. T his means 2.7 beds per 100 persons aged 60 years and more are provided , or 3.7 beds per 100 persons aged 65 years and more. 22.5 % of the ho me residents are in need of care, grade II (care is necessary for some activities of daily living), 55.6 % are in need of care, grade III (c are is necessary in most or all activities of daily living). Only thre e of the homes have a special department or ward for residents with hi gh grades of need of care; in all the other homes residents with high grades of need of care are supported together with residents with lowe r grades of need of care. One home has a special psychogeriatric depar tment with two wards, another one a single psychogeriatric ward. The l eading staff members of the homes assessed that 831 out of 1861 reside nts in the whole year 1991 were mentally disordered, i. e., a rate of 44.65 % in which is similar to the results of comparable studies. 75 % of the admissions of mentally disordered persons are arranged by fami ly members or relatives. Only 7 % come directly from the psychogeriatr ic department of the responsible psychiatric clinic in the area (Westf alische Klinik fur Psychiatrie). Thus, we can assume that mass transfe r of long-stay patients from a psychiatric clinic into homes for the e lderly does not exist (any more) in the district of Gutersloh. The psy chiatric support and treatment of the mentally disordered residents is insufficient. Only nine out of 19 homes have, together, 15 staff memb ers with psychiatric experience or skills. Only in 25 % of all homes a re the mentally disordered residents under medical treatment by a doct or for psychiatry. 21 residents of seven homes, that is 2.4 % of all m entally disordered residents, were transferred to the psychiatric clin ic for treatment in the year 1991. In toto, we have to speak of a defi cient psychogeriatric support and treatment of mentally ill or disorde red persons in homes and nursing homes for the elderly The empirical d ata emphatically support the most expressed demand of the staff member s (58 %), that is for more and better psychogeriatric qualification of the staff.