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Geropsychiatry in long-term care: a nurse-centered approach.

J Am Geriatr Soc

February 1991

Department of Nursing, Francis Scott Key Medical Center, Baltimore, MD 21224.

High prevalence rates of psychiatric disorders and disruptive behaviors in nursing home residents create the need for structured programs of psychiatric consultation and teaching in the long-term care setting. Over 40 months, 473 residents were evaluated by a psychiatric consultation-liaison clinical nurse specialist; 100 of these cases were reviewed in detail. Apparent depression was the most common reason for referral, and depressive and adjustment disorders were the most common diagnostic conclusions of the consultation team.

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The author describes the evaluation and treatment of 67 patients 60 years old or older who were referred to a consultation-liaison service in a university hospital. Age, sex, referring service, reasons for referral, psychiatric diagnosis, and interventions or recommendations were determined. Primary psychiatric diagnoses included depression (24%), dementia (19%), delirium (18%), schizophrenia (16%), and personality disorders (12%).

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