Depla M F, Pols A J, de Lange J
Afdeling Zorg & Rehabilitatie van het Trimbos-instituut, Utrecht.
Tijdschr Gerontol Geriatr. 1999 Jun;30(3):121-8.
The article reports on a study involving participants in six projects set up jointly by mental health care facilities and homes for the elderly. The projects were designed to offer protection and guidance in residential homes to older people whose psychiatric problems have rendered them permanently dependent on professional care. The primary focus of the study was on their problems and care needs. Structured interviews were conducted with 136 residents and with their supporting and treating staff. The older people presented an atypical pattern of symptoms. The supporting staff and the treating staff both cited the unsociable, apathetic behaviour of the residents as the most serious problem, followed by emotional problems. Only 37% of the residents were free of cognitive problems, and only 18% had no physical impairments. Although the projects were specifically designed for older people suffering long-term mental instability, more than a quarter of the residents turned out to have had little or no contact with mental health care services. Many had even been admitted to the projects with no prior psychiatric assessment. The study recommends that the projects mobilise more mental health expertise in carrying out needs assessment. To help alleviate the residents' apathy, in-service training programmers for the care staff should focus not on psychopathology alone, but also on ways to create a more stimulating residential and social atmosphere.
本文报道了一项研究，该研究涉及由精神卫生保健机构和养老院联合设立的六个项目中的参与者。这些项目旨在为那些因精神问题而永久依赖专业护理的老年人在养老院提供保护和指导。该研究的主要重点是他们的问题和护理需求。对136名居民及其支持人员和治疗人员进行了结构化访谈。老年人呈现出非典型的症状模式。支持人员和治疗人员都将居民不合群、冷漠的行为列为最严重的问题，其次是情感问题。只有37%的居民没有认知问题，只有18%没有身体损伤。尽管这些项目是专门为长期精神不稳定的老年人设计的，但超过四分之一的居民几乎没有或根本没有与精神卫生保健服务接触过。许多人甚至在没有事先进行精神评估的情况下就被纳入了这些项目。该研究建议这些项目在进行需求评估时调动更多的精神卫生专业知识。为了帮助缓解居民的冷漠情绪，护理人员的在职培训计划不应仅关注精神病理学，还应关注营造更具刺激性的居住和社会氛围的方法。
