Reifler Burton V, Bruce Martha L
Wake Forest School of Medicine, Winston-Salem, NC.
Weill Cornell Medical College, New York, NY.
Am J Geriatr Psychiatry. 2014 Mar;22(3):241-7. doi: 10.1016/j.jagp.2012.12.002. Epub 2013 Feb 12.
The objective is to provide information on successful programs providing home-based services to mentally ill elderly in order to assist other communities wishing to establish such programs.
The ten programs described in this article were selected by peer review from applications for an award given by the American Association for Geriatric Psychiatry and were participants in an invitational conference.
Eight of the programs were components of a community agency and two were components of a medical school department of psychiatry. Six of the programs focused primarily on individuals with anxiety and depression and utilized a range of individual psychotherapies. The other four accepted patients with any psychiatric diagnosis including dementia and included medication management as part of their services. The numbers served by the ten programs ranged from about 50 to 300 new cases per year, and the staffing ranged from 2 to 13 often with a combination of full and part time. The annual budget for the ten programs ranged from $30,000 to $1,250,000. Budget sources usually included some combination of public funds, philanthropy, and fee-for-service income.
Despite the logistic and fiscal challenges of providing home-based services to mentally ill older adults there are many long-standing successful programs that can serve as models for communities wishing to establish similar programs. A great opportunity exists for a unified outcome research endeavor as well as expansion into many more communities.
目的是提供有关为患有精神疾病的老年人提供居家服务的成功项目的信息，以协助其他希望建立此类项目的社区。
本文所述的十个项目是通过同行评审从美国老年精神病学协会颁发奖项的申请中挑选出来的，并且是一次邀请会议的参与者。
其中八个项目是社区机构的组成部分，两个是医学院精神病学系的组成部分。六个项目主要关注焦虑和抑郁患者，并采用了一系列个体心理治疗方法。其他四个项目接收包括痴呆症在内的任何精神疾病诊断的患者，并将药物管理作为其服务的一部分。这十个项目每年服务的新病例数从约50例到300例不等，人员配备从2人到13人不等，通常包括全职和兼职人员。这十个项目的年度预算从3万美元到125万美元不等。预算来源通常包括公共资金、慈善事业和服务收费收入的某种组合。
尽管为患有精神疾病的老年人提供居家服务存在后勤和财政挑战，但仍有许多长期成功的项目可以作为希望建立类似项目的社区的典范。开展统一的结果研究以及向更多社区扩展存在巨大机遇。
