A proactive geriatric liaison service to assess and manage medical problems on old age psychiatry wards

Abstract

IntroductionOlder people with mental ill health are more likely to receive lower quality of healthcare, inappropriate prescriptions and reduced access to services, leading to increased rates of mortality1,2,3. The NHS mandate 2015 to 2016 emphasises the need to deliver care, which is joined up and seamless for users of services4.Aims and objectivesTo identify the common medical comorbidities on the Old Age Psychiatry Wards and to assess the management outcomes.MethodsWe audited all patients referred to the Liaison Geriatrician from 2008 to October 2015 from the Mount Hospital Leeds, which consists of 4 Old Age Psychiatry Wards. Data was collected in October 2015 and included referral date, patients’ age and sex, number of referrals, reason for referral and the outcome.ResultsWe assessed 339 (142 F, 197 M) patients with a mean age of 77 (range: 56–94). Cardiovascular problems were the biggest group of referrals (in particular oedema, hypotension and rhythm disturbances) (34%) followed by central nervous system problems (11%), respiratory (8%), gastrointestinal (8%) and infection (8%). Some unusual problems were diagnosed including a spontaneous pneumothorax, primary biliary cirrhosis. The most common intervention was advice on treatment or investigation, very few patients needed acute admission and some unnecessary admissions were aborted as a result of the physician's intervention.ConclusionsThis audit emphasises the need for a joint coordinated approach between psychiatry and medicine in managing health problems in older people. A dedicated Geriatric Liaison service can improve care, avoid unnecessary acute admissions and is more convenient for patients who would otherwise attend repeated outpatient appointments.References are not available for this abstract.Disclosure of interestThe authors have not supplied their declaration of competing interest.