Results from multidisciplinary patient‐centered program implemented in a psychogeriatric unit in Brazil

Abstract

AbstractBackgroundPatient and families/caregivers centered care programs reduce the negative impact of hospitalizations in old age and improve health outcomes. We started an individual‐centered multidisciplinary program that contemplated hospitalization and day‐hospital care at Institute of Psychiatry USP Medical School, Brazil in march 2022 .Our program involves specific goals for inpatients and family members / caregiver’s integrating pharmacology and a multidisciplinary approach.MethodOur program involves interventions during the hospitalization, day‐hospital and transition to outpatient care. Individual specific needs are assessed at the admission, and an individualized specific plan centered on patient and caregiver is designed and carried on. The therapeutic program provides patients cognitive and functional stimulation and caregivers training in order to adapt to behavior changes and together develop a successful daily routine care at home. The multidisciplinary team involves: medical team, nurse, psychologist, speech therapist, physiotherapist, occupational therapist, nutritionist and social worker. The intervention involves psychoeducation, cognitive and social stimulation/training for patients and/or caregivers/family in groups (60‐90 min), 5‐days a week, twice a day and individual sessions. Assessments include clinical and sociodemographic data, days of hospitalization, clinical global impression, MADRAS, MMSE and KATZ scales.ResultThere were 61 consecutive admissions in the 10 months after the program implementation, main diagnosis at admission were depression and dementia . The mean age was 69,73, gender 40 female, 21 male, average hospital stay was 26,66 (inpatient unit), bed turnover 85,81%. Zero patient was readmitted in a period of 30 days after discharge. Admission mean: CGI 4,98, MADRAS 17,66,MMSSE 16,43 KATZ 3,98 and discharge: CGI 3,47,MADRAS 7,26. MMSSE 19,4.KATZ 4,36 .The reduction in CGI 31,3%, Madras 58,89% and improvement in MMSE 18%, KATZ 9,5%.ConclusionOur findings demonstrated confirmed that a patient‐centered program results in improvement in cognition, basic activities of daily life and reduction of depressive symptoms. The present intervention provides consistent recovery of hospitalization. It is an important strategy to improve health quality and recovery for old age psychiatric patients.Descriptors: psychiatry; aging; multiprofessional intervention