The Closure of a Major Psychiatric Hospital: Can Psychiatric Patients in Long-Term Care Be Integrated Into Existing Nursing Homes?

Abstract

Nursing homes are important alternatives to large hospitals when psychiatrically ill patients are relocated in the community, but their suitability for this type of patient is being questioned. This study compared patients in two traditional Swedish nursing homes (n = 66) and patients in long-term care at a large psychiatric hospital (n = 106). The results showed that both types of institutions housed patients with organic dementia and psychiatric symptoms. The hospitalized demented patients, however, displayed significantly more cognitive impairment, more confusion, and more behavioral disturbances than the nursing home patients. Significant differences were also found between the nursing home patients and hospitalized psychiatrically ill patients without dementia. The latter were younger, had better activities of daily living capacity, but displayed more psychiatric symptoms and behavioral disturbances than the nursing home patients. We concluded that all the patients in long-term psychiatric care will require sheltered accommodation. The demented patients could possibly be integrated into nursing homes, but successful integration would require special arrangements. Psychogeriatric units with staff qualified to care for patients with severe behavioral disturbances would be preferable. It would not be possible to meet the psychiatrically ill patients' special need of care in existing nursing homes. Alternative living arrangements, with care given by staff trained in psychiatry, are recommended.