Towards a consensus on continuing care for older adults with psychiatric disorder: report of a meeting on 27 March 1995 at the Royal College of Psychiatrists

Abstract

This meeting explored the role of the NHS in providing long-term care for older people with mental illness, principally those with dementia. NHS continuing care units medically supervised by a specialist consultant were an essential part of a system of assessment, treatment and care that must be sensitive to the needs of patients and carers. This system also involved family and friends, the independent sector, general practitioners, social services and other NHS providers. NHS long-stay units should be training centres and models of quality care linked to consultant-led multidisciplinary community mental health teams for older adults. Characteristics of patients likely to need admission to NHS units included: (a) sustained or frequently recurrent difficult behaviour arising from dementia or other serious psychiatric disorder which could not be managed elsewhere except with inappropriate sedation; (b) physical illness and sensory problems associated with the problems above if the needs of the patient could not better be met in another setting; (c) dementia or other serious psychiatric disorder with failure to cope or more rapid deterioration in other care settings. The extent and impact of the current wide local variations in NHS long-stay provision and the feasibility and benefits of general practice registers of patients with dementia were identified as areas for further investigation.