Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-25T04:20:41.841Z Has data issue: false hasContentIssue false
  • English
  • Français

Provision of specialist continuing care services for older adults across the UK

Published online by Cambridge University Press:  22 January 2016

Josie Jenkinson  and
Robert Howard
Josie Jenkinson*
Affiliation:
Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Box PO70, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
Robert Howard
Affiliation:
Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Box PO70, De Crespigny Park, Denmark Hill, London SE5 8AF, UK Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF, UK
*
Correspondence should be addressed to: Dr Josie Jenkinson, Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Box PO70, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. Phone: +44 (0) 20 7848 0508; Fax: +44 (0) 20 7848 0632. Email: [email protected].
Get access

Abstract

Background:

Older people with mental health problems who meet needs based criteria for National Health Service (NHS) continuing care funding may be cared for in a variety of settings. These services have evolved due to socio-economic and political pressure, with the extent of movement of care from traditional NHS run long stay units into the private sector being unclear. Little attention has been paid to the best model of service provision for this group in terms of quality of care, patient outcomes, and cost effectiveness.

Methods:

A literature review was conducted in order to explore what is known about service models for long-term psychiatric care for older people and their cost effectiveness. Following this review, an online survey was conducted in order to establish current specialist continuing care service provision by provider organizations, as well as any planned developments in services.

Results:

The way specialist mental health continuing care services are provided in the United Kingdom (UK) varies, with just 45% (33) of NHS providers still operating their own services. Specialist mental health continuing care is an area of current service review for a number of organizations.

Conclusions:

Specialist care services for older adults with mental health problems in the UK are changing, but there is a lack of research on models of service delivery for this group of vulnerable individuals with complex needs. In the context of financial pressures within the NHS, and an increasing awareness of the need to develop and improve quality of services both for those with dementia and other mental illnesses, an urgent need for further research in this area is identified.

Keywords

service evaluationcontinuing care
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 6 , June 2016 , pp. 959 - 966
Copyright
Copyright © International Psychogeriatric Association 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aldrich, C. K. and Mendkoff, E. (1963). Relocation of the aged and disabled, a mortality study. Journal of the American Geriatrics Society, 11, 185–194.Google Scholar
Annerstedt, L., Sanada, J. and Gustafson, L. (1996). A dynamic long-term care system for the demented elderly. International Psychogeriatrics, 8, 561–574.Google Scholar
Banerjee, S. (2012). The challenge of evaluating mental health services for older people. International Journal of Geriatric Psychiatry, 26, 551–557.Google Scholar
Banerjee, S. and Chan, J. (2005). Organisation of old age psychiatric services. Psychiatry, 4, 4.Google Scholar
Bartels, S. J., Moak, G. S. and Dums, A. R. (2002). Models of mental health services in nursing homes: a review of the literature. Psychiatric Services, 53, 1390–1396.Google Scholar
Beecham, J., Cambridge, P., Hallam, A. and Knapp, M. (1993). The costs of domus care. International Journal of Geriatric Psychiatry, 8, 827–831.Google Scholar
Beecham, J. C. et al. (2004). Twelve years on: service use and costs for people with mental illness who left psychiatric hospital. Journal of Mental Health, 13, 363–377.Google Scholar
Bellelli, G. F. et al. (1998). Special care units for demented patients: a multicenter study. The Gerontologist, 38, 456–462.Google Scholar
BGS (2004). The specialist health needs of older people outside an acute hospital setting. BGS Best Practice Guidelines. London: British Geriatrics Society.Google Scholar
Brodaty, H. et al. (2003). Randomized controlled trial of different models of care for nursing home residents with dementia complicated by depression or psychosis. Journal of Clinical Psychiatry, 64, 63–72.Google Scholar
Carr, S. J. and Marshall, M. (1993). Innovations in long stay care for people with dementia. Reviews in Clinical Gerontology, 3, 157–167.Google Scholar
Castle, N. G. (2001). Relocation of the elderly. Medical Care Research and Review, 58, 291–333.Google Scholar
Challis, D. R., Reilly, S., Hughes, J., Burns, A., Gilchrist, H. and Wilson, K. (2002). Policy, organisation and practice of specialist old age psychiatry in England. International Journal of Geriatric Psychiatry, 17, 1018–1026.Google Scholar
Comas-Herrera, A. et al. (2011). Future costs of dementia-related long-term care: exploring future scenarios. International Psychogeriatrics, 23, 10.Google Scholar
Danermark, B. D., Ekstrom, M. E. and Bodin, L. L. (1996). Effects of residential relocation on mortality and morbity among elderly people. European Journal of Public Health, 6, 213–217.Google Scholar
Dean, R., Briggs, K. and Lindesay, J. (1993). The domus philosophy: a prospective evaluation of two residential units for the elderly mentally ill. International Journal of Geriatric Psychiatry, 8, 807–817.Google Scholar
Department of Health (2007). The National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care. London: HMSO.Google Scholar
Department of Health (2012a). Decision Support Tool for NHS Continuing Care. London: HMSO.Google Scholar
Department of Health (2012b). National Framework for NHS Continuing Healthcare. London: HMSO.Google Scholar
Draper, B. (2000). The effectiveness of old age psychiatry services. International Journal of Geriatric Psychiatry, 16, 687–703 Google Scholar
Draper, B., Meares, S. and McIntosh, H. (1998). A psychogeriatric outreach service to nursing homes in sydney. Australasian Journal on Ageing, 17, 184–186.Google Scholar
Fischer, C. E. et al. (2011). Determining the impact of a psychogeriatric outreach network in long-term care. Psychiatric Services, 62, 299–302.Google Scholar
Francis, R. (2013). Report of the MID Staffordshire NHS Foundation Trust Public Inquiry. London: HMSO.Google Scholar
Green, S., Girling, D. M., Lough, S., Ng, A. M. N. and Whitcher, S. K. (1997). Service provision for elderly people with long-term functional illness. Psychiatric Bulletin, 21, 353–357.Google Scholar
Hellman, S. J. (1988). The continuing care service. In Shore, M. F. G. and , J. E. (eds.), Serving the Chronically Mentally Ill in an Urban Setting. San Francisco: Jossey-Bass.Google Scholar
Holmes, D. et al. (1990). Impacts associated with special care units in long-term care facilities. Gerontologist, 30, 178–183.Google Scholar
Jolley, D. J., Koskey, N. and Holloway, F. (2004). Older people with long-standing mental illness: the graduates. Advances in Psychiatric Treatment, 10, 27–34.Google Scholar
Jonsson, L. (2004). Economic evidence in dementia. European Journal of Health Economics, (Suppl. 1), S30–S35.Google Scholar
Knapp, M., Beecham, J., Hallam, A. and Fenyo, A. (1993). The costs of community care for former long-stay psychiatric hospital residents. Health and Social Care, 1, 193–201.Google Scholar
Killian, E. (1970). Efects of geriatric transfers on mortality rates. Social Work, 15, 19–26.Google Scholar
Leff, J., Trieman, N., Knapp, M. and Hallam, A. (2000). The TAPS project: a report on 13 years of research 1985–1998. The Psychiatric Bulletin, 24, 165–168.Google Scholar
Macdonald, A. and Cooper, B. (2007). Long-term care and dementia services: an impending crisis. Age and Ageing, 36, 16–22.Google Scholar
Macpherson, R., Shepherd, G. and Edwards, T. (2004). Supported accommodation for people with severe mental illness: a review. Advances in Psychiatric Treatment, 18, 381–391.Google Scholar
Mangen, S. P. (1994). “Continuing care”: an emerging issue in European mental health policy. International Journal of Social Psychiatry, 40, 235–245.Google Scholar
Mann, S. A. and Cree, W. (1976). “New” long stay psychiatric patients: a national sample survey of fifteen mental hospitals in England and Wales 1972/73. Psychological Medicine, 6, 603–616.Google Scholar
Martin, M. D. et al. (2002). An evaluation of needs in elderly continuing-care settings. International Psychogeriatrics, 14, 9.Google Scholar
Mccrae, N. and Banerjee, S. (2010). The challenge of evaluating mental health services for older people. International Journal of Psychogeriatrics, 26, 551–557.Google Scholar
Mccrae, N. and Banerjee, S. (2011). Modernizing mental health services for older people: a case study. International Psychogeriatrics, 23, 9.CrossRefGoogle ScholarPubMed
Monroe-Devita, M. B. and Mohatt, D. E. (1999). The state hospital and the community: an essential continuum for persons with severe and persistent mental illness. New Directions for Mental Health Services, 84, 85–97.Google Scholar
Prince, M. and McDaid, D. (2007). Financing and funding mental health care services. In Knapp, M., McDaid, D., Mossialos, E. and Thornicorft, G. (eds.), Mental Health Policy and Practice Across Europe. London: OUP.Google Scholar
Roberts, J. et al. (2000). Specialized continuing care models for persons with dementia: a systematic review of the research literature. Canadian Journal on Aging, 19, 20.Google Scholar
Rovner, B. W., Steele, C. D., Shmuely, Y. and Folstein, M. F. (1996). A randomized trial of dementia care in nursing homes. Journal of the American Geriatrics Society, 44, 7–13.Google Scholar
Royal College of Psychiatrists (2006a). Job Description for Old Age Psychiatry Consultants. London: Royal College of Psychiatrists.Google Scholar
Royal College of Psychiatrists (2006b). Raising the Standard. London: Royal College of Psychiatrists.Google Scholar
Ryan, T. (2005). Using a whole system approach to service development in rehabilitation and continuing care services. The Mental Health Review, 10, 5.Google Scholar
Sloane, P. D., Lindeman, D. A., Phillips, C., Moritz, D. J. and Koch, G. (1995). Evaluating Alzheimer's special care units: reviewing the evidence and idenitfying potential sources of study bias. Gerontologist, 35, 103–111.Google Scholar
Thornicroft, G., Bebbington, P. and Leff, J. (2005). Outcomes for long-term patients one year after discharge from a psychiatric hospital. Psychiatric Services, 46, 1416–1422.Google Scholar
Trieman, N. and Leff, J. (1996). Difficult to place patients in a psychiatric hospital closure programme: the TAPS project 24. Psychological Medicine, 26, 765–774.Google Scholar
Trieman, N. and Leff, J. (2002a). Long term outcome of long stay psychiatric inpatients considered unsuitable to live in the community: TAPS project 44. Brtish Journal of Psychatry, 181, 428–432.Google Scholar
Trieman, N. and Leff, J. (2002b). Long-term outcomes of long stay psychiatric inpatients considered unsuitable to live in the community: TAPS project 44. British Journal of Psychiatry, 181, 428–432.Google Scholar
Trieman, N. and Wills, W. (1997). The psychogeriatric population: in transition from hospital to community based services. In Leff, J. (ed.), Care in the Community: Illusion or Reality? Chichester: John Wiley & Sons.Google Scholar
Wells, Y. J. and Jorm, A. F. (1987). Evaluation of a special nursing home unit for dementia sufferers: a randomised controlled comparison with community care. Australian and New Zealand Journal of Psychiatry, 21, 524–531.Google Scholar
WHO (2004). What is the Effectiveness of Old Age Mental Health Services? Denmark: World Health Organisation Health Evidence Network.Google Scholar
Wimo, A., Mattson, B., Krakau, I., Eriksson, T., Nelvig, A. and Karlsson, G. (1995). Cost-utility analysis of group living in dementia care. International Journal of Technology Assessment in Health Care, 11, 49–65.Google Scholar