8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison

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Bristol & South GloucestershireOlder Peoples Mental Health Liaison

8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

Typical district general hospital with 500

beds will admit 5000 older people per year3000 will suffer a mental disorder.

On average, older people will occupy 330

of 500 beds at any time and 220 of thesewill have a mental disorder.

Who Cares Wins. Improving the outcome for older people admitted to thegeneral hospital: Guidelines for the development of Liaison Mental Health

Services for older people. 2005

8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

This means that the acute hospital will

have at least four times as many olderpeople with mental disorder on its wardsas the older peoples mental healthservice has on theirs.

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

Three disorders: depression, dementia

and delirium account for 80% of this

mental disorder.

In a 500 bed hospital:

96 patients will have depression 102 have dementia 66 have delirium

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

Mental disorder in this population is an

independent predictor of poor outcome:

increased mortality greater length of stay

loss of independent function higher rates of institutionalisation

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

What is needed?

improved recognition (50% unidentified) improved assessment

improved treatment and care management

improved partnerships between health careand social care

improved education and training of staff

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

Widow, 80, lives alone

Mild dementia (not identified)

Chest infection

GP sends to hospital

hospital acquired confusion

Stays in for 3 months

Despondent

Reduced mobility, weight loss,unsafe to return home

Discharged to a care home

www.intercom.net/~terrypl/photographypage

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

Widow, 80, lives alone

Mild dementia (not identified)

Chest infection

GP sends to hospital

hospital acquired confusion

Joint working with ward, liaison and

social work departments

Discharged home with home caresupport after 10 days

www.plunge.com

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

What we do:

triaged by mental health liaison nurse discussed in team meeting with Consultant

reassurance, management and medication

collaboration with social work department on:

risks and needs

capacity to make decisions

mental health support on discharge (if needed)

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

An ideal team would include:

nursing medical

occupational therapy

psychology physiotherapy

social work

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Bristol & South Gloucestershire

Older Peoples Mental Health LiaisonBenefits for the patient:

dignity

independence

reduced length of stay (by 3.6 DAYS in BRI)

early access to treatment and care:

anti-dementia drugs

medication management

support for carers

social care

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Bristol & South Gloucestershire

Older Peoples Mental Health LiaisonBenefits for the hospital:

increases bed availability

reduced length of stay, cost-effective

does not discriminate by age

basic care

liaison services

sense of mastery for staff

training, education, skills, job satisfaction

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Bristol & South Gloucestershire

Older Peoples Mental Health Liaison

You decide!