From psychiatric hospitals to residential facilities: Characteristics of patients who benefited from an institutional partnership.
long psychiatric stay
nursing homes
older psychiatric patients
psychiatric hospitals
Journal
International journal of geriatric psychiatry
ISSN: 1099-1166
Titre abrégé: Int J Geriatr Psychiatry
Pays: England
ID NLM: 8710629
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
09
05
2022
accepted:
09
06
2022
pubmed:
2
7
2022
medline:
6
7
2022
entrez:
1
7
2022
Statut:
ppublish
Résumé
The population of older adults is growing fast, especially in Europe and Northern America. Old age is often associated with mental health comorbidities. Moreover, life expectancy of people suffering from psychiatric disorders has increased, but with age-related difficulties, such as loss of independence. This represents a challenge for public health policies, as this population requires specific care and living conditions. As a response, a convention was signed between living facilities for dependent elderly (EHPAD) and the GHU Paris Psychiatry and Neurosciences. The agreement included dedicated places in EHPAD for older patients with psychiatric disorders. The aim of the study was to describe the sociodemographic and clinical characteristics of those patients. We conducted a cross-sectional study among patients who applied for an EHPAD admission. Between 2016 and 2019, 163 patients applied for placement in an EHPAD, and 117 were admitted (72%). Applicants were 71 years old on average. Admitted patients were older than non-admitted and lived in different Parisian sectors. Among admitted patients, nine in 10 were single, divorced or widowed, and 64.3% were childless. Almost half of them were schizophrenic or had delusional disorders (46.9%), and 65.3% were considered as moderately dependent. At the time of the study, 89 patients still lived in EHPAD. Almost half of them had anxiety and depressive disorders (48.3%), 19.1% had cognitive disorders, and 42.7% manifested agitation. Our study highlighted older psychiatric patients' specificities regarding their admission status into long-term living facilities.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2022 John Wiley & Sons Ltd.
Références
United Nations Department of Economic and Social Affairs - UN DESA. Growing at a slower pace, world population is expected to reach 9.7 billion in 2050 and could peak at nearly 11 billion around 2100. https://www.un.org/development/desa/en/news/population/world-population-prospects-2019.html
Brutel C. La population de la France métropolitaine en 2050: un vieillissement inéluctable. Econ Stat. 2002;355(1):57-71.
Organisation Mondiale de la Santé (OMS). Santé mentale et vieillissement. https://www.who.int/fr/newsroom/factsheets/detail/santémentaleetvieillissement
Andrade LH, Benseñor IM, Viana MC, Andreoni S, Wang YP. Clustering of psychiatric and somatic illnesses in the general population: multimorbidity and socioeconomic correlates. Braz J Med Biol Res. 2010;43(5):483-491.
Lobo-Escolar A, Saz P, Marcos G, et al. Somatic and psychiatric comorbidity in the general elderly population: results from the ZARADEMP Project. J Psychosom Res. 2008;65(4):347-355.
Schuster JP, Manetti A, Aeschimann M, Limosin F. Troubles psychiatriques du sujet âgé: données épidémiologiques et morbi-mortalité associée. Gériatr Psychol Neuropsychiatr Vieil. 2013;11(2):181-185.
Jovelet G. Admission d'un sujet psychotique en Ehpad et continuité des soins psychiatriques. Soins Psychiatr. 2019;40(322):12-17.
Jovelet G. Psychose et vieillissement. Inf Psychiatr. 2010;86(1):39-47.
Cohen L, Desmidt T, Limosin F. La psychiatrie de la personne âgée: enjeux et perspectives. Ann Méd-Psychol Rev Psychiatr. 2014;172(9):781-784.
Pancrazi MP. L'organisation de la psychiatrie du sujet âgé en Île-de-France. L'information Psychiatr. 2015;91:8.
728 000 résidents en établissements d'hébergement pour personnes âgées en 2015. Direction de la recherche, des études, de l'évaluation et des statistiques (DREES). Etudes et Résultats. Numéro 1015; 2017. https://drees.solidarites-sante.gouv.fr/publications/etudes-et-resultats/728-000-residents-en-etablissements-dhebergement-pour-personnes
Le personnel et les difficultés de recrutement dans les Ehpad. Direction de la recherche, des études, de l'évaluation et des statistiques (DREES). Etudes et Résultats. Numéro 1067; 2018. https://drees.solidarites-sante.gouv.fr/publications/etudes-et-resultats/le-personnel-et-les-difficultes-de-recrutement-dans-les-ehpad
Jones TS, Matias M, Powell J, Jones EG, Fishburn J, Looi JCL. Who cares for older people with mental illness? a survey of residential aged care facilities in the Australian Capital Territory: implications for mental health nursing. Int J Ment Health Nurs. 2007;16(5):327-337.
Circulaire DHOS/O2/DGS/SD. 5D/2002/157 du 18 mars 2002 relative à l'amélioration de la filière de soins gériatriques. Direction de l'hospitalisation et de l'organisation des soins. https://solidarites-sante.gouv.fr/fichiers/bo/2007/07-04/a0040058.htm
La santé mentale et l'avenir de la psychiatrie. Rapport d'Information. Assemblée Nationale. 2013. https://www.assemblee-nationale.fr/14/rap-info/i1662.asp
Fédération hospitalière de France (FHF). Charte de partenariat entre les EHPAD et les établissements de psychiatrie; 2017. https://www.apmnews.com/documents/201710192004350.charte_CHARTE_DE_PARTENARIAT_ET_EPS.pdf
Collet J, de Vugt ME, Verhey FRJ, Engelen NJJA, Schols JMGA. Characteristics of double care demanding patients in a mental health care setting and a nursing home setting: results from the SpeCIMeN study. Aging Ment Health. 2018;22(1):33-39.
van den Brink AMA, Gerritsen DL, Voshaar RCO, Koopmans RTCM. Residents with mental-physical multimorbidity living in long-term care facilities: prevalence and characteristics. A systematic review. Int Psychogeriatr. 2013;25(4):531-548.
Aschbrenner K, Grabowski DC, Cai S, Bartels SJ, Mor V. Nursing home admissions and long-stay conversions among persons with and without serious mental illness. J Aging Soc Policy. 2011;23(3):286-304. https://doi.org/10.1080/08959420.2011.579511
Atramont A, Rigault A, Chevalier S, Leblanc G, Fagot-Campagna A, Tuppin P. Caractéristiques, pathologies et mortalité des résidents en établissements d'hébergement pour personnes âgées dépendantes (Ehpad) admis au cours du premier trimestre 2013 en France. Rev DÉpidémiologie Santé Publique. 2017;65(3):221-230.
Hert DEM, Correll CU, Bobes J, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10(1):52-77.
Scott D, Happell B. The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs. 2011;32(9):589-597.
Groupe National des Etablissements Publics Sociaux et Médico-sociaux (GEPSO). Enquête relative à l'accueil des personnes en situation de handicap en EHPAD; 2013.
Projection des populations âgées dépendantes: deux méthodes d'estimation. Direction de la recherche, des études, de l’évaluation et des statistiques [Internet]. [cité 25 nov 2021]. Disponible sur. https://drees.solidarites-sante.gouv.fr/publications/dossiers-solidarite-et-sante-1998-2016/projection-des-populations-agees-dependantes
Perte d'autonomie: à pratiques inchangées, 108 000 seniors de plus seraient attendus en Ehpad d'ici à 2030. Projections de population âgée en perte d'autonomie selon le modèle Lieux de vie et autonomie (LIVIA). Direction de la recherche, des études, de l'évaluation et des statistiques (DREES). Etudes et Résultats. Numéro 1172; 2020. https://drees.solidarites-sante.gouv.fr/publications/etudes-et-resultats/perte-dautonomie-pratiques-inchangees-108-000-seniors-de-plus
Pickard L. A growing care gap? The supply of unpaid care for older people by their adult children in England to 2032. Ageing Soc. 2015;35(1):96-123.
Gaymu J, Festy P, Poulain M. Future elderly living conditions in Europe L'avenir des conditions de vie des Européens. Institut national d'études démographiques; 2008.
Jovelet G. 5 - La politique de la psychiatrie à l'adresse des Ehpad. LOffre Soins En Psychiatr; 2017:97-124.
Olivera J, Benabarre S, Lorente T, et al. Prevalence of psychiatric symptoms and mental disorders detected in primary care in an elderly Spanish population. The PSICOTARD Study: preliminary findings. Int J Geriatr Psychiatry. 2008;23(9):915-921.
Seitz D, Purandare N, Conn D. Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review. Int Psychogeriatr. 2010;22(7):1025-1039.
Jang Y, Bergman E, Schonfeld L, Molinari V. Depressive symptoms among older residents in assisted living facilities. Int J Aging Hum Dev. 2006;63(4):299-315.
Jongenelis K, Pot AM, Eisses AMH, Beekman ATF, Kluiter H, Ribbe MW. Prevalence and risk indicators of depression in elderly nursing home patients: the AGED study. J Affect Disord. 2004;83(2-3):135-142.
Creighton AS, Davison TE, Kissane DW. The prevalence of anxiety among older adults in nursing homes and other residential aged care facilities: a systematic review. Int J Geriatr Psychiatry. 2016;31:555-566. https://doi.org/10.1002/gps.4378
Drageset J, Eide GE, Ranhoff AH. Anxiety and depression among nursing home residents without cognitive impairment. Scand J Caring Sci. 2013;27(4):872-881.
Perrin-Hayne J, Chazal J. Les personnes âgées en institution. Direction de la recherche, des études, de l'évaluation et des statistiques (DREES). Dossier Solidarité et santé. 2011;32.
Belbeze J, Gallarda T. Very late onset psychotic symptoms: psychosis or dementia? a phenomenological approach. A systematic review. Geriatr Psychol Neuropsychiatr Vieil. 2020;18(1):77-87.
Clesse C, Dumand I, Nassau E, et al. Représentations sociales du vieillissement des sujets porteurs de troubles psychiques: impacts et conséquences d'une double stigmatisation. NPG Neurol - Psychiatr - Gériatrie. 2016;16(95):291. https://doi.org/10.1016/j.npg.2016.02.001
Hirsch E, Ollivet C, Narquin RB, Leclercq B. Repenser ensemble la maladie d'Alzheimer: éthique, soin et société. Vuibert; 2007:255. (Espace éthique).
Petrucci C, Marcucci G, Carpico A, Lancia L. Nursing care complexity in a psychiatric setting: results of an observational study. J Psychiatr Ment Health Nurs. 2014;21(1):79-86.