Geriatric Mental Health Care最新文献

Against the background of population ageing and the moving of the baby boomer cohorts into the highest ages, Germany will face a rising number of dementia cases. A brief summary of the past and future demographic development as well as a discussion of the explaining factors of the age-specific trajectory of dementia prevalence rates based on routine claims data from the public sickness fund AOK are given. A forecast estimates the future number of dementia cases in Germany in 2050. Seventy percent of the increase are due to the rising life expectancy, while 30% are the result of the changing age structure of the German population.

Like many other countries in the world, the Netherlands faces the challenges of the rising numbers of frail elderly resulting in high rates of institutionalization. This paper gives an overview of the specific Dutch approach in long-term care settings with a focus on people with mental health problems like dementia, depression and a combination of physical and psychiatric problems. The Netherlands is the only country in the world with specially trained Elderly Care Physicians (ECP’s), which specialty has a long academic tradition and therefore has academic networks to establish an infrastructure for teaching purposes, but also for multicenter research and development of best practices. The paper further emphasizes on dementia care and different care concepts like emotion oriented care and snoezelen with their evidence of effectiveness and ends with care for people with depression.

The majority of geropsychiatric patients live in the community and are supported by their families or by professional care providers. The multidimensional nature of the problems and the complexity of the professional care system require psychogeriatric-specific planning and regulation of health care services. In the majority of cases, medical care is provided by general practitioners. The belief that the supply of general psychiatric services alone can satisfy the demand for geropsychiatric care is not realistic. As an example, the situation of dementia patients highlights the problems of medical care in the geriatric psychiatry sector. It must be assumed that the patients will only meet demographic and epidemiological expectations where there is a functioning specific psychogeriatric health care. In the long term – due to the installation of efficient care networks – the significance of the inpatient sector will decline. In the meantime, there is a need for psychogeriatric centers and for competent inpatient care as an obligatory part of the regional mandatory care system. In order to keep up with international developments, the adequate and competent medical care of mentally ill elderly people in Germany urgently demands for the establishment of a psychogeriatric focus in the framework of psychiatric professional qualification.

In Switzerland the majority of elderly persons with psychiatric disorders live in their own families or in their own community and receive – if necessary – support by professional care services. The demographic development, the multi-dimensional nature of the care of the elderly, and the complexity of the in-patient and out-patient provision of services necessitates a specifically interdisciplinary approach involving medical, geriatric, and geronto-psychiatric concepts and interventions. Strategies adopted to ensure a high standard of care provision must be coordinated at the appropriate levels of responsibility which include the federal, the cantonal, and the communal levels. A further basic necessity is the inclusion of patients, their families, special interest groups, and advocacy groups especially in the treatment of dementia disorders.

This paper describes the principles and capabilities of health care services provided to elderly people with disabilities in Poland, particularly affected by mental disorders. We show that organizational forms of care for people with dementia do not always meet the needs of such patients and their carers. This requires an increase in the number of preventive and promotional programs and the number of institutions offering professional help. Difficulties with the organization and financing of care for patients with mental disorders and serious medical expenses are one of the biggest challenges for health care systems not only in Poland but also across the world.