[Prevention in residential and nursing homes].

"Health" in the elderly describes an instable balance that exists between physical, psychological, and social factors as they pertain to the individual. The disruption of this balance can render the patient incapable of taking care of himself, thus requiring comprehensive care either at home or in an institution. Even the circumstance under which a transfer to an institution is made can have a negative effect on the subjects health; a careful analysis should be made of these factors before a decision to transfer is made. The following factors are critical in preventing or limiting the negative impact of either home or institutional care: architectural structuring of the environment organization of patient care type of medical care required type of physical therapy required It is a primary importance that the parties involved (patient and immediate family) be allowed to make and/or influence the decision on care and that they retain a feeling of personal responsibility for what happens. When a patient is institutionalized, he should be given the chance to continue his individual lifestyle whenever possible; his private sphere should be maintained. Disturbances that are caused by inappropriate changes in these structural factors should not be considered symptoms requiring psychopharmacological therapy.