Bristol & South Gloucestershire Older People’s Mental Health Liaison

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Bristol South Gloucestershire Older Peoples
Mental Health Liaison
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Bristol South Gloucestershire Older Peoples
Mental Health Liaison

Typical district general hospital with 500 beds
will admit 5000 older people per year 3000 will
suffer a mental disorder. On average, older
people will occupy 330 of 500 beds at any time
and 220 of these will have a mental disorder.
Who Cares Wins. Improving the outcome for older
people admitted to the general hospital
Guidelines for the development of Liaison Mental
Health Services for older people. 2005
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• This means that the acute hospital will have at
  least four times as many older people with mental
  disorder on its wards as the older peoples
  mental health service has on theirs.

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• 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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• 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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• What is needed?
• improved recognition (50 unidentified)
• improved assessment
• improved treatment and care management
• improved partnerships between health care and
  social care
• improved education and training of staff

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• 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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• 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 care support after 10
  days

www.plunge.com
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• 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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• An ideal team would include
• nursing
• medical
• occupational therapy
• psychology
• physiotherapy
• social work

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• Benefits 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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• Benefits 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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• You decide!