The planning and organization of services for older adults

Pamela S. Melding

New Oxford Textbook of Psychiatry (2 ed.)

Edited by Michael Gelder, Nancy Andreasen, Juan Lopez-Ibor, and John Geddes

Publisher:: Oxford University Press

Print Publication Date:: Feb 2012

Print ISBN-13:: 9780199696758

Published online:: Oct 2012

DOI:: 10.1093/med/9780199696758.001.0001

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Contents

Front Matter
- Preface to the second edition
- Preface to the first edition
- Acknowledgements from the first edition
- Contributors list
Section 1 The Subject Matter of and Approach to Psychiatry
- 1.1 The patient's perspective
- 1.2 Public attitudes and the challenge of stigma
1.3 Psychiatry as a worldwide public health problem
- 1.3.1 Mental disorders as a worldwide public health issue
- 1.3.2 Transcultural psychiatry
1.4 The history of psychiatry as a medical specialty
1.5 Ethics and values
- 1.5.1 Psychiatric ethics
- 1.5.2 Values and values-based practice in clinical psychiatry
1.6 The psychiatrist as a manager
1.7 Descriptive phenomenology
1.8 Assessment
- 1.8.1 The principles of clinical assessment in general psychiatry
- 1.8.2 Assessment of personality
- 1.8.3 Cognitive assessment
- 1.8.4 Questionnaire, rating, and behavioural methods of assessment
1.9 Diagnosis and classification
1.10 From science to practice
Section 2 The Scientific Basis of Psychiatric Aetiology
- 2.1 Brain and mind
- 2.2 Statistics and the design of experiments and surveys
2.3 The contribution of neurosciences
- 2.3.1 Neuroanatomy
- 2.3.2 Neurodevelopment
- 2.3.3 Neuroendocrinology
- 2.3.4 Neurotransmitters and signalling
- 2.3.5 Neuropathology
- 2.3.6 Functional positron emission tomography in psychiatry
- 2.3.7 Structural magnetic resonance imaging
- 2.3.8 Functional magnetic resonance imaging
- 2.3.9 Neuronal networks, epilepsy, and other brain dysfunctions
- 2.3.10 Psychoneuroimmunology
2.4 The contribution of genetics
- 2.4.1 Quantitative genetics
- 2.4.2 Molecular genetics
2.5 The contribution of psychological science
- 2.5.1 Developmental psychology through infancy, childhood, and adolescence
- 2.5.2 Psychology of attention
- 2.5.3 Psychology and biology of memory
- 2.5.4 The anatomy of human emotion
- 2.5.5 Neuropsychological basis of neuropsychiatry
2.6 The contribution of social sciences
- 2.6.1 Medical sociology and issues of aetiology
- 2.6.2 Social and cultural anthropology: salience for psychiatry
2.7 The contribution of epidemiology to psychiatric aetiology
Section 3 Psychodynamic Contributions to Psychiatry
- 3.1 Psychoanalysis: Freud's theories and their contemporary development
- 3.2 Object relations, attachment theory, self-psychology, and interpersonal psychoanalysis
- 3.3 Current psychodynamic approaches to psychiatry
Section 4 Clinical Syndromes of Adult Psychiatry
- 4.1 Delirium, dementia, amnesia, and other cognitive disorders
- 4.2 Substance use disorders
- 4.3 Schizophrenia and acute transient psychotic disorders
- 4.4 Persistent delusional symptoms and disorders
- 4.5 Mood disorders
- 4.6 Stress-related and adjustment disorders
- 4.7 Anxiety disorders
- 4.8 Obsessive–compulsive disorder
- 4.9 Depersonalization disorder
- 4.10 Disorders of eating
  - 4.10.1 Anorexia nervosa
  - 4.10.2 Bulimia nervosa
- 4.11 Sexuality, gender identity, and their disorders
- 4.12 Personality disorders
- 4.13 Habit and impulse control disorder
  - 4.13.1 Impulse control disorders
  - 4.13.2 Special psychiatric problems relating to gambling
- 4.14 Sleep–wake disorders
- 4.15 Suicide
- 4.16 Culture-related specific psychiatric syndromes
Section 5 Psychiatry and Medicine
- 5.1 Mind–body dualism, psychiatry, and medicine
- 5.2 Somatoform disorders and other causes of medically unexplained symptoms
- 5.3 Medical and surgical conditions and treatments associated with psychiatric disorders
- 5.4 Obstetric and gynaecological conditions associated with psychiatric disorder
- 5.5 Management of psychiatric disorders in medically ill patients, including emergencies
- 5.6 Health psychology
- 5.7 The organization of psychiatric services for general hospital departments
Section 6 Treatment Methods in Psychiatry
- 6.1 The evaluation of treatments
  - 6.1.1 The evaluation of physical treatments
  - 6.1.2 The evaluation of psychological treatment
6.2 Somatic treatments
- 6.2.1 General principles of drug therapy in psychiatry
- 6.2.2 Anxiolytics and hypnotics
- 6.2.3 Antidepressants
- 6.2.4 Lithium and related mood stabilizers
- 6.2.5 Antipsychotic and anticholinergic drugs
- 6.2.6 Antiepileptic drugs
- 6.2.7 Drugs for cognitive disorders
- 6.2.8 Drugs used in the treatment of the addictions
- 6.2.9 Complementary medicines
- 6.2.10 Non-pharmacological somatic treatments
- 6.3 Psychological treatments
- 6.4 Treatment by other professions
- 6.5 Indigenous, folk healing practices
Section 7 Social Psychiatry and Service Provision
- 7.1 Public policy and mental health
- 7.2 Service needs of individuals and populations
- 7.3 Cultural differences care pathways, service use, and outcome
- 7.4 Primary prevention of mental disorders
- 7.5 Planning and providing mental health services for a community
- 7.6 Evaluation of mental health services
- 7.7 Economic analysis of mental health services
- 7.8 Psychiatry in primary care
- 7.9 The role of the voluntary sector
- 7.10 Special problems
Section 8 The Psychiatry of Old Age
- 8.1 The biology of ageing
- 8.2 Sociology of normal ageing
- 8.3 The ageing population and the epidemiology of mental disorders among the elderly
- 8.4 Assessment of mental disorder in older patients
- 8.5 Special features of clinical syndromes in the elderly
  - 8.5.1 Delirium in the elderly
  - 8.5.1.1 Mild cognitive impairment
- 8.5.2 Substance use disorders in older people
- 8.5.3 Schizophrenia and paranoid disorders in late life
- 8.5.4 Mood disorders in the elderly
- 8.5.5 Stress-related, anxiety, and obsessional disorders in elderly people
- 8.5.6 Personality disorders in the elderly
- 8.5.7 Suicide and deliberate self-harm in elderly people
- 8.5.8 Sex in old age
- 8.6 Special features of psychiatric treatment for the elderly
- 8.7 The planning and organization of services for older adults
Section 9 Child and Adolescent Psychiatry
- 9.1 General issues
- 9.2 Clinical syndromes
- 9.3 Situations affecting child mental health
- 9.4 The child as witness
- 9.5 Treatment methods for children and adolescents
Section 10 Intellectual Disability (Mental Retardation)
- 10.1 Classification, diagnosis, psychiatric assessment, and needs assessment
- 10.2 Prevalence of intellectual disabilities and epidemiology of mental ill-health in adults with intellectual disabilities
- 10.3 Aetiology of intellectual disability: general issues and prevention
- 10.4 Syndromes causing intellectual disability
- 10.5 Psychiatric and behaviour disorders among mentally retarded people
- 10.6 Methods of treatment
- 10.7 Special needs of adolescents and elderly people with intellectual disability
- 10.8 Families with a member with intellectual disability and their needs
- 10.9 The planning and provision of psychiatric services for adults with intellectual disability
Section 11 Forensic Psychiatry
- 11.1 General principles of law relating to people with mental disorder
- 11.2 Psychosocial causes of offending
- 11.3 Associations between psychiatric disorder and offending
- 11.4 Mental disorders among offenders in correctional settings
- 11.5 Homicide offenders including mass murder and infanticide
- 11.6 Fraud, deception, and thieves
- 11.7 Juvenile delinquency and serious antisocial behaviour
- 11.8 Child molesters and other sex offenders
- 11.9 Arson (fire-raising)
- 11.10 Stalking
- 11.11 Querulous behaviour: vexatious litigation, abnormally persistent complaining and petitioning
- 11.12 Domestic violence
- 11.13 The impact of criminal victimization
- 11.14 Assessing and managing the risks of violence towards others
- 11.15 The expert witness in the Criminal Court: assessment, reports, and testimony
- 11.16 Managing offenders with psychiatric disorders in general psychiatric services
- 11.17 Management of offenders with mental disorder in specialist forensic mental health services
End Matter
- Index: A
- Index: B
- Index: C
- Index: D
- Index: E
- Index: F
- Index: G
- Index: H
- Index: I
- Index: J
- Index: K
- Index: L
- Index: M
- Index: N
- Index: O
- Index: P
- Index: Q
- Index: R
- Index: S
- Index: T
- Index: U
- Index: V
- Index: W
- Index: X
- Index: Y
- Index: Z

Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

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The planning and organization of services for older adults

Chapter:: The planning and organization of services for older adults

Author(s):: Pamela S. Melding

DOI:: 10.1093/med/9780199696758.003.0207

Worldwide, population ageing is driving the development of mental health services for older adults. Finite resources, burgeoning costs, expanding therapeutic repertoires, and increasing consumer interest in involvement in health care is challenging health organizations to develop effective, efficient, and economic patient- centred services for older adults. Fundamentally, the quality of services is dependent on health personnel working with their patients and other providers, towards shared aims of improving health outcomes and quality of life. Clinicians’ adaptability, flexibility, responsiveness, availability for patients, and willingness to collaborate are the keys to success in developing future services for older adults.

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Edited by Michael Gelder, Nancy Andreasen, Juan Lopez-Ibor, and John Geddes

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The planning and organization of services for older adults

Pamela S. Melding