ABSTRACT
BACKGROUND AND OBJECTIVES: Coercion in psychiatry is legally tolerated as a last resort. The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercion. These risk factors in geriatric psychiatric inpatient settings are not well known, especially regarding seclusion. Through examining the prevalence of coercion and patients' characteristics, this study aims to identify risk factors for coercion in elderly people. METHODS: The use of coercion in the geriatric psychiatry division of Geneva University Hospital in 2017 was retrospectively analyzed. The incidence rate ratios were estimated with multivariable Poisson regressions to assess risk factors for coercion. RESULTS: Eighty-one of 494 patients (16.4%) experienced at least one coercive measure during their stay (mainly seclusion). The risk factors for coercion were younger age, male gender, being divorced or married, cognitive disorders, high item 1 of the Health of the Nation Outcome Scales (HoNOS) score (overactive, aggressive, disruptive or agitated behavior) at admission, previous psychiatric hospitalizations and involuntary referrals from the emergency department. Other disorders and global HoNOS scores were not associated with the use of coercion. CONCLUSION: Higher risks of coercion were outlined in men with cognitive disorders, agitated behaviors, and previous psychiatric hospitalizations. They differed from those observed in younger adults in terms of age, civil status, disorders, global HoNOS scores and referrals. Therefore, geriatric psychiatric populations should be specifically investigated for the development of interventions aiming coercion reduction.
Subject(s)
Mental Disorders , Psychiatry , Adult , Aged , Coercion , Geriatric Psychiatry , Hospitals, Psychiatric , Humans , Inpatients , Male , Mental Disorders/epidemiology , Mental Disorders/therapy , Patient Isolation , Prevalence , Restraint, Physical , Retrospective Studies , Risk FactorsABSTRACT
Sexuality in an important aspect of human life at all ages and expressing it is an essential human need regardless of age. Society is ageing and people are living longer life. As the sexuality continues during the entire life many factors affect the sexuality in older population. The aging process and remodeling of the life style play an important role in the alteration of sexual needs and sexual behavior in advanced age. Sexuality expression is considered as a fundamental mental health need of all individuals, regardless of gender and age. The majority of healthcare professionals do not proactively discuss sexuality issues with old age patients, and this requires further attention.
La sexualité est un aspect important de la vie humaine à tous les âges et son expression est un besoin humain essentiel, quel que soit l'âge. La société vieillit et les gens vivent plus longtemps. Alors qu'elle se poursuit tout au long de la vie, de nombreux facteurs influent sur la sexualité des personnes âgées. Le processus de vieillissement et le remodelage du mode de vie jouent un rôle important dans la modification des besoins sexuels et du comportement sexuel à un âge avancé. L'expression de la sexualité est considérée comme un besoin fondamental de la santé mentale de tous les individus, sans distinction de sexe et d'âge. La majorité des professionnels de la santé ne discutent pas de manière proactive des problèmes de sexualité avec les personnes âgées, ce qui nécessite une plus grande attention.
Subject(s)
Aging/psychology , Cognitive Dysfunction , Geriatrics , Sexuality , Aged , Humans , Sexual BehaviorABSTRACT
Geropsychiatry is a branch of psychiatry which focuses on the mental disorders of elderly people. Also known as psychiatry of old age, geriatric psychiatry or psychogeriatrics, this discipline provides people of retirement age with the psychological, somatic and social care which their health requires.
