A descriptive survey of acute bed usage for dementia care in old age psychiatry.

OBJECTIVE: To examine the reasons why patients are admitted to acute dementia care assessment beds in one large district health authority (Leicestershire). DESIGN: A prospective questionnaire was completed by the RMO for every admission to dementia care assessment beds over a 6-month survey period. RESULTS: The most common reasons for admission were behavioural problems (most frequently aggression). Other common reasons included self-neglect, psychotic symptoms and comorbidity with functional psychiatric illness. Classification of patients by their social circumstances before admission indicated different patterns of presenting features, length of stay and place of discharge. CONCLUSIONS: The need for acute beds is demonstrated by the large number of emergencies, with a significant proportion admitted under the Mental Health Act, the type and complexity of reasons for admission and the preceding involvement of community mental health services. Multi-axial classifications including presenting problems and social circumstances, rather than the traditional method of looking purely at diagnosis, may offer some advantage in assessing outcomes.

Job satisfaction and stress in staff working in a specialist psychiatric unit for the elderly following relocation from a traditional psychiatric hospital setting.

AIM: This study examines self-reported stress and job satisfaction of staff working in a specialist psychiatric unit for the elderly (n = 79) following relocation from a traditional psychiatric hospital setting (n = 66). The levels of reported stress were examined in relation to the two staff groups before and after the relocation, and in relation to data available for similar occupational groups. METHODS: Stress and job satisfaction levels were surveyed using the Occupational Stress Indicator. The analysis of data included t-test for independent groups. FINDINGS: The results suggested that that there were no significant changes in the patterns of the staff groups' experience of stress at the traditional psychiatric hospital and later at the new purpose-built unit. However, it was felt that there may have been different factors contributing to staff stress at the two time-points. The staff groups in this survey reported similar, and in some areas more positive levels of occupational stress than both community and other health authority samples. However, it was felt that, due to the limited response rate of staff at both times (63 and 59%), the results may be an underestimate of stress levels. In the absence of a measure of general health and symptomatology it was not possible to assess the impact of stress levels on the psychological well-being of staff. CONCLUSIONS: Routine audit of staff stress would be beneficial to identify potential for staff training, and individual professional development plans. This is particularly important in view of the current difficulties both locally and nationally in the recruitment and retention of qualified staff in this speciality.