[The "restraint" controversy in geriatric psychiatry. Focus study of factors influencing restraint measures]. / Problemfeld "Fixierung" in der Gerontopsychiatrie. Stichtagserhebung über Einflussfaktoren bewegungseinschränkender Massnahmen.

The study examines the relationship between frequency and duration of restraints in psychogeriatric inpatients with their respective diagnosis, medication, reason for restraints, and age as a socio-demographic variable. Entered in the analysis were data from 590 inpatients from a total of 29 institutions within the Federal Republic of Germany psychogeriatric facilities; this was 24.7% of all psychogeriatrically treated inpatients on the survey day in the said 29 institutions. The data were analyzed via simple multifactorial analyses of variance followed by multiple classification analysis (SPSS for Windows). Neither age nor diagnosis showed any differential influence on frequency or duration of restraints. Among the reasons for restrains hetero-aggression led to fewer and shorter restraints; self-aggression led to fewer but longer restraints. Restless patients were restrained more often but for shorter intervals. The main psychopharmacological strategy, while having no influence on the frequency of restraints, showed a marked influence on their duration; patients treated with low potent neuroleptics had particularly short intervals of restraints, whereas patients free from psychopharmacological agents showed distinctly longer intervals of restraints than the mean of restrained patients.

Measurement in psychogeriatrics.

Stake's concept of Responsive Evaluation is applied in evaluating the chain of psychogeriatric services of a general psychiatric hospital. Central to the approach presented are methodological considerations in describing individual treatment courses in their objective and subjective features. This can only be accomplished by establishing multidimensional strategies, incorporating biological, mental, psychological, and sociocultural aspects.

[Evaluation of day clinic treatment in geriatric psychiatry]. / Evaluationsansätze tagesklinischer Behandlung in der Gerontopsychiatrie.

Experiences with day hospitals for elderly patients in various countries have led to differing views regarding specific indications for this particular treatment mode. In a series of investigations we tried to clarify the place of a day hospital for elderly patients which is an integrated part of a psychiatric hospital within the total of psychiatric care of the elderly. As a result we are able to demonstrate a spectrum of indications for psychogeriatric day hospital treatment far broader than mentioned in the majority of the relevant literature of the UK and the Netherlands e.g. In this particular setting it is possible to give treatment not only to patients with dementia of differing degree but also to mild or moderately disturbed affective or schizophrene psychoses. Thus the psychogeriatric day hospital can be demonstrated to be a necessary link within the chain of psychiatric care of the elderly.