Treatment goals in geropsychiatry

Each geriatric patient has observable problems which can generate treatment goals implemented by a treatment plan. Extensive record keeping would be required to document this tripartite scheme. In practice, either problem-oriented or goal-oriented records are used. Problem records tend to drift toward a goal concept, since problems are usually stated in only sufficient detail to serve as a guide to treatment. The results of a problem-oriented format are described for 143 state hospital patients whose mean age was 74 years. The most common number of problems was 5 per patient. Physical problems were the most frequent (N equals 456), followed by behavioral (N equals 203), thought-related (N equals 156), administrative (N equals 99), affective (N equals 69), and attitudinal (N equals 10). The author's experience with both systems leaves them with preference for the problem-oriented system with geriatric patients since physical problems are so numerous.