Establishing a Geriatric Psychiatric Consultation in a VA Medical Center

Area of Science:

• Geriatric Psychiatry
• Consultation-Liaison Services
• Healthcare Management

Background:

• Veterans Administration Medical Center (VAMC) lacked a dedicated geriatric psychiatry service.
• Older, chronically ill veterans in intermediate care required psychiatric support.
• Existing services were insufficient for the geriatric population's needs.

Purpose of the Study:

• To establish and evaluate a Geriatric Psychiatry Consultation-Liaison Team (GPCLT) at a VAMC.
• To address psychiatric needs of elderly, medically ill veterans.
• To assess the team's impact and acceptance within the VAMC.

Main Methods:

• Formation of a multidisciplinary GPCLT (geriatric psychiatrist and social worker).
• Inclusion of diverse team members to address patient and staff concerns.
• Provision of consultation services to three intermediate-care units.

Main Results:

• High compliance rates with GPCLT recommendations (89%-98%).
• GPCLT selected as a training site for a Geriatric Psychiatry Fellowship Program.
• Increased allocation of social work hours to the GPCLT, indicating positive reception.

Conclusions:

• The established GPCLT was positively perceived by the VAMC and affiliated university.
• Multidisciplinary and diverse teams can effectively address geriatric psychiatric needs.
• The model provides a framework for similar healthcare settings.