Treatment of the elderly on a general hospital psychiatric short-stay unit

Two out of seven general hospital psychiatric units and the local mental hospital in the Vancouver area set an arbitrary age limit of 65 or 70 on admissions. Administrative reasons given for this include the presumed likelihood of organicity and chronicity, implying difficulties in disposition, and problems in maintaining an active therapeutic milieu with patients of other ages. Data are presented on 40 patients who were over the age of 65 and accounted for 8% of all admissions during 1977 to a Psychiatric Short-Stay Unit in a downtown general hospital. It was found that over three-quarters of the admissions had a primary functional diagnosis, that the mean duration of stay was 5.73 days, that two-thirds of the patients were able to return to their former place of living on discharge and that over one-half of the patients located on follow-up, 18 to 24 months later, were still residing in the same situation. During hospitalization, almost one-half of the patients received no psychotropic prescription and almost one-third, no physical prescription. Some of the psychosocial factors in the treatment program are presented. It is concluded that this preliminary study suggests that the administrative apprehensions in relation to treatment of the elderly in general hospital psychiatric units and mental hospitals can be countered.