On-site geropsychiatric services to guests of residential homes

During a 7.5-year liaison between a 152-bed residential (multi-level care) home for the aged and a psychiatrist-social worker team, 58 of the 339 residents were referred to the team. With increasing expertise of the staff of the home and with early psychosocial intervention, the need for psychiatric hospitalization dropped virtually to zero. Of the 23 persons currently referred, 65 percent are recovering well with psychiatric-social-nursing support and psychotropic drugs; another 26 percent are achieving significant behavioral improvement without change in their chronic mental confusion. The average time required of the psychiatrist proved to be four hours monthly; telephone consultations averaged two hours monthly. About half an hour per week was spent in conference between the psychiatrist and social worker, to allow achievement of mutual goals. Appropriate one-site psychiatric-social therapy permitted continuity of care and usually prevented threatened disruption of the residnets' lives. Thus the modest investment of time by the psychiatrist and social worker improved the level of life satisfaction, not only for the patients but for the Home.