An Outreach Activity for the Elderly in Psychiatry(Workshop Therapeutic Progress in Neurological Diseases)

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  • 高齢者への精神科アウトリーチ(ワークショップ:神経疾患診療の進歩,2012年,第53回日本心身医学会総会ならびに学術講演会(鹿児島))
  • 高齢者への精神科アウトリーチ
  • コウレイシャ エ ノ セイシンカ アウトリーチ

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Abstract

The elderly easily fall into multiple problems on psychological, physical, economical, and social issues in their daily lives. We have already known that their disorders are partially improved by changing their habits in daily life such as taking healthy food, supplements and medicines. However, solutions through typical medical model against aging involving dementia and chronic regressive changes are inadequate. Now we need to construct the holistic care model based on subjects of the development stages in life history such as life functional model. It seems that all clinical health care workers are demanded to change their attitude from diagnosis and therapy to spending time together as the family of society. And the all-around development in holistic care model must be achieved through this attitude. The activity on Comprehensive Geriatric Assessment : CGA is essential. Out-reaching care programs performed by multi professions are examples for that. This paper introduces the activity in Tanegashima : one of the remote islands in Japan where I was engaged in health care work for psychiatry to help future progress in the geriatric care. That is Community Oriented System of Medical Intent Care for Psychiatry : COSMIC-P. COSMIC-P named after the island's location where the "COSMIC" rockets in Japan are launched. Generally, we experience good-relationships with patients and their family, and provide good services to them. Additionally, health care workers can have better motivation to geriatric care through this activity. But income and expenditure balance is a problem when a hospital in psychiatry tries to change its form from hospitalization to care in their community. A short time summary from initial sessions to 14 months for COSMIC-P activity reveals some important and affirmative aspects in that island where the population was about 32000 people and the aging rate was estimated about 32% around 2011. The number of clients was increasing every month but finally subtle. At the last session, 74 subjects for the activity were over 65 years in 88 persons, with 58% physical complication rates. Diagnosis of the most of clients were dementia (62/74 persons) especially Alzheimer type (30/62 persons). The common degree of dementia in that group was ranged from moderate to severe, FAST stage 4 or 5. Then the care performed by the activity resulted in some improvements, CGI-I 3.5. I hope this paper shows that one of the good solutions for geriatric care in the present time is outreach care.

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