A psychogeriatric outreach service to nursing homes in Sydney

Objective: To describe nursing home referrals to a multidisciplinary psychogeriatric outreach service. Methods: Retrospective case note audit of all nursing home referrals to a psychogeriatric outreach service in Sydney during 1996. Results: Of 106 referrals (mean age 76.9 years) from 22 nursing homes, 101 (95%) were assessed in the home. Behavioural problems were identified in 87 referrals (82%), usually being associated with chronic organic brain syndromes including dementia (n = 75, 86%). Aggressive behaviours (45%), agitation (32%), uncooperativeness (17%) and vocally disruptive behaviour (16%) were the most frequently identified problems. Depression was diagnosed in 33 referrals (31%), often comorbid with dementia (n =16). Multiple diagnoses were present in 58 (55%) referrals. The mast frequent treatment recommendations related to the use of nursing interventions (73%), psychotropic medication (70%), behavioural programs (29%) and family involvement (29%). Admission to the acute psychogeriatric ward occurred in 18 cases (17%). Conclusion: Psychogeriatric services should provide adequately staffed outreach teams to nursing homes.