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© 1996 Oxford University Press

research-article

No Way Out: The Delayed Discharge of Elderly Mentally III Acute and Assessment Patients in North and South Thames Regions

JONATHAN KOFFMAN1, NAOMI J. FULOP1, DAVID PASHLEY2 and KEN COLEMAN2

1Department of Public Health, Kensington & Chelsea and Westminster Health Authority 50 Eastbourne Terrace, London W2 6LX
2North Thames Region 40 Eastbourne Terrace London W2 3QR

We examined the characteristics of patients occupying elderly-mentally-ill acute and assessment beds in all mental health units within North and South Thames Regions; the proportion of patients defined as no longer requiring acute care (inappropriately located); and the unmet need for alternative service provision these patients required. Of the 1510 patients surveyed, 24.4% (n = 368) were defined as inappropriately located. For inappropriately located patients unable to be discharged home most (52.8%, n = 154) required residential care or nursing-home provision. A large proportion of these patients were very elderly (aged 85+ years), had dementia, and required high levels of supervision. This study indicates that purchasers, mental health service managers and social services departments should devise a more appropriate mix of inpatient and community provision. Particular emphasis needs to be placed on the greater provision of residential care and nursing homes with an appropriate skill-mix to care for this complex care group.

Received December 28, 1995;
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