Geriatric psychiatric patients benefit from closely networked care

04.03.2015 18:31

The central association ZNS (SPiZ) is calling for closely networked care for patients with neurological and psychiatric diseases of old age on the occasion of the twelfth congress of the German Society for Geriatric Psychiatry and Psychotherapy eV (DGGPP). “Undercare and incorrect care are not just slogans, but a sad reality - this particularly affects patients with neurological and psychiatric diseases in old age,” said the chairman of the SPiZ, Dr. Frank Bergmann, today in Essen.

Bergmann gives three examples that illustrate the particular importance of structured care networks, especially in geriatric psychiatry:

– When diagnosing dementia early, the focus should be on coordinated collaboration with the family doctor. As part of an early specialist medical assessment, psychiatrists, neurologists or neurologists can then rule out treatable causes and initiate stage-appropriate therapy for dementia. Bergmann pointed out that, for example, according to a study by the IGES Institute Berlin, only around half of patients with dementia are diagnosed or cared for by a specialist. Many demented patients are not treated at all or treated far too late. The psychiatric and psychotherapeutic care of patients with depression in old age is also usually inadequate.

– Patients with diseases of the central nervous system (CNS) are often unable to make and keep appointments with a specialist or psychotherapist themselves. A coordinated clinical treatment path involving general practitioners, specialists and geriatric psychiatrists, but also nursing and social services, could provide relief here.

– Collaboration between psychiatrists or neurologists with family doctors and nursing services as well as neurologists is also necessary in the treatment of dementia-related behavioral disorders, especially in the area of home care. For example, coordinated primary care and specialist home care reduces inpatient stays, not least by avoiding polypharmacy. Uncoordinated treatment with many medications often leads to side effects, including in the central nervous system. Fatigue, deterioration of cognitive functions or even an increased risk of falling can result.

Quite a few nursing home residents suffered from mental illnesses such as dementia or depression. “But there are often too few colleagues in the area to adequately supply all the homes. However, these patients often no longer have the opportunity to find a doctor themselves and are dependent on visiting specialists,” explained Bergmann. A comprehensive regional care network, which also includes nursing homes, could better ensure patient care. In addition, advice on topics such as care law, treatment or health care power of attorney could also be coordinated and provided online, as well as specialist medical advice, possibly including specific diagnostic tests, on the delicate question of fitness to drive, which is often rightly asked, especially by relatives.