The benefits of psychiatric hospitalization for older nursing home residents.

OBJECTIVE

To examine the demographic characteristics and treatment outcomes of nursing home residents admitted to a geropsychiatric inpatient unit.

DESIGN

A retrospective cohort design based on an ongoing data base effort.

SETTING

The geropsychiatric inpatient unit of the Houston Veterans Affairs Medical Center Hospital.

PARTICIPANTS

All admissions to the unit from nursing homes during an 18-month period.

MEASUREMENTS: Mini-Mental State Examination, Brief Psychiatric Rating Scale, Hamilton Rating Scale for Depression, Cohen-Mansfield Agitation Inventory, Rating Scale for Side Effects, and Global Assessment of Functioning were administered on admission and discharge.

RESULTS

Paired t tests comparing change scores revealed significant decreases in general psychiatric symptoms (P < .001), depression (P < .001), and agitation (P < .001); significant improvement in global functioning (P < .001); with no significant changes in cognitive status (P = .485) or side effects (P = .120). When the patients were subgrouped according to reasons for admission, paired t tests revealed decreases in violence (CMAI Factor 1; P = .000), psychosis (BPRS thought disorder scale; P = .000 and hostility subscale; P < .008), and depression (HAM-D; P = .002). Four patients were discharged to less restrictive environments, all with chronic mental illnesses.

CONCLUSION

Inpatient psychiatric hospitalization significantly benefits nursing home residents with and without dementia who are admitted for severe behavior problems.