RESUMO
BACKGROUND: The French government gave a consensual definition of reinforced care units for Behavioral and Psychological Symptoms in Dementia (BPSD) within the project "Plan Alzheimer 2008/2012." These Cognitive and Behavioral Units (CBU) differ in resources from the traditional reference units for BPSD management, the Acute Psychogeriatric Units (APU). However, a better understanding of their operational specificities may enhance the CBU and APU synergies. OBJECTIVES: To describe one of the first CBU experiments, with regard to preexisting BPSD management in an APU in the same geriatric hospital. PARTICIPANTS: A total of 129 patients with BPSD, 35 from the CBU and 94 admitted to the APU before opening the colocated CBU. RESULTS: Patients from the CBU often showed comorbidities and a lower nutritional status, but these conditions were more frequent in the APU (P ≤ 10(-4)). Severe dementia, night time and aberrant motor behavior, and agitation were more frequent in the CBU (P ≤ 0.0015). In both the units, about 80% of patients were improved without increased use of psychotropic medications and there was a high discharge rate back home of about 30%. CONCLUSIONS: These findings that are still preliminary support a particular role for the CBU for elderly patients showing the most advanced dementia and disruptive BPSD. Colocated APU and CBU may allow for more effective integration of medical and psychiatric care in elderly patients with BPSD with frequent comorbidities.
Assuntos
Demência/psicologia , Demência/terapia , Geriatria/estatística & dados numéricos , Unidades Hospitalares/estatística & dados numéricos , Idoso de 80 Anos ou mais , Demência/complicações , Feminino , Geriatria/métodos , Geriatria/organização & administração , Unidades Hospitalares/organização & administração , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Transtornos Mentais/etiologia , Transtornos Mentais/terapia , Projetos Piloto , Psicologia/métodos , Psicologia/organização & administração , Psicologia/estatística & dados numéricosRESUMO
If it is common place to claim that old age is not a disease, however the losses and mournings related to that stage of life generate the production of acute psychopathological disorders. A few of them will be approached and treated as emergencies and required from the physician a good command of their existence and of specificities: atypical depressive disorders stressed by the risk of suicide, sits of delusions some themes of which are typical of senesence, excitement and aggressiveness inherent to dementia. As to the ill-treatment of the elderly often under-diagnosed, it requires urgent interventions both clinical and even juridical.
