Staff awareness of the application of Mental Health and Guardianship Legislation in the care of hospitalised older persons.

OBJECTIVE: The study aimed to survey hospital staff knowledge of the application of the Mental Health Act 2007 (NSW) (MHA) and the Guardianship Act 1987 (NSW) (GA) in the care and treatment of older persons in a teaching hospital in Sydney. Method Over a two-month period in 2017, a survey questionnaire was distributed to staff involved in older persons' care across the hospital. RESULTS: The majority of the hospital staff demonstrated basic theoretical knowledge of both the GA (76%) and of the MHA (84.5%). Fewer (64.5%) appeared to understand the practical application of the MHA in the hypothetical clinical situations. An even lower proportion of staff appeared to understand the application of the GA either to obtain consent for medical treatment or to appoint a guardian through the Guardianship Division of the NSW Civil and Administrative Tribunal (NCAT). CONCLUSION: Although clinical staff of the hospital displayed fair knowledge and awareness about the application of the MHA and the GA to inpatient care of older adults, further education is necessary, particularly about the application of the GA. The authors suggest similar findings may occur at other New South Wales hospitals, which may raise concern and need for education.

Clinical outcomes and length of stay of a co-located psychogeriatric and geriatric unit.

To examine the effect of co-location of psychogeriatric and geriatric services on length of stay and changes in patients' psychosocial characteristics. A retrospective analysis of the performance indices of psychogeriatric patients aged > or =50 years admitted to a co-located psychogeriatric and geriatric unit at Bankstown-Lidcombe Hospital, New South Wales (NSW), Australia from April 2004 to June 2006. Comparisons were made between the performance of the Bankstown-Lidcombe's unit and the NSW state average (consisting of traditional solitary models of care) with respect to patients' length of stay (LOS) and changes in psychosocial indices. Bankstown's patients had a higher burden of psychosocial impairments. The mean LOS for psychogeriatric episodes was significantly shorter at Bankstown-Lidcombe Hospital than the NSW state average (28.3+/-19.6 days vs. 33.4+/-22.7 days, p<0.001). The overall improvement in aspects of mental state and social behaviors for psychogeriatric admissions at Bankstown-Lidcombe Hospital was significantly better than the NSW state average. Co-location of psychogeriatric and geriatric services reduced patients' LOS and improved psychosocial performance compared to traditional models of care. However, more robust studies are required to fully examine the benefits of this type of service.