Biomedical subjects
Publications and source records attributed to B S Gurian.
Case finding and early detection and referral of elderly persons with mental problems can be accomplished by trained and supervised drivers as part of a transportation service. Increased access to community programs and services as a result of provided transportation helped clients maintain their independence and self-esteem.
This paper presents the results of four studies that evaluated the use of neuroleptics in an aging population both in nursing homes and in a psychiatric teaching hospital. The purpose was to determine the degree to which prescribing practices were in compliance with recent court rulings respecting the right of patients to informed consent to "exceptional" medication. The results indicate that physicians in nursing homes do not inform their patients of the risks of neuroleptics, do not seek consent, and do not consider competency to be even an issue. Elderly patients in the acute academic setting were informed of risks and benefits. However, both consent to medication and the competency to give this consent were presumed until or unless the patient failed to acquiesce. The degree to which these practices might be in potential conflict with state law, ignore the benefits of a negotiated doctor/patient partnership, and demonstrate one aspect of poor quality of care are discussed, and policy recommendations are made.
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Although caregivers in many disciplines have provided home visits as part of their services, psychiatrists have rarely made house calls. The author discusses some of the practical and emotional issues that have traditionally caused both patient and psychiatrist sufficient discomfort to limit this model of therapeutic intervention. Special emphasis is made in support of the psychiatric house call for elderly persons.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.