[Life-terminating actions in severely demented patients].
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Aged↗
Biomedical subjects
D J Ringoir
Publications and source records attributed to D J Ringoir.
Balancing tradition with innovation.
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Aged↗
[Contributions to the specialty geriatrics. The geriatrician--tolerated or appreciated?].
In this article an outline for the development of geriatrics in the Netherlands is given based on experiences in the United States and Great Britain. From the beginning geriatrics should be brought upon "first class' level in order to avoid the development of a "second class' specialism - unwanted and not respected by other specialists. Therefore in the author's opinion geriatrics should start in the universities as a part of the total education, training and research in medical gerontology which contains not only (somatic) geriatrics, but also physiology, pathology, psychogeriatrics, neurology, general practice and social medicine. To begin with we should start with specialists in internal medicine who make their daily job in geriatrics. New style geriatricians could be educated and gradually take over the posts of the geriatricians of the "first hour' after 5 to 10 years. When an internal ward is changed into a geriatric ward, the modification should not only contain the indication shields, but also include a change of attitude towards elderly patients, more nurses (one on every patient), a psychogeriatric consultant, a social worker, a geronto-psychologist and facilities for disturbed patients, etc. In future geriatricians could be employed on geriatric assessment units in general hospitals, psychogeriatric assessment units in mental hospitals and as consultants in nursing-homes, residential homes and social-psychogeriatric (ambulant) services.
Academic Medical Centers↗
[Estimated health care expenditures for 'demented' patients].
The authors try to give a cost containment analysis of the health care costs spent on patients labelled as suffering from dementia (presenile, senile dementia, Alzheimer's disease, organic psychotic conditions, arteriosclerotic dementia, depressive and paranoid dementia and others). Due to the difficulties in defining dementia, only a rough impression of the costs can given. The total costs of intramural care in 1977-1978 were about of f 912,9 million/year ($ 456,4 million). Intramural care in the Netherlands includes general hospitals, psychiatric hospitals and nursing homes (longstay annexes) with a psychogeriatric ward. This is about 7% of all costs spent on intramural care in the Netherlands. Extramural, ambulatory care was estimated circa f 274 million ($ 137 million) and daycare centres in nursinghomes on f 2 million ($ 1 million). Extramural care is given by general practitioners, ambulant social psychogeriatric teams and community services delivered by public health nurses. The estimated total costs were circa f 1189 million ($ 594 million) or about 5% of the total costs spent on health care/year which is f 761 ($ 380)/elderly person and 0,4% of the national income. In contrast the expenses on scientific research in gerontology in the Netherlands--especially in the field of dementia--are almost nil. Dementia needs more attention than it receives today.
Aged↗
[The National Hospital Federation report: assessment of the elderly with mental disorders].
Since long there is a discussion in the Netherlands about the definition of assessment and the place where observation of psychogeriatric patients could take place: geriatric department general hospital, psychogeriatric unit, psychiatric hospital or psychogeriatric nursing-home. The report gives a very good description of an assessment program by a multidisplinary team with a social, psychiatric, somatic, psychological screening and behaviour observation. Conditions for quality and assessment are developed and seen as conditions for official recognition by the authorities, wherever it may be in a hospital, psychiatric hospital or nursing home. This report fails however to elucidate the term 'screening' and the responsibility of the proposed team. The central role of ambulant services like the social psychogeriatric services is underestimated. Uncertainly about the place of assessment in the system of health care in the Netherlands makes the proposed uniform financing of assessment an illusion.
Aged↗
[Not Available].
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Academies and Institutes↗