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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55

S37

Mental health in nursing homes: Current best

practice

S58

Organizing mental health care in

nursing homes: How, by whom and

what for?

C.A. de Mendonc¸ a Lima (Head)

Unity of Geriatric Psychiatry, Centre Les Toises, Lausanne.

Switzerland

Though care should be provided in patients’ homes for as long as

possible, itmust be recognised that care in an alternative residential

setting may be the only way of meeting some patients’ needs effec-

tively or avoiding intolerable carer burden. Such care will always

be necessary, for people who have no relatives available. The res-

idential care may be useful for respite care including a range of

time limited services, to support the carers. Residential care should

also be available for those patients whose physical, psychological,

and/or social dependencies make living at home no longer possible.

This provision includes a range from supported accommodations

with low level supervision, medium level care facilities and full

nursing facilities. There is a high prevalence of mental disorders in

nursing homes and very often the staff is not adequately educated,

trained and supported to care these individuals. Psychiatric consul-

tation liaison services should be provided not only for residents but

also to support the staff of these facilities. The most recent interna-

tional documents point out the necessity to offer the best available

care

[1] f

or these vulnerable persons in the deep respect of their

dignity

[2] . I

t becomes urgent to launch a deep debate on this sub-

ject in order to recommend to authorities the best guidelines to

support policies to be adopted in this field.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

References

[1] OMS. Rapport mondial sur le vieillissement et la santé. Genève:

OMS; 2015 [WHO/FWC/ALC/15.01].

[2] WHMH. Dignity in mental health. World Mental Day Report

2015. Occoquan: WFMH; 2015.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.874

S59

Treating chronically psychotic

patients in nursing homes

J. Gauillard

Centre d’action sociale de la ville de Paris, Unité de Liaison

Psychiatrique, Paris, France

The increase of aging patients with schizophrenia becomes a pub-

lic health issue. The exponential demography of the elderly, the

improvement of cares associated with better physical follow-up

directly impact the number of old patients with chronic psychi-

atric disease. Deinstitutionalization associated with a dramatic

enhancement of ambulatory and community cares has led to

a reduction of beds in psychiatric hospitals. When dependency

occurs, due to physical comorbid illness or a worsening of the nega-

tive symptoms, psychiatric teams should find appropriate housing

and no longer the psychiatric hospital. Nursing home and sheltered

housing for the elderly dependent persons become a solution, but

geriatric staffs are not always prepared to receive resident with

schizophrenia and other psychotic disorders. They often are at a loss

when faced with the expression of psychiatric symptoms or with

the specificity of caring for often-younger patients whose behavior

is different from older people with neurodegenerative disorders.

How psychiatric teams could long-term assist the sheltered hous-

ing and nursing home and bring a psychiatric know-how within

staffs often reluctant to deal with psychotic patients who could

burden caregivers. How could they be trained to cope with com-

plex cognitive functions impairments of schizophrenia, far from

cognitive impairments of Alzheimer dementia? How to change the

representation of psychiatric illness, which often leads to a double

stigmatization (old age andmadness)? Improving the quality of life

of aging patients with severe chronic mental illness in homes for

seniors is a great challenge for psychiatric teams in collaboration

with geriatric caregivers.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.875

S60

Modell Donaustadt: A best practice

example for treatment of mental and

physical comorbidity in long-term

care

B. Hobl

, B. Schreiber

Haus der Barmherzigkeit, Geriatric Psychiatry, Vienna, Austria

Corresponding author.

Evidence consistently demonstrates that people with long-term

mental health conditions develop serious physical comorbidities

at an earlier age than the average population. These physical

comorbidities are often exacerbated because long-term psychi-

atric conditions reduce the patient’s ability to manage somatic

symptoms effectively, thus hindering treatment. This highlights the

critical importance of continuous support by primary care physi-

cians and nursing staff. People with persistent mental illnesses

typically require long-term care significantly earlier than people

without mental illness.

As a consequence, elderly patients with chronic mental illnesses

who are essentially unable or unprepared to function in the outside

world or are in need of constant medical attention are typically

placed into long-term care facilities and nursing homes geared to

serving physically disabled elderly.

These LTC institutions have no capacity to provide specific care for

mentally ill patients. Difficulties in treating psychiatric patients in

these LTC facilities often result in transfers to and repeated admis-

sions in acute psychiatric hospitals.

In an effort to resolve the “revolving-door” situation of these

patients and reduce the rates of re-admission to acute psychiatric

hospitals, Modell Donaustadt was developed. In the talk, Modell

Donaustadt will be presented as a best practice example for the

treatment of mental and physical comorbidities in long-term care.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.876

Offenders with intellectual disability: Best

practice update

S61

Sex offenders and intellectual

disability

K. Goethals

University Forensic Centre, Antwerp University Hospital, Edegem,

Belgium & CAPRI, University of Antwerp, Belgium

Ethical controversies in patientswith intellectual disabilitywho are

sex offenders.