European Psychiatry - Volume 33 - March 2016

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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 or these vulnerable persons in the deep respect of their
dignity 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.
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.
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.
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.