| Abstract: | The development of and the demand for geriatric psychiatric services (GPS) have increased over the past decade. Psychopathology, autonomy, physical disorders, sociodemographics, social support and caregivers' burden have all been advanced as influencing the elderly's risk of hospitalization. These factors were examined in a 1-year prospective study of 87 new patients consulting a catchment-area GPS. Standardized assessments were used, including both patients' and caregivers' independent measures of patients' social network. Entry points to the study were as follows: 70.1% of patients came from an outpatient clinic and 25.3% were admitted directly to psychiatric wards. Subjects were followed up 1 year after discharge or first contact. Overall, 47.1% of the sample was admitted to a higher-supervision setting during the 1-year follow-up, including 20.7% of the total sample admitted to GPS wards. Multivariate logistic regression analysis indicated different factors influencing admission according to the definition of admission. Loss of autonomy was a key factor related to both psychiatric and overall admissions. Previous admission was a predictor of psychiatric admissions only. Relatives' strain and not living with spouse were predictors of overall admissions. The results indicate that functional consequences of disease (eg loss of autonomy) and resilience of relatives are key in predicting the elderly's need for greater supervision. |
