Objective: To identify factors determining perceived inadequacy of psychogeriatric service provision to older people in care homes in the UK.
Materials and Methods: We conducted a postal survey of managers of a stratified (based on registration type and region) random sample of 2638 (14% of 18698) care homes in the UK caring for older (over 65) residents. Reminders were sent to those not returning the questionnaires.
Results: The response rate was 64% (n=1689). 41% of home care managers felt that at least 50% of their residents needed psychiatric evaluation. Overall, only a half of home managers felt that current frequency of service provision by Old Age Psychiatrists (OAPs) was adequate. Advice regarding diagnosis and pharmacological treatment was perceived to be adequate by about two thirds and three-fourths of home managers but less than half felt that non-pharmacological advice was adequate and about 80% wanted more input for staff education and training. Perceived need (p<0.001), frequency of visits by OAPs (p=0.001), availability of geriatrician (p=0.001), amount of non-pharmacological advice (p=0.014) and direct access to OAPs for known patients (p=0.036) were found to be independent predictors of perceived inadequacy of service provision by OAPs.
Conclusion: The survey highlights the perceived inadequacy of psychiatric service provision to older people living in care homes in the UK. The study findings, if confirmed by direct observational studies, may have a considerable impact on already sparse resources with a need to explore efficacy of different models of care in meeting this need.
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