PMID- 32554354
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210427
IS  - 2115-7863 (Electronic)
IS  - 2115-7863 (Linking)
VI  - 18
IP  - 2
DP  - 2020 Jun 1
TI  - [The role of the old age psychiatrist in a mobile geriatric team: an example in 
      Tours city area (France)].
PG  - 223-231
LID - 10.1684/pnv.2020.0857 [doi]
AB  - BACKGROUND: Demographic changes require an adaptation of the geriatric care 
      offer, which is readily oriented towards the community and including the 
      development of out-of-hospital mobile geriatric team (MGT). Although psychiatric 
      disorders of older persons require a comprehensive, integrative and 
      multidisciplinary approach, geriatrics and old age psychiatry mobile units often 
      work in parallel without concertation for the management of complex pathologies. 
      The aim of this paper is to present the organisation and the results of a 
      out-of-hospital MGT with a geriatrician and old age psychiatrists (OAP) in a same 
      unit. METHOD: Data were collected during the first-year (2018) of the 
      out-of-hospital MGT of Tours University hospital. After initial geriatric 
      assessment and when old age psychiatry (OAP) intervention was needed, referral 
      mode and justification, patient's characteristics and recommendations made by the 
      team were collected. RESULTS: During the study period, 151 patients were 
      assessed, 53% (n=80) had out-of-medical follow-up or difficulties to access to 
      healthcare; 40% (n=60) had behavioural and psychological symptoms of dementia 
      (BPSD), 30% (n=45) falls, 15% (n=23) social problems, 10% (n=15) alteration of 
      overall health status and 5% (n=7) drug conciliation; 40% (n=60) benefited from 
      an OAP evaluation; 100% (n=60) had out of medical follow-up, 83% (n=50) had 
      severe BPSD, 17% (n=10) psychological symptom with psychiatric condition, 10% 
      (n=6) misused psychotropic medications in charge of general comorbidities 
      decompensation; 32% (n=19) had geriatric, OAP consultations and 33% (n=20) were 
      in denial of care; 23% (n=14) with severe BPSD had a second OAP consultation. 
      DISCUSSION: Relationship between geriatrician and OAP in the same MGT enables to 
      deliver comprehensive care, including organic, psychiatric and cognitive 
      comorbidities and collaborative assessment of iatrogenicity. A strengthened 
      relationship with general practitioners is a possible option for these frail 
      older patients, out-of-medical follow-up allowing their reintegration in the 
      geriatric healthcare system.
FAU - Nkodo, Jacques-Alexis
AU  - Nkodo JA
AD  - Service de medecine geriatrique, CHU Tours, Tours, France, Service de psychiatrie 
      universitaire, CHU Tours, Tours, France.
FAU - Dubnitskiy-Robin, Sophie
AU  - Dubnitskiy-Robin S
AD  - Service de medecine geriatrique, CHU Tours, Tours, France.
FAU - Debacq, Camille
AU  - Debacq C
AD  - Service de medecine geriatrique, CHU Tours, Tours, France.
FAU - Desmidt, Thomas
AU  - Desmidt T
AD  - Service de psychiatrie universitaire, CHU Tours, Tours, France.
FAU - Mennecart, Marc
AU  - Mennecart M
AD  - Service de medecine geriatrique, CHU Tours, Tours, France.
FAU - Camus, Vincent
AU  - Camus V
AD  - Service de psychiatrie universitaire, CHU Tours, Tours, France.
FAU - Fougere, Bertrand
AU  - Fougere B
AD  - Service de medecine geriatrique, CHU Tours, Tours, France, Education, ethique, 
      sante (EES ; EA 7505), Universite de Tours, Tours, France.
LA  - fre
PT  - Journal Article
TT  - Place du psychiatre de la personne agee au sein d'une equipe mobile de geriatrie 
      extrahospitaliere : l'exemple tourangeau.
PL  - France
TA  - Geriatr Psychol Neuropsychiatr Vieil
JT  - Geriatrie et psychologie neuropsychiatrie du vieillissement
JID - 101553404
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - France
MH  - *Geriatric Psychiatry
MH  - Humans
MH  - Male
MH  - *Mobile Health Units
MH  - *Patient Care Team
MH  - *Physician's Role
MH  - *Urban Health Services
OTO - NOTNLM
OT  - geriatric psychiatry
OT  - geriatrics
OT  - healthcare organization
OT  - mobile unit
EDAT- 2020/06/20 06:00
MHDA- 2021/04/28 06:00
CRDT- 2020/06/20 06:00
PHST- 2020/06/20 06:00 [entrez]
PHST- 2020/06/20 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
AID - pnv.2020.0857 [pii]
AID - 10.1684/pnv.2020.0857 [doi]
PST - ppublish
SO  - Geriatr Psychol Neuropsychiatr Vieil. 2020 Jun 1;18(2):223-231. doi: 
      10.1684/pnv.2020.0857.