Services for older people

A recent report by the Audit Commission surveyed 850 carers and 1005 general practitioners by visiting 12 areas of the United Kingdom and conducting face to face interviews.2 The results showed that the range of services in health authorities was patchy and varied between the different authorities; in addition, coordinated care between health and social services was lacking. Individual components of old age psychiatry services have been evaluated and described in the literature. Memory clinics, for example, improve significantly the quality of life in carers of people with dementia because of the treatment and advice they offer.3,4 In dementia, there has been a particular emphasis on earlier and more open diagnosis to enable individuals to make choices and decisions about their future care at an earlier stage and to offer possible opportunities for treatment.5 Considerable interest has also been shown about improving care for people with established dementia—for example, using the person centred approach advocated by Kitwood.6 Effective liaison services at the interface between old age psychiatry and old age medicine lead to workable models, with some early indications of good efficacy.7