PHYSICAL AGGRESSION IN THE MENTALLY ILL ELDERLY

这个项目旨在研究身体攻击性是如何在 老年精神病对患者、方案和工作人员的影响，以及 公共部门精神卫生系统的政策。攻击性强 年，老年患者可能占所有老年患者的7%。 公共部门的精神卫生系统，但20%的老年人 住进了州立医院。初步证据表明 这些客户的攻击性与 有机系统的存在。这类患者更有可能 比非暴力的老年人有多次入院记录。 现有的治疗方法似乎是最低限度有效的，而且出院 因为缺乏合适的安置而非常困难 设施。有理由相信这一数字和 这类客户的比例正在增长，并将继续扩大 进入下个世纪。尽管情况很严重， 几乎没有关于这个问题的经验数据库或 关于它的潜在解决方案。当前项目旨在 收集和编译四个最有用的数据集 评估攻击行为对老年人的影响 患者、方案和工作人员、系统策略以及 为这三项中的每一项定义改进行动的参数 影响程度。与科罗拉多州分部合作 心理健康，数据集将被汇编为包括：(1) 科罗拉多州九年详细的计算机化档案，(2) 科罗拉多州病历记录中的治疗和结果数据 医院四年，(3)一年的纵向数据 科罗拉多州立医院将包括痴呆症的分期和 记录伴随特定攻击的因素 事件，以及(4)科罗拉多州医院的档案记录 九年，涵盖员工因袭击而受伤的情况。总而言之， 对数据集的分析将允许对临床和 这些客户的治疗概况，对相关因素的评估 发病和治疗结果以及对计划和 工作人员，以及对当前和潜在的系统政策的影响。

This project is designed to examine how physical aggression in the elderly mentally ill impacts patients, program and staff, and policy in the public sector mental health system. Assaultive geriatric patients may account for 7% of all geriatric clients in the public sector mental health system, but 20% of all the elderly admitted to state hospitals. Preliminary evidence suggests that assaultiveness in these clients is highly correlated with the presence of organic system. Such patients are much more likely than nonviolent elderly to have a record of multiple admissions. Existing treatment appears to be minimally effective, and discharge is very difficult because of the lack of suitable placement facilities. There is a reasons to believe that the number and percentage of such clients is growing and will continue to expand into the next century. Despite the seriousness of the situation, there is almost no empirical database available on the problem or on potential solutions to it. The current project is designed to collect and compile four data sets that will be most useful in assessing the implications of assaultive behavior for geriatric patients, programs and staff, and system policy, as well as defining parameters for ameliorative action at each of these three levels of impact. In collaboration with the Colorado Division of Mental Health, data sets will be assembled to include: (1) detailed computerized archives for nine years from Colorado, (2) treatment and outcome data from chart records in Colorado state hospitals for four years, (3) longitudinal data for one year at colorado state hospitals that will include staging of dementia and recording of factors concomitant with specific assaultive incidents, and (4) archival Colorado state hospital records for nine years covering staff injuries due to assaults. Altogether, analysis of the data sets will permit a study of the clinical and treatment profiles for these clients, an assessment of correlates of onset and treatment outcomes as well as impact on program and staff, and implications for current and potential system policies.