Fachklinik für Psychiatrie und Psychotherapie der Marienborn GmbH, Zülpich
Implementation of a basic palliative care need assessment in a geriatric psychiatric unit
Patients treated in a geriatric psychiatric unit are > 60 years old and suffer mostly from dementia, delirium, depression, the consequences of addiction or schizophrenic residuums. The complexity of this patient group is the age-related comorbidities, which lead to difficulties in medical treatment as well as the fact, that most patients are not able to form their own will.
The aim of my project is to implement a basic palliative care need assessment in the geriatric psychiatric unit (22 beds) in the Psychiatric Hospital Marienborn GmbH in Zülpich, Germany by means of the surprise question.
Every week a staff meeting with nurses, ward physician and social worker is planned to discuss the “surprise question” (Would I be surprised if this patient died in the next 12 months?) for every new patient (on average 6/week) for in total six months. If a patient is estimated to be in the group of “I won ́t be surprised”, it will be checked if there is any patient ́s provision available, an emergency information will be provided and a basic need assessment with the help of the Karnofsky-Index, the MIDOS and the palliative outcome scale will be done. After that the outpatient care will be planned. Before the intervention, after three and after six months the team’s knowledge, their sensitivity and their spirit for palliative care will be evaluated. They are going to be trained before the beginning of the intervention and after 3 months.
As there is no implemented palliative care in the geriatric psychiatric unit, we basically hope to create a new sensitivity for palliative care and therefore improve the treatment for this patient group. As far as we know this is the first study in this field.