ABORDAGEM DA COMORBILIDADE NO IDOSO INTERNADOMiguel Martins* & Aucíndio Valente**
Summary: The hospitalisation of an old aged patient, from an holistic point of view, demands careful psychiatric and medical examination. In this study we aimed to determine the viability and relevance of some simple clinical tools applied by the clinician in a first interview, for analysis of the comorbility and for diagnostic support.
Having recoursed to a psychiatric and medical semi-structured interview, to a physical exam, laboratorial study, brain scan, the Geriatric Depression Scale and the Mini Mental State Examination, we aimed to achieve data that allowed us a more accurate diagnostical and therapeutic analysis of these elderly patients. Usually they present a high average of organic comorbility with cognitive malfunction and depressive symptoms which are often devalued at the moment of the psychiatric hospitalisation.
Key-words: Old age, comorbility, psychiatric hospitalisation, semi structured interview.
*Interno de Psiquiatria, Centro Hospitalar de V.N. de Gaia -CHVNG
**Psiquiatra, Chefe de Serviço, CHVNG
ABORDAGEM PSICOFARMACOLÓGICA NAS DEMÊNCIAS
Ângela Venâncio1 Magda Pereira1 Teresa Salgado2
Abstract: Dementia in general, especially Alzheimer disease and vascular dementia, are diseases of high prevalence with severe socio-economic consequences in all countries. In recent years, due to the obtention of new pharmaceutical products acting on different brain neurotransmitters. Although these drugs do not stop disease progression, there is a consistent evidence of their usefulness in cognitive, behavioral and functional domains. This article reviews the main drugs available for treatment of Dementia and for the comportamental sintomatology that acompained them.
Key Words: Dementia; Neurotransmitters; Therapeutic strategies
1 Interna Complementar de Psiquiatria do Hospital de Magalhães Lemos
2 Directora do Serviço de Psicogeriatria do Hospital de Magalhães Lemos
GERONTOLOGIA PREVENTIVA
Raul Guimarães Lopes
Abstract: It is given importance to the geriatric epidemiology and to stories of life of people "aging with success" according to the prevention and the improvement of the quality of life. Ten rules for the healthful aging are justifiable.
Key Words: Epidemiology; quality of life; prevention; successful aging; salutogenesis; primary care.
O IDOSO E AS SUAS CIRCUNSTÂNCIAS
Silva Martins
Summary: All of the elderly psychopathology must be interpreted and understood in a elderly/environment relations basis. Thus the necessity of taking these two elements into account, when elaborating any program of elderly assistance. That’s why that program must be technically conceived and executed by multidisciplinary teams, headed by the general practicioner, after his adequate formation.
Key Words: Elderly; Dependency; Depressive; Degenerative; Environment; Hostility; Incubency.
Domiciliary Intervention in Psychogeriatrics
Margarida Sotto Mayor, Isabel Varandas
Enfermeiras Especialistas em Enfermagem de Saúde Mental, Serviço de Psicogeriatria, HML
Oscar Ribeiro
Psicólogo, ICBAS, Universidade do Porto
António Leuschner
Psiquiatra Director do HML
ABSTRACT: Psychogeriatric home visit’s main goal is to provide health care in specific home environments, delaying as much as possible the patient’s institutionalization. Multidisciplinary teams consider several monitoring tasks, directed both to the older person and to the informal carer, but they are often not clearly organized.
Objective: To identify and systematize the main specific activities developed by a psychogeriatric team in home care delivery.
Methodology: The authors studied a random sample of 134 patients aged 65 and over, selected from a universe of 267 that were part of a home visit program (Psychogeriatric Service -HML). 403 records of home visits from January 2000 to September 2004 have been studied, carrying out a content analysis.
Results: Three major themes were found: (1) appraisal of the patient’s mental state and functional autonomy, the community support network and the caregiver condition; (2) detection of risk situations and their reorientation to specific services; and (3) health education activities.
Conclusion: The authors suggest that the major domains of appraisal-intervention, and related monitoring, should be included in a prototypical fill-in form. The need to consider Psychogeriatric home care management and optimization through the enhancement of socio-familial resources available, namely the caregivers, is emphasized.
Key Words: Psychogeriatrics; Multidisciplinary Team; Home Care; Caregivers
VISITA DOMICILIAR
- uma forma de abordagem no tratamento de pacientes em processo demencial1
Ana Elisa Bastos Figueiredo*; Jerson Laks**; Eleonora de Sá e Benevides Muniz***; Elaine Balassiano****.
Summary: This paper approaches the Home Care Visiting Project for pacients with severe dementia that is developed in the Center for People with Alzheimer’s Disease and other Mental Disorders of Old Age of the Psychiatry Institute of Federal University of Rio de Janeiro. This Project is coordinated by Ana Elisa Bastos Figueiredo. This paper also describes the topics defined at the Home Care Visiting Project, as the general and specific objectives, the inclusion and exclusion criteria, and the team and the attending organization.
Key Words: home care visiting; dementia; way therapeutic
1 Este Projeto é parte integrante da Pesquisa intitulada “Envelhecimento e Fragilidade: aspectos sócio-culturais e itinerário terapêuticos” coordenada pela Dra. Ana Elisa Bastos Figueiredo e desenvolvida no Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro-Brasil.
* Assistente Social. Doutora em Ciências da Saúde-IPUB/UFRJ.Coordenadora do Projeto de Visita Domiciliar do Centro para Pessoas com Doença de Alzheimer e outros Transtornos Mentais na Velhice (CDA)
** Médico. Doutor em Psiquiatria - IPUB/UFRJ. Coordenador do CDA.
*** Psicóloga. Especialista em Terapia de Família -IPUB/UFRJ. Estagiária de Pesquisa.
**** Fonoaudióloga. Especialista em Psicogeriatria – IPUB/UFRJ. Estagiária de Pesquisa.
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