The Elderly and the Community: Reidentifying Unmet Needs

A study of 348 geriatric patients referred to two mental hospitals, one with a screening unit and one accepting all applicants, indicates that, although complaints about the patients' behavior by those referring varied, two-thirds could have been cared for outside the hospital through coordinated health and social services. Nevertheless, one-fourth who could have remained in the community were admitted despite a screening process at one hospital that was intended to refer them to more appropriate targets, and, at the hospital without screening, half of those accepted could have remained outside. On follow-up 4 in 10 released or rejected patients were judged to need one or more social and medical services; hospitalization had provided only a temporary solution for patients. Few received health or social services; when they did, these were uncoordinated. Some reasons for the continued lack of coordinated services are proposed.