The Elderly in the Wrong Unit

Patients over 65 admitted from an area of North London forming the overlapping part of the catchment areas of a geriatric unit and a psychiatric unit were studied, with particular reference to misplacement in the inappropriate hospitals service and its consequences.The incidence of misplacement found was much lower than previously reported. In the geriatric unit 2.2% of admissions were definitely and 6.0% were probably misplaced. In the psychiatric unit 6.2% were definitely and a further 8.4% were probably misplaced. Misplacement did not materially affect the outcome. The striking differences that were found between the patterns of death and discharge in the geriatric and psychiatric units were determined principally by the type of illness leading to admission.The frequent coexistence of mental and physical disorders in the elderly patient, which this study confirms, indicates the need for further development of effective liaison at a local level between the geriatric, psychiatric, and social services.