‘Factors affecting services offered to older adults with psychological morbidity: an exploration of health professional attitudes’

Aim: Poor collaboration between the multiple services involved in hospital discharge planning may contribute to suboptimal patient outcomes post discharge. This study aimed to explore clinician (medical, allied health and nursing) attitudes towards the management of the older patient with psychological morbidity during and following hospitalization. Methods: Focus groups were held with 54 health professionals comprising of 7 from acute, 20 from subacute (geriatric assessment and rehabilitation), and 27 from community care settings. A qualitative study using focus groups of clinicians from a range of disciplines working within a large Australian health care service. Data were analysed using an inductive thematic approach with constant comparison. Results: Key themes included: (1) Clinician decision making towards psychological morbidity; (2) Supply of people with specialised skills dealing with psychological morbidity; (3) Confidence and capability; (4) Facilitating continuity of care; and (5) Perception of depression and aging. Conclusions: Clinicians across healthcare settings are uniquely placed to identity psychological morbidity in older patients and make appropriate referrals for support. Management and referral making for older patients with psychological morbidity can be enhanced by routine education for clinicians and the introduction of clinical pathways. This has potential to improve management of psychological morbidity; however, evaluation of impact on patient outcome is required. Specifically, there is a need for greater access for counselling services.