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Biomedical subjects

J D Lieff

Publications and source records attributed to J D Lieff.

5 recordsLinked to original sources

High technology and psychiatric care of the elderly.

The dramatic explosion of scientific information, as well as the development of computerized devices in medicine, will continue to change both the diagnosis and treatment of the elderly as it changes our entire culture. There are many technological forces now combining to push the frontiers of knowledge about the brain to new levels. This article outlines these new scientific and technological frontiers in psychiatric diagnosis including: diagnostic imaging, computer EEG, and psychiatric evaluation; treatment including health-related computerized aids, computerized psychopharmacology, neuropsychiatric training for handicapped and brain-injured, and chronic care; and medical education. This article discusses some of the issues that arise due to these new developments. Computers have multiplied the kinds of questions that can be meaningfully asked. In this way, the advent of the computer has opened the minds of many researchers to new frontiers. An important question is, "What will the psychiatric 'state of the art' be in a technological age?" Other issues include confidentiality with new devices, use of high technology to define malpractice liability, the lack of professional standards in software, the resistance of medical profession to computers, and the increased ability to misuse statistics. Geriatric psychiatrists must take an active role in planning the future impact of high technology in our field.

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A program for treating isolated elderly patients living in a housing project.

A comprehensive psychiatric treatment program called Outlook was designed to treat isolated residents of inner-city housing projects for the elderly. A large proportion of the elderly referred to the program had no family members or were estranged from them; approximately 80 per cent lived alone. All had multiple problems, and almost all were shown to be at high risk of institutionalization. During the first two years of the program, 108 clients were treated through a problem-oriented approach using a counselor-case manager and multiple therapies; only nine clients had to be referred to nursing homes or other institutions. The data suggest that well-designed programs can help elderly patients who have multiple problems but no family support to remain independent.

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A psychogeriatric nursing home resocialization program.

The institutional atmosphere and programming of a nursing home can often engender a downward spiral of increasing dependence and learned helplessness in its elderly residents. Elderly patients with chronic medical complaints combined with psychiatric and management problems are especially susceptible. An intermediate-and skilled-care nursing home began a special program in 1974 to deal with these patients. The program features problem-oriented rather than diagnosis-oriented recordkeeping and the use of a multidisciplinary therapeutic team to treat problem residents. Over the first four years of the program, behavior problems of many residents were resolved, and many of the original residents admitted to the program were released, some into independent community living. Case studies highlight the type of patients successfully handled in the program.

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