The first modern psychiatric day hospital founded over 40 years ago has gone through a number of re-organizations which reflect utilization patterns representative of day hospitals in general. The author traces chronologically the dynamic movement from self-contained settings emphasizing group integration to expanded structures providing individualized treatment approaches. The day hospital's unique location at the interface of the institution and the community has important implications for today's mental health policy.
The proportion of individuals with dementia is increasing in all kinds of institutions. Specialised day hospitals are now being developed as an alternative to long term care for the demented. Twelve day hospital wards, with 312 individuals suffering from dementia, were included in a study aiming to assess functional abilities and frequencies of participation in different activities. Eighty-nine per cent of the day hospital patients could be classified as having a dementia disease. Seventy-eight per cent of the population were dependent on some kind of help from a caregiver in the performance of ADL activities. The most common occupations that could be seen in the programmes were physical activities, entertainment, and personal care activities. The activities were often undertaken as large group activities, often including more than ten patients. The functional abilities that characterise the population are comparable with those of the population living in pensioners' service blocks with full board.
Highlighted is the experience gained in the organization of a day hospital created for general and neurologic patients at Polyclinic N 166 of the Krasnogvardeisk region of Moscow. The preliminary outcomes of the treatment of 167 patients are briefly analyzed. The results of the study on the population's opinion on the exapediency of day hospitals are provided. It is pointed out that treatment in a day hospital is regarded as an advanced form of medical care.
The authors analyze activities of the daytime gerontopsychiatric hospital as a new organizational form within the structure of the district psychoneurological dispensary. During 12 months, 70 patients were treated at the hospital. The demographic, nosological and syndromological characteristics of the patients are provided. A range of the clinical indications were determined for referral to the specialized semi-hospital with regard to the mental status, somatic pathology and social status of the patients.
Respite care can be considered an illness prevention and health promotion intervention for both caregivers and the older people dependent on them. By maintaining clients' level of functioning, the process of deterioration is delayed and a degree of health promotion is achieved. Similarly, the relief of caregivers' burden, although minimal, sustains them in their role. A community-based mode of providing adult day care is supported in the literature. It seems logical to combine the services of a community-based organization and a long-term care institutional setting whenever possible.