Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-7qhmt Total loading time: 0 Render date: 2024-03-27T04:47:18.779Z Has data issue: false hasContentIssue false

12 - Managing aggression and violence in older people

Published online by Cambridge University Press:  02 January 2018

Graeme A. Yorston
Affiliation:
Consultant Forensic Psychiatrist, St Matthews Hospital
Get access

Summary

Introduction

Historical context

In the past, older people with mental health problems received the same treatment as younger adults. They were admitted to the same hospitals and the same wards. Older mentally disordered offenders who committed serious offences were admitted to hospitals for the criminally insane (East, 1944). In the UK the differentiation of generic mental health services into more specialist clinical services started slowly, but by the 1970s it had gathered enough momentum for both old age psychiatry and forensic psychiatry to split off from general psychiatry and develop along parallel service model lines. This led to the emergence of totally separate in-patient and community services often on geographically separate sites. Despite the obvious advantages of this approach in terms of developing expertise and research, the downside was that older adults were neglected as a group by developing forensic services which concentrated on young men with psychosis. The result was that only 1% of patients newly admitted to high and medium secure beds in England and Wales between 1988 and 1994 were over the age of 60 (Coid et al, 2002). In 1999, I highlighted the paucity of services for older adults and called for greater collaboration between old age and forensic psychiatrists (Yorston, 1999) and over the next few years a number of specialist secure services were established in the independent sector in the UK.

Much of the published research on older offenders includes a preliminary discussion of the issue of age. All figures based on chronological age, however, are arbitrary and it is better to consider age-related needs arising from life-cycle events, multiple physical comorbidities and neurodegenerative disorders, that is biological age rather than chronological age.

Though older patients have some similarities with one another owing to their age, the range of problems they present and their needs are just as varied as those of younger patients. It would be wrong therefore to confine them all together solely on grounds of chronological age.

Type
Chapter
Information
Publisher: Royal College of Psychiatrists
Print publication year: 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×