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Care program for elderly people with psychotic disorders

Nowadays there are programs for elderly people with psychotic experiences. In this article I will go into this in more detail. Figures show that more and more elderly people are experiencing these symptoms. And with it their children, who often become overstressed due to the pressure. Parnassia, the largest medical center in the Netherlands, works with care programs. It functions! The article below is about that.

Care program for psychotic disorders in the elderly

Who is the care program for psychotic disorders in the elderly intended for? This program is intended for people in the so-called third and fourth phase of life (usually from the age of 60) who suffer from psychotic problems.What does psychosis mean for the patient and the environment? Patients with psychosis often suffer severely. By hearing voices or sounds and/or by certain suspicious thoughts (delusions), they often experience the world around them as threatening or frightening.The aim of the treatment is to make psychotic disorders in the elderly bearable. The care program treats patients who have recently experienced psychosis for the first time, but also patients who have been known to have psychosis(s) for a long time. The patient who has reached old age is at home in a care program where specific knowledge and attention is paid to third and fourth phase problems in the social, psychological and somatic areas. The current practice is that these people often lack such a specific approach.The aim of the treatment is to relieve the complaints through psychotropic drugs, psychoeducation, psychotherapy and supportive forms of therapy. This can take place individually or in a group. The family is also involved in the treatment. Special attention is paid to life phase problems in all therapy components.

Care program components

The most important components of the care program for psychotic disorders in the elderly are the following:

Further Diagnostics

This takes place before the treatment starts and to monitor the course. The SCL-90 (a complaints list) and the CGI (an assessment of the patient’s global functioning) are completed periodically. Special lists are also used for people with psychotic disorders, such as the PANNS and CASH. These are taken on indication


This takes place as standard after the intake and during the consultation, but also during the further course of the treatment. These interventions are partly applied during individual treatment contacts with a doctor/psychiatrist, psychologist and nurse (SPV), and partly through a group offer.


The general interventions consist of: pharmacotherapy, somatic screening for medication use, psychotherapy, and supportive structuring interventions. This includes relaxation exercises, walking and more exercise for the elderly, gender-specific interventions, activity guidance, and non-verbal forms of therapy.There are more specific interventions, including cognitive behavioral therapy for hearing voices. In addition, there is a so-called G-training for psychoses.

Involve family/informal care

Partners or family members of patients are also involved in the treatment. Partly to inform them about the patient’s clinical picture, but also to prevent the family’s burden from being exceeded.


If the depression cannot be fully combated and there are (permanent) limitations, active attention is paid to rehabilitation in the areas of living/ADL, work/daytime activities, learning, relationships, and finances.

Crisis policy

A crisis policy has been formulated for each patient. Crisis policy/interventions are discussed with the patient and those around him. A relapse prevention plan provides guidance for the patient and those around him: it makes clear what can be done in the event of a relapse. A risk assessment of suicidality is one of the standard interventions in this care program.

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