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From custodial care to rehabilitation : the changing philosophy at Valleyview Hospital Josey, Kay

Abstract

In 1960, the Home for the Aged, an institution of the Province of British Columbia, underwent an official name change to Valleyview Hospital. The change in name indicated a change in the philosophy toward the treatment of the aged mentally ill person. This change can be equated with new knowledge about the physical, psychological and social aspects of aging. Formerly the program and the goal were related to custodial care; now, the program and the goal are related to treatment which will result in the aged mentally ill patient returning to a living arrangement in the community that is most appropriate to his needs. This study, cites the problems of aged people in this province, with particular reference to problems of mental illness. The process of admission to hospital, treatment programs and discharge procedures, particularly as they relate to the work of the Social Service Department, are described. Against this background of procedures, the particular criteria for discharge and rehabilitation planning, as related to the hospital and to the resources available in the community are examined. Particular patient groups are noted in relationship to the particular resource required to receive them back into community. The study reveals that, although, using hospital criteria for discharge, a large number of patients could be appropriately rehabilitated, but sufficient community resources, including family care, boarding and nursing homes, are lacking for such patients. Furthermore, community attitudes towards the aged mentally ill person have not changed to meet the new philosophy about their treatment in Valleyview Hospital. Since correspondence revealed that Valleyview Hospital is unique amongst mental hospitals for the aged on this continent, the study was of necessity a pilot one, and is primarily descriptive. However, the questionnaire method was used to gather data about existing living accommodation available to discharged patients. Finally, the study offers some suggestions for improvement and expansion of community resources, and of legislation concerning them which, if carried out, would ensure, to a greater extent, that the philosophy of treatment and rehabilitation, rather than custodial care, could be translated into practice.

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