Old age liaison psychiatry during COVID-19; an audit of pre- and mid-pandemic service provision

Older adults in acute hospitals are uniquely vulnerable to mental illness during the COVID-19 pandemic. We describe two eighteen-week periods of specialised liaison psychiatry for older inpatients in a large teaching hospital, pre- and mid-pandemic. Service delivery went from almost completely via face-to-face consultation in the Routine period, to majority remote work in the Pandemic period. During the Routine period, 195 patients were assessed, and patients received a mean number of 2.6 consultations (range 1-15). In the Pandemic period, 197 patients were assessed and received 3.1 consultations on average (range 1-19). Patient age trended toward older in the Pandemic period, mean 77 years (SD 6.9) vs 78 years (SD 1.32) in the Routine period. There were more referrals for behavioural disturbance and confusion during the Pandemic period, and more diagnoses of Behavioural and Psychological Symptoms of Dementia, Delirium and Adjustment Disorder during the Pandemic period vs the Routine period.