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Geriatric psychiatry is now a mandatory part of psychiatric residency education in Canada. Educational requirements in geriatric psychiatry were updated by the Royal College of Physicians and Surgeons of Canada in 1988, and guidelines were developed in more detail in 1989 by the Section on Geriatric Psychiatry of the Canadian Psychiatric Association (CPA). These guidelines are presented here together with a survey, conducted in the fall of 1991, of all 16 Canadian psychiatry residency programs. Thirteen of the training centres now require residents to have a formal rotation in geriatric psychiatry, generally three months in length. Residents are exposed to elderly patients in other services, such as consultation/liaison, but these services may not include formal teaching in geriatric psychiatry. Most programs have a seminar series in geriatric psychiatry and have training guidelines similar to those of the CPA. However, it is not clear how closely these are being followed, since it was felt in almost one-third of all programs that there was an insufficient number of teachers to fulfill the training requirements. In addition, a number of training directors felt that the objectives were too comprehensive to be met in the three month period. Earlier studies in the field are reviewed, implications of the current findings are discussed, and suggestions are made for further research.

A retrospective descriptive study of the elderly patients served by a respite admission program in a teaching hospital is described. Data were collected by health record review and interviews with the program social worker. In the three years covered by the study there were 28 patients, with a mean age of 80.5 years. Fifty-seven per cent were male, 68 per cent, married, 29 per cent, widowed, and 3 per cent, single. When first admitted they were all living in their own homes or the home of a child. Seventy-nine per cent of the patients had moderate or severe dementia, with or without physical disability. Family members were the main caregivers and home care services provided support in 54 per cent of cases. Ninety-three per cent of the patients attended the geriatric day hospital. The patients received respite admissions for a mean of 10.8 months. At the end of the study more than a third of the patients were still living at home and half had entered long-term care facilities. By means of respite admissions supplemented by day hospital attendance it has been possible to maintain in the community disabled elderly patients who might otherwise have required immediate institutionalization. The need for more respite care and in-home services is discussed and a role for long-term care facilities as major providers of respite care suggested.