Cognitive Impairment, Psychiatric Disorders, and Problematic Behaviors in a Tribal Nursing Home

Abstract

Tribal NH residents were likely underdiagnosed for dementia and anxiety. Residual behavioral and psychiatric symptomatology suggest room for improvement in the NH's behavioral management regimen. Need for greater attention to conceptual, diagnostic, clinical, and documentation processes in the NH setting is noted.

The prevalence of anxiety among older adults in nursing homes and other residential aged care facilities: a systematic review

“…Seven studies used a diagnostic interview to examine the prevalence of anxiety disorders, while one study (Forsell and Winblad, ) utilized a rating scale. In terms of the specific anxiety disorders included in each overall prevalence rate, five studies (56%; Arvaniti et al ., ; Forsell and Winblad, ; Jervis and Manson, ; Kay et al ., ; Parmelee et al ., ) did not report which disorders were assessed, Junginger et al . () included six disorders (panic disorder, agoraphobia, social phobia, specific phobia, obsessive–compulsive disorder (OCD), and GAD), Smalbrugge et al .…”

“…Eight studies reported no age cut-off but had a mean age ranging from 74.9 years to 86.2 years. In terms of level of cognitive functioning, two studies (11%; Drageset et al, 2013;Haugan, 2014) excluded residents with any cognitive impairment or dementia; two studies (11%; Cheok et al, 1996;Smalbrugge et al, 2005) included residents with a mini-mental state examination (Folstein et al, 1975) score of ≥18 and ≥15, respectively; and eight (44%; Class et al, 1996;Jervis and Manson, 2007;Kang et al, 2010;Neville and Teri, 2011;Sandberg et al, 1998;Selbaek et al, 2007;Smith et al, 2008;Zuidema et al, 2007) included residents with and without a dementia diagnosis. Two studies (Bland, Newman, & Orn, 1988;Parmelee et al, 1993) excluded residents who could not communicate meaningfully or were mute.…”

Racial and Ethnic Comparisons of Nursing Home Residents at Admission

“…21 Other studies have focused on nursing home care provided at individual tribal nursing facilities. [22][23][24] Racial/ethnic studies of the nursing home care provided in the United States have focused primarily on African Americans, with limited research on the care provided to Hispanics or Asians and no large-scale studies on Native Americans. We used the national "Minimum Data Set (MDS) for Nursing Home Resident Assessment and Care Screening" to develop racial/ethnic comparisons of comprehensive profiles of nursing home residents at admission throughout the United States, including whites (not of Hispanic origin), African Americans (not of Hispanic origin), Hispanics, Asians/Pacific Islanders, and American Indians/Alaska Natives.…”

Challenges to the recognition and assessment of Alzheimer's disease in American Indians of the southwestern United States

“…Recent, albeit preliminary, evidence suggests that with an increasing life expectancy, more cases of dementia and AD are being detected in clinics and nursing homes serving AIs [10][11][12][13]. A more accurate reflection of the prevalence of AD in AI communities awaits a study with adequate sampling of the population; however, it is reasonable to expect that AD will become an increasing problem that will begin to have significant impact on AI health care services.…”