Psychological consultation to nursing homes: Description of a six-year practice.

Abstract

The prevalence of psychological problems in nursing homes is estimated to be as high as 50-90% of residents. Yet psychological consultation is rarely available. This article describes six years of experience by one practitioner consulting to nursing homes in the Midwestern U.S., combining clinical and anecdotal descriptions with data collected on all the referrals during the six years. Data include referral questions; standardized assessments of mental status, memory, and depression; disposition; and therapy outcome ratings. The most common referral questions were depression and behavior problems. Staff assessment of presenting problems differed significantly from assessments by clients and therapist. Results suggest that the presence of a consultant may have a positive environmental impact. Interventions used included staff training, behavioral techniques, and cognitive therapy for depression and anxiety. Although there are numerous barriers to psychological work in nursing home settings, results suggest that this is an important and fruitful area of practice.

Pharmacological treatments for neuropsychiatric symptoms of dementia in long-term care: a systematic review

“…Non-pharmacological interventions are usually recommended as first-line treatments for NPS. Unfortunately, knowledge of psychosocial interventions in LTC is low (Cohen-Mansfield and Jensen, 2008), access to services for these interventions is limited (Conn, 1992; Burns et al ., 1993; Meeks, 1996; Reichman et al ., 1998; Seitz et al ., 2011), their effectiveness may be modest (Seitz et al ., 2012), and patients may not cooperate with these interventions (Cohen-Mansfield et al ., 2012). Therefore, there remains a potential role for medications in managing NPS in LTC.…”

Psychotherapy in long-term care: II. Evidence-based psychological treatments and other outcome research.

“…Dementia-related behavioral disruptions are common reasons for referral to a psychologist by LTC staff (Meeks, 1996). Logsdon et al (2007) focused on EBTs for behavioral problems in dementia and found two studies with LTC samples that supported EBT status for behavioral interventions (Lichtenberg, Kemp-Havican, MacNeill, & Johnson, 2005; Proctor et al, 1999).…”

Functional Analysis and Treatment of Problem Behavior of Elderly Adults in Long‐term Care

“…Approximately 1.6 million (5%) of those older adults live in long-term care facilities (Aiken, 2001). Problem behaviors are the most common precipitating factor for institutionalization (O'Donnell et al, 1992;Plaud, Moberg, & Ferraro, 1998), and up to 80% of nursing home residents exhibit problem behaviors such as physical aggression, wandering, and repetitive vocalizations (Allen-Burge, Stevens, & Burgio, 1999;Meeks, 1996).…”