Reasons for psychiatric medication prescription for new nursing home residents

Abstract

While the results suggest that NHs may be providing more mental health care than in the past, psychopharmacological treatment remains the dominant approach, perhaps because of limited mental health training of staff, and lack of diagnostic precision due to few trained geriatric mental health professionals. A critical review of the role of the PASRR process is suggested.

Influences on Decision-Making Regarding Antipsychotic Prescribing in Nursing Home Residents With Dementia: A Systematic Review and Synthesis of Qualitative Evidence

“…Table 1 outlines the characteristics of the 18 included studies. The studies were conducted in six different countries: UK (n=7), 19,[25][26][27][28][29][30] US (n=5), 18,[31][32][33][34] Australia (n=3), [35][36][37] Canada (n=1), 38 The Netherlands (n=1) 17 and South Africa (n=1). 39 Eleven of the studies employed a purely qualitative methodology, [17][18][19][25][26][27]30,[35][36][37]39 while seven utilized mixed-methods.…”

“…39 Eleven of the studies employed a purely qualitative methodology, [17][18][19][25][26][27]30,[35][36][37]39 while seven utilized mixed-methods. 28,29,[31][32][33][34]38 A total of 1,609 unique participants were involved: nurses (n=479), other nursing home staff (n=657), family carers (n=239), physicians (n=144), pharmacists (n=49) and old age advocates (n=6). One study did not provide a disciplinary breakdown for its 35 participants.…”

“…A common weakness, found in twelve studies, was inadequate researcher reflexivity. 17,18,25,[27][28][29][30][31][32][33]35,39 The relationship between the researcher and participants had not been effectively addressed in these studies. The overall quality of one study was assessed to be low due to concerns across several CASP domains.…”

Counselling Older Adults Living in Residential Aged Care Settings: Four Illustrative Case Studies

“…Referrals to psychological services from residential aged care nursing and professional care staff are low (Davison, Karantzas, Mellor, McCabe, & Mrkic, 2012). Residents are more likely to be offered pharmacological rather than psychological therapies (Brodaty et al, 1993;Molinari et al, 2011), possibly reflecting ambivalent or negative attitudes towards counselling and psychology services for late-life psychiatric conditions (Burroughs et al, 2006;Murray et al, 2006). However, even when psychological services may be seen as acceptable and appropriate, there is a shortage of psychologists who are trained in providing mental health services to older adults.…”

Introduction of a university‐based counselling service for older adults

“…general practitioners) and nursing care staff [7]. Older adults living in the community and in residential care settings are more likely to be offered biological therapies such as medication and electroconvulsive therapy than psychological therapies [8,9], even though nonpharmacological approaches are effective [10][11][12] and recommended as first-line responses for managing emotional and behavioural difficulties [13].…”