Review: Quality of Mental Health Care for Nursing Home Residents: A Literature Review

Abstract

Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors.

Medical Comorbidity and Functional Status Among Adults With Major Mental Illness Newly Admitted to Nursing Homes

“…Most nursing homes do not have access to mental health providers. In a recent review of the literature on the quality of mental health care in nursing homes, Grabowski and colleagues (12) found that the treatment of mental health problems in nursing homes is often substandard. The American Geriatrics Society and the American Association for Geriatric Psychiatry (13) recommend setting policies that require nursing facilities to establish formal agreements with consulting mental health providers for ongoing training, consultation, and treatment services.…”

Successful Strategies for Discharging Medicaid Nursing Home Residents With Mental Health Diagnoses to the Community

“…Existing research documents concerns with mental health services provided in the NH (Grabowski, Aschbrenner, Rome, & Bartels, 2010) and concerns that NHs are being used as substitutes for inpatient psychiatric care (Simon, Lipson, & Stone, 2011). However, little is known about discharging this population specifically.…”

Risk Factors of Dizziness among Institutionalized Elderly Persons: A Case Control Study

“…Living in such institutions can result in social isolation, with the elderly person feeling deprived of his or her previous activities, thus decreasing their independence and functionality. Currently, most elderly persons living in Nursing Homes are affected by a disabling disease, dementia or terminal illness [1].…”