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Behavioral problems among patients in skilled nursing facilities.

J G Zimmer, N Watson, A Treat

    American Journal of Public Health
    |October 1, 1984
    PubMed
    Summary
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    A study found that 64.2% of skilled nursing facility (SNF) patients exhibit behavioral issues, with 22.6% having serious problems. This highlights a need for better mental health care and psychiatric support in SNFs.

    Area of Science:

    • Gerontology
    • Psychiatry
    • Healthcare Management

    Background:

    • Behavioral problems are prevalent in skilled nursing facilities (SNFs).
    • Accurate assessment and management of these behaviors are crucial for patient well-being.
    • Existing data on the prevalence and characteristics of serious behavioral problems in SNF populations is limited.

    Purpose of the Study:

    • To determine the prevalence of significant and serious behavioral problems among SNF patients.
    • To analyze the characteristics, history, management, and consultation patterns for patients with serious behavioral problems.
    • To identify gaps in documentation and physician/psychiatric support.

    Main Methods:

    • A survey was conducted on a random sample of 1,139 patients across 42 SNFs in upstate New York.

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  • Data collected included patient demographics, diagnoses, behavioral issues, previous history, current management, psychiatric consultations, and medical record documentation.
  • Patients were categorized based on the severity of behavioral problems, with a focus on "serious" issues.

    • Main Results:

    • 64.2% of patients displayed significant behavioral problems; 22.6% had serious issues.
    • The majority of patients with serious problems had organic brain syndrome diagnoses (66.5%), but few had specific psychiatric diagnoses.
    • Physician documentation of behavioral problems (9.7%) and requests for psychiatric consultation (14.8%) were notably low.

    Conclusions:

    • There is a high prevalence of significant behavioral problems in SNF patients, necessitating improved mental health care.
    • Inadequate physician documentation and limited psychiatric consultation highlight systemic issues in SNF patient care.
    • Enhanced staff training in mental health, increased physician awareness, and greater access to psychiatric consultative services are recommended.