Invisible residents: the chronically mentally ill elderly in nursing homes

Area of Science:

• Geriatric Psychiatry
• Psychiatric Nursing
• Long-Term Care

Background:

• Federal mandates require psychological assessments for mentally ill individuals in long-term care facilities.
• The Preadmission Screening and Resident Review (OBRA 87) process aims to ensure appropriate placement and treatment.
• Nursing home residents often have chronic mental illness, necessitating tailored care strategies.

Purpose of the Study:

• To analyze psychological assessment data of elderly individuals with chronic mental illness in nursing homes.
• To identify common symptoms and treatment patterns within this population.
• To explore the relationship between demographic/clinical factors and treatment recommendations.

Main Methods:

• Retrospective analysis of psychological assessments for 570 nursing home residents.
• Coding of narrative assessment data due to lack of quantifiable metrics.
• Focus on diagnoses, cognitive function, physical dependency, and symptoms.

Main Results:

• The majority of residents had schizophrenia and a history of early psychiatric hospitalization.
• Most individuals exhibited mild cognitive impairment and were not fully dependent physically.
• Social withdrawal was the most frequently observed symptom; 64% received neuroleptic medication.

Conclusions:

• No correlation was found between demographic/clinical data and treatment recommendations.
• Findings highlight the need for evidence-based treatment planning in geriatric psychiatric care.
• Implications for psychiatric nurses include adapting care to the specific needs of this population.