ABSTRACT
Administrators of 94 assisted living facilities in Michigan completed a 19-item survey about the extent of mental health problems of residents and how such problems were addressed. In 45 facilities more than half of the residents were reported to be cognitively impaired. The two most common problems were dementia and depression. The most common problematic behaviors were resistance to care and wandering. Two-thirds of the facilities conducted some type of mental health evaluation at admission, and two-thirds conducted evaluations as needed. The most common treatment barriers were patient refusal and family refusal. Results of the study suggest that there may be a significant need for mental health services in assisted living facilities.
Subject(s)
Assisted Living Facilities , Health Facility Administrators/psychology , Mental Health , Data Collection , Humans , MichiganABSTRACT
Depression in nursing home residents is a common phenomenon, though there is a wide range in the severity of this disorder as experienced by elderly adults in the United States. Treating older patients for depression is costly in both human and financial terms. The authors review guidelines and recommendations for the diagnosis of depression and medical treatment of depressed elderly adults from the 1993 Clinical Practice Guidelines for Depression in Primary Care by the US Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality), making note also of similar guidelines provided by the American Medical Directors Association in 1996 and those provided by the American Psychiatric Association in 2000. In November 1999, the authors used a Delphi survey to gather data from prescreened panelists (N = 10) to have the panel review and clarify the importance and feasibility of each "A" rated item in the US Agency for Health Care Policy and Research guidelines. This research allows health care providers to evaluate the importance and feasibility of items related to the delivery of mental health services for the elderly in nursing homes.
