Mental Health Care in Nursing Homes

There are 15,600 nursing homes in the U.S. This means that all 15,600 of these nursing homes are able to provide 24/7 care for the residents. “Care” for many people is physical care: feeding the resident, bathing the resident, providing medicines to the resident, allowing the resident to exercise, etc. However, we often forget that “care” also relates to mental health care, and that is what is missing in these nursing homes.

Nursing homes can do a stupendous job bathing, cleaning, and feeding the residents; however, they lack the ability to support the residents who are suffering from a mental illness or a declining mental health.

“A high proportion of nursing home residents have a significant mental disorder, with estimates ranging from 65% to 91%” (Grabowski).

This clearly shows that more than half of the residents admitted to nursing homes suffer from a mental illness.

Despite this fact, it is proven that nursing home staff are still “ill-equipped to serve residents with mental illness” (Grabowski).

When reading “Quality of Mental Health Care for Nursing Home Residents: A Literature Review” I was shocked to read the cause behind the drastic increase of mentally ill residents in nursing homes.

The fact that those with mental illnesses were not given the right treatment from psychiatric hospitals, and instead were placed in nursing homes, which were not adequately prepared for treatment, is outrageous. Due to the downsizing of the psychiatric hospitals, the elderly were affected deeply.

Before:

Back in the 1980s, it was proven that nursing home staff inappropriately used “antipsychotic drugs and physical restraints, as well as inadequate treatment of depression in nursing homes” (Grabowski).

Thankfully, Congress enacted the Nursing Home Reform Act to end the abominable treatment of residents. This act is supposed to apply the Bill of Rights to the residents and also provide the proper treatment and care needed. In addition, other regulations part of this act also require the staff to conduct “periodic evaluations of nursing home residents to be conducted with a standardized resident assessment instrument designed to enhance the recognition of mental and behavioral symptoms that should be addressed in the treatment plan” (Grabowski).

Today:

Although a lot has changed in the way nursing homes function over the years, they still have not reached the point where the mentally ill residents are given the proper treatment. It is proven that most of the residents suffer from dementia. Dementia is “an overall term for diseases and conditions characterized by a decline in memory, language, problem-solving and other thinking skills that affect a person's ability to perform everyday activities” (“What is Dementia?”). As a result, the treatment of residents with dementia can not be generalized to the treatment of residents suffering from other mental health illnesses, like depression, schizophrenia, bipolar disorder, etc.

Another excerpt from ““Quality of Mental Health Care for Nursing Home Residents: A Literature Review” shows a 3 step approach to treating the residents.

This “team” approach should be implemented, if it isn’t already, into the care provided by nursing homes to better help the residents.

Most of the residents admitted into nursing homes are put there by their families. This can be due to increased health problems, including chronic diseases like heart disease and diabetes. It is crucial for us to also take into account the residents’ mental health when they are admitted as mental health is as important as the physical health of any individual. The elderly have already been through so much and have offered us so much, so it’s time we foster them with our care and love.

Sources:

Grabowski, David C, et al. “Quality of Mental Health Care for Nursing Home Residents: a Literature Review.” Medical Care Research and Review : MCRR, U.S. National Library of Medicine, Dec. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2981653/#R31.

“Nursing Home Reform Act - Background & Regulations.” Nursing Home Abuse Guide, nursinghomeabuseguide.com/resources/nursing-home-reform-act/.

“What Is Dementia?” Alzheimer's Disease and Dementia, www.alz.org/alzheimers-dementia/what-is-dementia.