These days, mental health in long-term care is receiving much more attention than ever before. After 25 years as a psychologist in a nursing home, it’s very exciting to see.
I read the April print edition of McKnight Long Term Care News and found articles on the impact of nurse stress on quality of care, the connection between nursing staff turnover and the emotional cost of work, and the importance of mental health support for staff.
In the past week, by McKnight Senior Editor Kimberly Marselas wrote about the increased attention CMS is paying to mental health conditions, and about iCare’s Chris Wright: Leveraging Skilled Nursing Behavioral Health Opportunities.
I hope that this attention will lead to a change in the way psychology services are used and reimbursed.
While there is value in providing individual services to residents with identified mental health problems, psychologists can and should do much more.
Mental health challenges in nursing homes would be better served if psychologists were involved in programming, such as the STAR-VA model for behaviors related to dementia, or the Elderly care methoddeveloped by senior living consultant Kelly O’Shea Carney, Ph.D., ALPP to address the behavioral health needs of long-term care residents.
She and Margaret Norris, Ph.D., wrote “Transforming Long-Term Care: Expanded Roles for Mental Health Professionals,” which “shows how mental health professionals can use their full range of skills to create systems that provide more support and engagement for residents, while providing staff with greater opportunities for professional growth and meaning.”
As I have written in the past, psychologists can be instrumental in a wide variety of currently problematic areas, such as:
- Staff trainingincluding education on the basics of mental health and psychiatric illness, working with families, stress management techniques, and other issues that often arise for staff in a nursing home setting.
- teamworkwhich focuses on addressing the specific needs of units and departments, such as conflict resolution, communication skills, etc.
- boost moraleusing the psychologists’ training and knowledge of the facility’s emotional climate to design interventions that can enhance the facility’s culture, such as improving staff common areas or collaborating with the recreation department on activities that inspire the community.
- Enhanced Onboardingaddressing often undiscussed but vitally important topics such as coping with the loss of residents or dealing with challenging families.
- behavior roundsto assist staff with interventions to reduce problem behaviors in residents or families.
- office hourswhere residents, workers and family members can have a quick chat to address their concerns and get directions to additional services if needed.
- systems interventions where psychologists collaborate with facility leaders to optimize systems and resolve issues, often between departments, such as communication breakdowns or turf disputes.
- Group sessions for residents. that address topics such as how to get the most out of rehabilitation or psychoeducation about diseases such as diabetes, and that foster connections and reduce isolation.
- Group sessions for families.to reduce your anxiety, increase your ability to manage the health issues of your loved ones, improve your understanding of partnering with the team, and decrease the amount of time staff spend dealing with family concerns.
- family psychotherapy sessionssince admitting a loved one to a nursing home can be very distressing.
- End of life supportbecause we must be experts in recognizing when residents are close to death and helping them, their families and team members to cope with the process and their grief.
- Individual psychotherapy for residents. because, yes, this is also important.
A few years ago, I was referred to a very anxious 90-year-old rehab resident. Initially, she was extremely reluctant to talk to me, but eventually she became a fan of psychotherapy.
The morning before I returned home, he called me to his spot in the living room and said, “I wish I had talked to you when I was young. The work you’re doing is just as important, just as important as the cardiologist or the surgeon.”
“I know,” I replied.
Long-term care is like this woman, who could have benefited from psychological services decades ago.
I am pleased that increased awareness of mental health has entered the spirit of LTC and would like to think that columns like mine have contributed to this recognition.
The work continues, but I wanted to let you know in advance that this is my penultimate column “The world according to Dr. El”. More on that next time.
Eleanor Feldman Barbera, Ph.D., author of The Smart Resident’s Guideis a Excellence Award Winner in the Blog Content category of the APEX Awards for Publication Excellence program. She is also a bronze medalist for best blog in the American Society of Business Publication Editors National Competition and a gold medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for conference commitments, visit her at EleanorFeldmanBarbera.com.
The opinions expressed in McKnight Long Term Care News guest submissions are the author’s and are not necessarily those of McKnight Long Term Care News or their publishers.
