Studies show that residents of nursing homes and assisted living facilities are at a substantial risk of having psychiatric disorders. This practical volume provides much-needed clinical guidance for the prevention and appropriate treatment of mental illness in long-term care settings. Abhilash K. Desai and George T. Grossberg offer a basic framework for a humanistic, team-based approach to meeting the needs of elder persons with mental disorders in long-term care facilities. Early chapters cover the demographics of residents, the epidemiology of their psychiatric symptoms, and the assessment process. Subsequent chapters focus on major disorders, including dementia, delirium, depression, psychosis, and anxiety. The authors discuss end-of-life issues and treatments and offer suggestions for improving care. Throughout, they highlight the importance of the relationship between staff and residents. Emphasizing creative engagement and hands-on care and featuring clinical vignettes and practical tips, this optimistic volume reinforces the potential for nursing homes and assisted living facilities to be communities where residents thrive.
"The most complete book to date concerning the institutionalized care of the mentally ill elderly. A compassionate, comprehensive portrayal of the problems of caring for older persons by family members and nursing home staff. Essential reading for all those working with the elderly." --Bertram J. Cohler, Committee on Human Development, University of Chicago "The real strength of this book lies in its initial conceptualization of the nursing home as a community with a community's complexity of forces working both for and counter to the best interests of its members...contrasting the traditional view that the institution is the enemy of its residents." --M. Powell Lawton, Director of Research, Philadelphia Geriatric Center "This eminently readable book meets a long-standing need in the field of mental health, reflected in the fact that many nursing home residents suffer mental and emotional problems not infrequently the cause of their placement. Rooted solidly in theory, research, and clinical evidence, yet with a clear eye to practical applications, this excellent book will appeal to scholars, educators, students, administers, consultants, and practitioners." --Barbara Silverstone, Executive Director, The Lighthouse "This book come out at the right time in our return to a national discussion of the mental health needs of older adults. Scholarly in breadth and thoroughness, the authors draw on their wealth of practical experience to edify topics on the nursing home industry and its community of caregivers, families, and residents, and on strategies for mental health consultation, assessment, and intervention. It is thoughtfully written." --Carrell Wendland, Ph.D., President Beverly Foundation
Mental Health Consultation in Infant?Toddler Child Care addresses the impact of the caregiver'child relationship on the mental health of young children. As young children spend more and more time in child care programs, those programs have an increasingly significant effect on their healthy social and emotional development. Kadija Johnston and Charles Brinnamen review current theory and offer practical suggestions for improving relationships between program directors, staff, parents, children, and mental-health consultants to help identify and remove obstacles to quality care. The authors also offer real-life examples of effective programmatic functioning, interstaff and parent'staff relationships, and direct child interventions. Mental health professionals at all levels, early childhood educators and trainers, and policy makers will find this book useful guide to making positive changes in the childcare environment.
At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
