Why Provide Psychological Services in a Nursing Home?

As people age, they lose their independence and the power to control their own lives, their financial resources are depleted by medical costs and their perceptual abilities of vision, hearing, smell and taste are also adversely affected. To compensate for these losses they may work to achieve control through rigid, often difficult to understand, behaviors. They strive to be independent of people that love and care for them or try to manipulate others into providing for seemingly endless demands.

Each person admitted to a nursing home is going through major changes in his or her life. The resident and their families experience major stress. The predominant feelings experienced at this time are anxiety, fear, anger, guilt and shame. The resident, moved from a familiar to an unfamiliar environment, adjusts his or her behaviors and perceptions so that they can get some sense of control over their lives and reduce these feelings of anxiety, fear and anger.

In a nursing home environment the resident’s only source of a perception of control is achieved by making mental adjustments. This happens at a time when mental functioning is more impaired than at any other previous stage of their lives.

Who Pays for Senior Connections Therapy?

Therapy is:

• Paid for by Medicare part B, Medicaid, private and supplemental insurance, residents and, in some cases, the facility.
• Done by Licensed Psychologists and Psychotherapists.
• Accomplished in individual and group sessions in the nursing home.
• Tailored to the special needs of nursing home residents.
• Available for residents with long term needs.
• Available two to four days per week, depending on the caseload at the facility.

Our Psychological Services Extend the Power of the Physician:

• By providing the physician with an additional support team for positive care-giving to the residents.
• By working in a supporting educational role with the families of residents, and reducing the number of distress calls from families.
• By documenting the physician's compliance with OBRA regulations in the use of psychotropic drugs.
• By working with residents to encourage compliance with physician's orders.
• By reducing the number of emergency calls from the nursing home due to agressive and/or inappropriate behavior by residents.
• By communicating the cooperating with physician's assistants and nurse practicioners where physicians have delegated responsibility.
• By providing in-service training at all levels of the facility to increase awareness of psychological issues.
• By working with the nursing staff to improve relationships and communications between residents and staff.

The Human Element^®Program

Senior Connections employs a unique team approach to deliver effective mental health services to residents in assisted living and long-term care facilities. A licensed clinical psychologist and professional staff provide a consistent and predictable presence at the facility, utilizing a variety of treatment approaches to increase the quality of life for residents, which also provides a benefit to facility staff in reducing the burden of care.

We support and assist residents, family members, physicians and interdisciplinary staff members in recognizing existing and potential problems and formulating solutions. An active program of therapeutic services is developed, implemented and monitored to meet the individual needs of residents referred for psychological services. Typical referrals for services include residents who are depressed or anxious. Others have chronic mental health issues that existed prior to placement in the care community and require professional services to be able to remain at their present level of functioning. Our program of services provides residents the opportunity to attain or maintain their highest level of emotional and cognitive functioning. We have an ongoing training program that maintains our staff’s skills in the most current geriatric mental health approaches to care. Our assessments and documentation provides support to facility staff in the areas of integrated, interdisciplinary care plans, reduction of psychotropic medications, and behavioral management of difficult residents.

Facility Staff Support

Our team is available as a resource to the facility staff when crises arise with residents and/or families. The Supervising Psychologist is available to attend the psychosocial portion of the care plan meetings and supply documentation to substantiate the levels of care needed for residents who have mental health or behavioral issues. We offer facility staff training on a variety of relevant topics and are approved providers of nursing continuing education credits. We often provide brief consultations to assist facility staff in responding to resident’s issues.

Our assessments, treatment plans and program notes become a regular portion of your medical record, available for state surveyors and for appropriate staff and physicians to review.

Staff Training

In-service training is conducted with the approval and scheduling requirements of the facility Administrator, although the Administrator may delegate management of in-service training to other facility personnel. We recognize that because of the different levels of staff sophistication, education and turnover, there are varying and shifting needs for in-service training in long term care facilities.

The supervising psychologist and staff teach various modules. There are half-hour modules conducted one on one as needed. Additionally, half-hour to 1 hour modules on various subjects are offered to groups of facility staff, as requested. We are a continuing education provider so that the sessions can provide Continuing Education Units for facility staff.

The following list of topics are those for which we have seen a frequent need. This list is not all inclusive:

• Introduction to Mental Health Services in a Long Term Care Facility.
• Skilled listening - education and continuing education and practice with staff on listening skills with residents and their families.
• Dealing with a resident's demands in a non-confrontational, non-opposing manner.
• The psychological management of confused and aggressive patients.
• Memory disorders of aging - description of the various kinds of memory problems observed in the elderly and how to deal with these problems in practical ways.
• Practical management ideas for dealing with dementia, sundowner's symptoms and wandering.
• The management of delusional beliefs. Training focuses on how to respond to delusions. Training on this subject may also be conducted with family members, who often try to talk the resident out of a delusional belief, increasing the resident's agitation.
• Recognizing depression - identification of early warning signs of different kinds of depression. Additionally, new Medicare pilot programs pay the facility for identifying depressed residents.
• An overview of the aging process: common mental health problems found in nursing homes, and interventions utilized.
• Psychological management of inappropriate sexual behavior.

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