Overview.Its astonishing in today’s America someone can say the elderly do not represent
a population that can change, learn from, and desire better control over their coping
ability.Fact is that over 75% of the elderly in facilities have a psychiatric diagnoses,
but due to the level of advanced skill needed to reach the resident patient and to
sustain treatment only a handful of behaviourists are available.Even fewer have gerontology
certification even fewer want to do the work in what is viewed as the most challenging
nursing & hospital settings.
The Driving Need for Emotional Care
Nursing Home care. Not the same any longer.The changing face of this setting may
include the developmentally disabled,Huntington’s Disease in their twenties,stroke
resident patients, rehabilitation, and those awaiting to go home as well as the frail
elderly.What we do know from fact is that their emotional care will help determine
their physical outlook. Not the other way around.
Psychiatric clinical social work and an education specialty is well suited for this
challenging environ-ment.We understand that more and more its evident that the doctoral
level clinician is best suited for this setting.Some of the problems that arise are
friendship, disagreements, inappropriate sexuality, disorientation, confusion,appetite,
paranoia,aggressive dementia, anxiety,non-compliance, hospice,and anger.To name the
basic need. For many of these problems it would be impossible for the facility to
have a dedicated staff to make an ongoing plan to address these concerns. There just
aren’t enough people. Plus the regulatory duties.
OBRA REGULATIONS Drive & insist nursing facilities to provide alternatives to the
use of psychotropic medication and physical restraints. This is a persistent reality
meant to increase the quality of life while making a balance between what is achievable
by behaviour change approaches with medication to address the long term care of resident
patients.As with most things in psychiatry, by its very nature, it may be dependent
upon cooperation, it is a time measured activity and not an instantaneous response
most people would like to see. In other words, it is very similar to other medical
fields.
