scholarly journals 12-month incidence, prevalence, persistence, and treatment of mental disorders among individuals recently admitted to assisted living facilities in Maryland

2013 ◽  
Vol 25 (5) ◽  
pp. 721-731 ◽  
Author(s):  
Quincy M. Samus ◽  
Chiadi U. Onyike ◽  
Deirdre Johnston ◽  
Lawrence Mayer ◽  
Matthew McNabney ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Assisted Living ◽  
Cognitive Disorders ◽  
Cognitive Disorder ◽  
Incidence Rates ◽  
Direct Care ◽  
Care Staff ◽  
Care Practice ◽  
Longitudinal Impact ◽  
Incidence Prevalence

ABSTRACTBackground: To estimate the 12-month incidence, prevalence, and persistence of mental disorders among recently admitted assisted living (AL) residents and to describe the recognition and treatment of these disorders.Methods: Two hundred recently admitted AL residents in 21 randomly selected AL facilities in Maryland received comprehensive physician-based cognitive and neuropsychiatric evaluations at baseline and 12 months later. An expert consensus panel adjudicated psychiatric diagnoses (using DSM-IV-TR criteria) and completeness of workup and treatment. Incidence, prevalence, and persistence were derived from the panel's assessment. Family and direct care staff recognition of mental disorders was also assessed.Results: At baseline, three-quarters suffered from a cognitive disorder (56% dementia, 19% Cognitive Disorders Not Otherwise Specified) and 15% from an active non-cognitive mental disorder. Twelve-month incidence rates for dementia and non-cognitive psychiatric disorders were 17% and 3% respectively, and persistence rates were 89% and 41% respectively. Staff recognition rates for persistent dementias increased over the 12-month period but 25% of cases were still unrecognized at 12 months. Treatment was complete at 12 months for 71% of persistent dementia cases and 43% of persistent non-cognitive psychiatric disorder cases.Conclusions: Individuals recently admitted to AL are at high risk for having or developing mental disorders and a high proportion of cases, both persistent and incident, go unrecognized or untreated. Routine dementia and psychiatric screening and reassessment should be considered a standard care practice. Further study is needed to determine the longitudinal impact of psychiatric care on resident outcomes and use of facility resources.

scholarly journals HOW STATES CHANGED REGULATORY REQUIREMENTS FOR ASSISTED LIVING STAFF SINCE 2003

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S441-S441
Author(s):  
Paula Carder ◽  
Sarah Dys
Keyword(s):  
Assisted Living ◽  
Management Practices ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Criminal Background Checks ◽  
Background Checks ◽  
Human Resource Policies ◽  
Criminal Background ◽  
Future Policy

Abstract In 2003, the Assisted Living Workgroup (ALW) published quality improvement recommendations for states’ regulations, including 26 regarding staffing/workforce. We reviewed states’ 2003 and current regulations to identify the presence of ALW standards. Over half of states’ regulations reflect 7 of the 26 staffing/workforce recommendations. Those most often added after 2003 concern criminal background checks, with a 58.8 percent increase in states that added federal background checks and use of criminal background checks to inform hiring. At least 40 states’ regulations reflect the ALW recommendations for administrator and direct care staff training. Very few states require staff performance evaluations (n=13), human resource policies to improve retention (n=1), or management practices to improve retention (0). The 10 ALW recommendations concerning staff who administer medications have been adopted by fewer than 23 states. These findings can inform future policy analysis and research on staffing/workforce in assisted living communities.

scholarly journals AN ANTIDOTE TO COMPASSION FATIGUE: DIRECT CARE STAFF USING CALM FOR ASSISTED LIVING RESIDENTS

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 721-721
Author(s):  
D Woods ◽  
L Phillips ◽  
R Johnson ◽  
V Knox
Keyword(s):  
Compassion Fatigue ◽  
Assisted Living ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff

Credentialing dementia training: the Florida experience

2010 ◽  
Vol 22 (6) ◽  
pp. 864-873 ◽  
Author(s):  
Kathryn Hyer ◽  
Victor Molinari ◽  
Mary Kaplan ◽  
Sharmalee Jones
Keyword(s):  
Assisted Living ◽  
Home Health ◽  
Direct Care ◽  
Care Staff ◽  
Program Review ◽  
Direct Care Workers ◽  
Adult Day Care ◽  
Direct Care Staff ◽  
Inaccurate Information ◽  
Care Workers

ABSTRACTBackground: Florida is a leader in requiring that all direct care staff employed in assisted living, nursing homes, hospice, adult day care and home health undergo Alzheimer's disease (AD) training. Legislative requirements prescribe the curricula components and require a review of curricular content and minimum standards for the training providers.Methods: We describe Florida's AD training program review process, and report the results of our review of 445 curricula received over four and a half years.Results: On initial submission, over 90% of curricula submitted did not include learning objectives, time formats or didactic approach. During a review of content we often found inaccurate information, language that was not person-centered, and missing required training components.Conclusion: Form and content problems were prevalent across all curricular types. We propose the Florida credentialing program as a model to ensure that accurate and educationally sound curricula are used to train direct care workers.

scholarly journals Neuropsychological Diagnostics of Mental Disorders in Forensic Psychiatry

Doctor Ru ◽  
2021 ◽  
Vol 20 (9) ◽  
pp. 60-65
Author(s):  
V.V. Vandysh-Bubko ◽  
◽  
Yu.V. Mikadze ◽  
D.A. Pilechev ◽  
D.V. Velisevich ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Neuropsychological Assessment ◽  
Forensic Psychiatry ◽  
Common Mental Disorders ◽  
Cognitive Impairments ◽  
Cognitive Disorders ◽  
Diagnostic Procedures ◽  
Cognitive Disorder ◽  
Expert Assessment ◽  
Neurocognitive Impairments

Objective of the Review: To justify possible use of neuropsychological assessment of cognitive impairments in some most common mental disorders encountered in forensic psychiatry, using analysis of the classic and modern empiric studies conducted with the help of psychometric and brain imaging methods. Key Points. The biopsychological and social nature of disorders associated with a mental pathology can form the methodological basis to choose various diagnostic procedures to study mental disorders. Analysis of biological and psychological aspects within such an approach can be associated with diagnostics of neurocognitive impairments. The term “neurocognitive impairments”, meaning cognitive disorders causing impaired fulfilment of professional, social and community functions, is now commonly used by psychiatrists and psychologists, and soon it will be officially included into diagnosable disorders of the International Classification of Diseases, revision 11. The article discusses justification of introduction of operational methods to assess cognitive dysfunction, in particular of neuropsychological assessment, into forensic psychiatry to ensure that expert conclusions made during borderline mental disorder assessment are valid. Conclusion. The use of neuropsychological methods for cognitive disorder assessment in psychiatry, especially in forensic examinations, is a promising tool for identification of actual cognitive impairments with the possibility to locally diagnose dysfunctions and dimensionally assess the intensity of neurocognitive disorders. Keywords: neuropsychology, cognitive functions, organic mental disorders, expert assessment outlooks.

scholarly journals TWELVE YEARS OF CHANGES IN STATES’ ASSISTED LIVING REQUIREMENTS FOR DEMENTIA-SPECIFIC STAFF TRAINING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S545-S545
Author(s):  
Paula Carder ◽  
Lindsey Smith ◽  
Seamus Taylor ◽  
Brian Kaskie ◽  
Kali S Thomas
Keyword(s):  
Assisted Living ◽  
Staff Training ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Specific Training ◽  
Training Requirements ◽  
Admission Screening ◽  
State Variation ◽  
Discharge Criteria

Abstract We describe two categories of dementia-specific AL requirements: staff training and admission/discharge criteria. We reviewed current requirements for all states and the District of Columbia, and amendments made over 12 years. Current and historic regulations were collected and analyzed using policy surveillance and qualitative coding. Twenty-three states currently require dementia-specific training, and 22 require continuing education. Nearly all states (49) require administrators to complete dementia-specific training. Of these, 13 states specified 7 to 120 hours of dementia care training. Some states added pre-admission screening for cognitive impairment; a few require a dementia diagnosis for admission. We describe state variation longitudinally in direct care staff training requirements, including: number of training hours, training content, and use of examinations or other tests of knowledge, skills and abilities. In addition, we categorize changes in admission/discharge criteria over time, including the use of medical versus behavioral health symptoms.

scholarly journals From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Fixed Effects ◽  
Nursing Home Residents ◽  
Direct Care ◽  
Multiple Perspectives ◽  
Person Centered Care ◽  
Fixed Effects Panel Regression ◽  
Centered Care ◽  
The Impact

Abstract Advancing our knowledge related to honoring nursing home resident preferences is a cornerstone of person-centered care (PCC). While there are multiple approaches to providing PCC, we focus on resident preferences as assessed via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In this symposium, we explore the perspectives of a variety of stakeholders including nursing home residents, staff, and the impact of preference-based care on provider level regulatory outcomes. First, we present a comparative study of preference importance among n=317 African America and White nursing home residents that found more similarities than differences between the two groups. Second, a content analysis of the responses from n=196 interviews with nursing home residents details the barriers and facilitators connected to their levels of satisfaction with their preferences being fulfilled. Third, perspectives from n=27 direct care workers explore the concept of pervasive risk avoidance to the delivery of PCC. Fourth, systems-level practices, such as shift assignments and provider schedules are identified as barriers to successfully fulfilling resident preferences from the perspectives of n=19 staff within assisted living. Our final presentation utilizes a fixed-effects panel regression analysis with n=551 Ohio nursing home providers to explore the impact of PELI use on regulatory outcomes such as substantiated complaints and deficiency scores reported in the CMS Nursing Home Compare data. Discussant Dr. Kristi Williams will integrate findings, highlighting implications for policy, practice, and future directions. Research in Quality of Care Interest Group Sponsored Symposium.

scholarly journals Mealtime Care for People With Dementia: What Do Nursing Home Staff Think?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 182-183
Author(s):  
James Faraday ◽  
Clare Abley ◽  
Catherine Exley ◽  
Joanne Patterson
Keyword(s):  
Nursing Homes ◽  
Ethnographic Study ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Structured Interviews ◽  
Staff Members ◽  
People With Dementia ◽  
Comparison Approach ◽  
The Right

Abstract More and more people with dementia are living in nursing homes (NH). Often, they depend on NH staff for help with eating and drinking. It is important that staff have the skills and support they need to provide good care at mealtimes. This qualitative study explores mealtime care for people with dementia, from the perspective of NH staff. Semi-structured interviews with NH staff (n=16) were carried out in two nursing homes. The homes were chosen to have diverse characteristics: one home had a large number of beds and was part of a small local organization; the other had a small number of beds and was part of a large national organization. Various staff members were interviewed, including direct care staff, senior carers, nurses, managers, and kitchen staff. Interviews were audio-recorded and transcribed verbatim. A constant comparison approach was taken, so that data from early interviews were explored in more depth subsequently. From the analysis, five themes emerged as important in mealtime care for people with dementia living in nursing homes: Setting the right tone; Working well as a team; Knowing the residents; Promoting autonomy and independence; Gently persevering. This work forms part of a larger ethnographic study on the topic, which includes data from residents with dementia, and family carers. Results will inform the development of a staff training intervention to optimize mealtime care for this population.

scholarly journals Why should medical students (not) be recruited to care for patients with COVID-19?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ivan Bank ◽  
Marjo Wijnen-Meijer
Keyword(s):  
Young Adults ◽  
Risk Factor ◽  
Medical Students ◽  
Mental Disorders ◽  
Medical Care ◽  
Well Being ◽  
Direct Care ◽  
Hygiene Measures ◽  
Development Of Anxiety ◽  
Mental Well Being

Abstract Worldwide it is being discussed whether medical students might be of help during the present COVID-19 epidemic. Although this question is probably a legitimate one, one should however discuss this thoroughly before deciding whether medical students are to be included in this kind of medical care on a larger scale. Various arguments should be weighted, and potential tasks should be chosen carefully. This period could however be also an opportunity for medical students to learn things they would probably never learn about. Nevertheless, medical students have a deficit concerning knowledge about epidemics, and they are also not really well skilled in many hygiene measures. Furthermore, some of the known medical students’ behaviour could be a risk factor for further spread of the virus as well. Then, young adults are at risk of getting infected themselves. Last but not least, medical students in general are under a great deal of pressure from their studies which could lead to the development of anxiety and other mental disorders. One could only speculate on the effects of this epidemic on their further mental well-being. Therefore, medical students participating in direct care of patients with COVID-19 should first be trained well, and then properly supervised at all times. Only then it might be a really useful and exceptional experience, for healthcare, medical schools as well as for society.

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