Serious Mental Illness and Dementia in Assisted Living

Abstract Little is known about trends in the prevalence of serious mental illness (SMI) and Alzheimer’s disease and Related Dementias (ADRD) in assisted living (AL). We summarize changes in the prevalence of SMI and ADRD in larger AL settings (25+ beds) from 2008-2017 using Medicare claims data. We compare these changes to nursing home (NH) and community rates of SMI and ADRD. We also examine state variability in SMI and ADRD in AL in 2017. The prevalence of SMI in AL increased 37%, from 7.8% in 2008 to 10.7% in 2017; ADRD prevalence increased 34%, from 27% to 36.4%. Over time, NHs exhibited the greatest increases in SMI (53%), followed by AL (37%) and the community cohorts (27%). Increases in ADRD were highest in AL. Rates of SMI in AL ranged from 3.5% in Wyoming to 28.7% in New York. We discuss implications for future research and policy.

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Assisted Living Care for Special Populations

Innovation in Aging ◽

10.1093/geroni/igaa057.2350 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 676-676

Author(s):

Philip Sloane ◽

Sheryl Zimmerman

Keyword(s):

Older Adults ◽

Mental Illness ◽

Serious Mental Illness ◽

Assisted Living ◽

Sleep Disturbances ◽

Future Research ◽

Care Needs ◽

Term Care ◽

State Study ◽

Hospice Use

Abstract Assisted living (AL) is a notable provider of residential long-term care for older adults; there are almost twice as many AL communities as nursing homes, and they provide care to more than 800,000 older adults. As AL has evolved, it has come to serve more individuals with cognitive, mental, and health care needs. For example, 70% of residents have sleep disturbances, 42% have moderate/severe dementia, and mortality rates average 14% annually. Care needs include those for behaviors such as agitation, serious mental illness, and at the end-of-life. However, not all AL communities provide similar care. This symposium will use national data and data from a seven state study of 250 AL communities to focus on four populations receiving care in AL: persons with dementia, serious mental illness, sleep disturbances, and on hospice. The first speaker will discuss how AL staff conceive of and respond to behavioral expressions of persons with dementia; the second will focus on the use of psychosocial/environmental practices for persons with dementia in AL. The third speaker will discuss the growing proportion of persons with serious mental illness in AL and related implications for care. The fourth presenter will address the high use of melatonin in AL, as well as resident- and community-level correlates of melatonin prescribing. The final speaker will examine hospice use in AL and how it varies based on community characteristics. These findings related to care and care needs for four key populations have important implications for practice, policy, and future research.

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Gun Policy and Serious Mental Illness: Priorities for Future Research and Policy

Psychiatric Services ◽

10.1176/appi.ps.201300141 ◽

2014 ◽

Vol 65 (1) ◽

pp. 50-58 ◽

Cited By ~ 22

Author(s):

Emma Elizabeth McGinty ◽

Daniel W. Webster ◽

Colleen L. Barry

Keyword(s):

Mental Illness ◽

Serious Mental Illness ◽

Future Research ◽

Gun Policy ◽

Research And Policy

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Serious Mental Illness in Assisted-Living Facilities

PsycEXTRA Dataset ◽

10.1037/e533132007-001 ◽

2006 ◽

Author(s):

Adam Rosenblatt

Keyword(s):

Mental Illness ◽

Serious Mental Illness ◽

Assisted Living ◽

Assisted Living Facilities

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Quality of Care for Florida Nursing Home Residents With Serious Mental Illness

PsycEXTRA Dataset ◽

10.1037/e533112007-001 ◽

2006 ◽

Author(s):

Kathy Hyer ◽

Christopher Johnson ◽

Victor A. Molinari ◽

Marion Becker

Keyword(s):

Mental Illness ◽

Nursing Home ◽

Quality Of Care ◽

Serious Mental Illness ◽

Nursing Home Residents

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Clinical Applications and Investigation of the Acceptance of Mental Illness

Acceptance of Mental Illness ◽

10.1093/med:psych/9780190204273.003.0010 ◽

2016 ◽

pp. 146-158

Author(s):

Lauren Mizock ◽

Zlatka Russinova

Keyword(s):

Mental Illness ◽

Serious Mental Illness ◽

Culturally Diverse ◽

Clinical Care ◽

Clinical Applications ◽

Barriers And Facilitators ◽

Future Research ◽

Potential Development ◽

Peer Specialists ◽

Diverse Groups

This chapter reviews the 14 key principles of the process of acceptance of mental illness among culturally diverse groups that emerged from the findings in this book. Each principle is accompanied by clinical recommendations for facilitating the process of acceptance of mental illness. Examples are provided as to how clinicians, peer specialists, and researchers might respond to issues of acceptance of mental illness to facilitate hope and recovery. A number of acceptance-related techniques and theories in clinical care are also discussed. To further understanding and promote the process of acceptance of mental illness among persons in recovery, areas of potential development for future research are reviewed. An “Acceptance of Mental Illness Checklist” with scoring information is provided to assess the dimensions of acceptance and barriers and facilitators among people with serious mental illness and to aid further clinical and research examination of this construct.

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Contact with recovered peers: buffering disempowering service experiences and promoting personal recovery in serious mental illness

BJPsych Open ◽

10.1192/bjo.2019.72 ◽

2019 ◽

Vol 5 (6) ◽

Author(s):

Bronte McLeod ◽

Denny Meyer ◽

Greg Murray ◽

Fiona Foley ◽

Nev Jones ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Serious Mental Illness ◽

Self Efficacy ◽

Process Models ◽

Future Research ◽

Involuntary Treatment ◽

Personal Recovery ◽

Treatment Experience ◽

Stigma Of Mental Illness

Background Mental health patients can experience involuntary treatment as disempowering and stigmatising, and contact with recovered peers is cited as important for countering stigma and fostering agency and autonomy integral to recovery. Aims To advance understanding of the interaction between involuntary treatment and contact with recovered peers, and explore hypothesised relationships to mechanisms of self-evaluation relevant to recovery. Method Eighty-nine adults diagnosed with serious mental illness completed items to assess involuntary treatment experience and the extent of prior contact with recovered peers, the Internalised Stigma of Mental Illness Scale, the Self-efficacy for Personal Recovery Scale, the Questionnaire about the Process of Recovery and relevant demographic and clinical scales. Results Contact with recovered peers was found to moderate the effects of involuntary treatment on internalised stigma. Sequential conditional process models (i.e. moderated mediation) then demonstrated that conditional internalised stigma (i.e. moderated by contact with recovered peers) mediated the indirect effect of involuntary treatment on recovery-specific self-efficacy, which in turn influenced recovery. Compared with those with low contact with recovered peers, recovery scores were 3.54 points higher for those with high contact. Conclusions Although study methods limit causative conclusions, findings are consistent with proposals that contact with recovered peers may be helpful for this patient group, and suggest this may be particularly relevant for those with involuntary treatment experience. Directions for future research, to further clarify measurement and conceptual tensions relating to the study of (dis)empowering experiences in mental health services, are discussed in detail.

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