Forensic Issues in Long-Term Care Psychiatry

2017 ◽  
Author(s):  
Marshall B. Kapp
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
Psychiatric Treatment ◽  
Health Assessment ◽  
The United States ◽  
Assisted Living Facilities ◽  
Nursing Facilities ◽  
Care Providers ◽  
Term Care

This chapter focuses on medical-legal issues that may arise in the context of identifying psychiatric needs and providing psychiatric care for older persons in long-term care institutional settings, specifically residents of nursing facilities and assisted living facilities. Following general observations about the present regulatory climate in the United States governing nursing facilities and assisted living facilities, the chapter explores mental health assessment requirements for residents of those venues. Key legal responsibilities and restrictions regarding the psychiatric treatment of those residents are then discussed, as well as several areas of concern about potential exposure to litigation and liability on the part of long-term care providers. Finally, some of the most salient future legal and policy challenges confronting those who plan, fund, provide, and evaluate long-term care institutional psychiatric services are noted.

Ethical Considerations in the Conduct of Electronic Surveillance Research

2006 ◽  
Vol 34 (3) ◽  
pp. 611-619 ◽  
Author(s):  
Ashok J. Bharucha ◽  
Alex John London ◽  
David Barnard ◽  
Howard Wactlar ◽  
Mary Amanda Dew ◽  
...  
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
The United States ◽  
Assisted Living Facilities ◽  
Ethical Considerations ◽  
Term Care ◽  
Baby Boomer Generation ◽  
Demographic Shifts

Nearly 2.5 million Americans currently reside in nursing homes and assisted living facilities in the United States, accounting for approximately five percent of persons sixty-five and older. The aging of the “Baby Boomer” generation is expected to lead to an exponential growth in the need for some form of long-term care (LTC) for this segment of the population within the next twenty-five years. In light of these sobering demographic shifts, there is an urgency to address the profound concerns that exist about the quality-of-care (QoC) and quality-of-life (QoL) of this frailest segment of our population.

scholarly journals Major Disasters’ Impacts on Long-Term Care Settings, Vulnerable Older Adults, and Care Providers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 201-201
Author(s):  
Leah Haverhals ◽  
Katie Cherry
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Long Term Care ◽  
The United States ◽  
Care Providers ◽  
Term Care ◽  
The Us ◽  
The Impact ◽  
Hurricane Irma

Abstract The COVID-19 pandemic has disproportionately negatively affected older adults, and has specifically devasted older adults who are minorities and those who reside in long-term care (LTC) facilities. For professionals working in LTC facilities, major stressors and challenges due to the pandemic must be navigated, sometimes in parallel with the effect that major disasters like hurricanes can have on LTC facilities. This symposium will focus on the impact major disasters, including the COVID-19 pandemic and Hurricane Irma, had on LTC settings and those who live and work there, as well as older adults who are minorities and their communities. First, Dr. Roma Hanks will present findings from a study of community members and leaders in a majority African-American community in the United States (US) about their experiences with and challenges faced related to the pandemic. Second, Dr. Lisa Brown will share experiences and perceptions of mental health clinicians from across the US who worked in LTC settings before and during the pandemic. Third, Dr. Ella Cohn-Schwartz will describe how the pandemic impacted Holocaust survivors ages 75+ in Israel compared to older adults who did not experience the Holocaust. Fourth, Dr. Lindsay Peterson will present findings from interviews with nursing home and assisted living community representatives in the US regarding vulnerabilities LTC facilities experienced related to Hurricane Irma in 2017. As a whole, these presenters will provide insights into experiences of older adults, care providers, LTC facilities, and communities as they navigated challenges associated with the COVID-19 pandemic and a major hurricane.

A Comparison of Wandering Behavior in Nursing Homes and Assisted Living Facilities

2005 ◽  
Vol 19 (2) ◽  
pp. 181-196 ◽  
Author(s):  
Elizabeth R. A. Beattie ◽  
JunAh Song ◽  
Shane LaGore
Keyword(s):  
Nursing Homes ◽  
Assisted Living ◽  
Challenging Behavior ◽  
Long Term Care ◽  
Assisted Living Facilities ◽  
Term Care ◽  
Training Requirements ◽  
Care Facilities ◽  
Staffing And Training

Wandering, a challenging behavior associated with dementia, affects many residents of long-term care facilities and can result in elopement, injury, and death. Most studies of wandering have taken place in nursing homes (NH). Expansion of the long-term care sector over the last 2 decades has resulted in a surge in options such as assisted living facilities (ALF). This study compared wandering behavior of residents (N = 108) in 21 long-term care facilities (15 NH, 6 ALF). Staff used the Revised Algase Wandering Scale-Nursing Home Version (RAWS-NH) to quantify wandering. While there were some differences in demographic variables (i.e., race, motor ability) between NH and ALF participants, no significant differences were found in either RAWS-NH overall or any of the 6 subscale scores. This suggests that the expression of wandering is similar in long-term care residents across all dimensions of the RAWS-NH regardless of facility type. Findings are of concern for those involved in the safe management and protection of residents at risk for wandering, particularly in long-term care facilities with underregulated staffing and training requirements.

Characterizing healthcare delivery in the United States using Census Bureau’s County Business Patterns (2000–2016)

2020 ◽  
Vol 41 (6) ◽  
pp. 723-728
Author(s):  
Astha KC ◽  
Melissa K. Schaefer ◽  
Nimalie D. Stone ◽  
Joseph Perz
Keyword(s):  
Long Term Care ◽  
Healthcare Delivery ◽  
The United States ◽  
Healthcare Sector ◽  
Nursing Facilities ◽  
Term Care ◽  
The North ◽  
The Us ◽  
Care Facilities

AbstractBackground:The US Census Bureau’s County Business Patterns (CBP) series provides a unique opportunity to describe the healthcare sector using a single, national data source.Methods:We analyzed CBP data on business establishments in the healthcare industry for 2000–2016 for all 50 states and the District of Columbia. Setting and facility types were defined using the North American Industry Classification System.Results:In 2016, CBP enumerated 707,634 US healthcare establishments (a 34% increase from 2000); 86.5% were outpatient facilities and services followed by long-term care facilities (12.5%) and acute-care facilities (1.0%). Between 2000 and 2016, traditional facilities such as general medical surgical and surgical hospitals (−0.4%) and skilled nursing facilities (+0.1%) decreased or remained flat, while other long-term care and outpatient providers grew rapidly.Conclusion:This analysis highlights the steady growth and increased specialization of the US healthcare sector, particularly in long-term care and outpatient settings.

scholarly journals USING A UNIVERSAL SATISFACTION SCORE IN LONG-TERM CARE SETTINGS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S744-S744
Author(s):  
Nicholas Castle ◽  
Lindsay Schwartz ◽  
David Gifford
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
Pay For Performance ◽  
Psychometric Testing ◽  
Satisfaction Score ◽  
Nursing Facilities ◽  
Term Care ◽  
Skilled Nursing ◽  
National Quality

Abstract The CoreQ (not an acronym) consists of a limited number of satisfaction items (3-4 items, depending on setting) that are used to create an overall satisfaction score for long-term care facilities. This measure has been used in assisted living (AL) and skilled nursing facilities (SNFs) and has been endorsed by the National Quality Forum (NQF). Briefly, the development and psychometric testing of the CoreQ will be described, including the rationale for producing an overall satisfaction score and correlation with important quality indicators like Five-Star. Using data collected over the past 3 years, comprising more than 100,000 respondents, the use of the CoreQ measure will be described. For example, the CoreQ scores are used in MA to allow providers to benchmark their performance. The use of the scores in this way will be discussed including how providers have used the scores for quality improvement. Some states have elected to use CoreQ in pay for performance and other state initiatives. A case study of how New Jersey uses CoreQ with SNFs will be presented, including distribution of scores and addressing data collection challenges. CoreQ can be utilized as a short customer satisfaction measure to allow providers to benchmark their performance, residents and families in decision-making, and states and others to use for accountability.

Long-Term Care/Residential Care

2018 ◽  
Author(s):  
Tahira I. Lodhi ◽  
Tania Alchalabi
Keyword(s):  
Assisted Living ◽  
Independent Living ◽  
Long Term Care ◽  
Assisted Living Facilities ◽  
Geriatric Population ◽  
Term Care ◽  
Levels Of Care ◽  
Care Plans ◽  
Care Systems

Given the increase in the geriatric population, the norms of long-term care systems will be forced to change in societies all over the world. This chapter provides an overview of the different levels of care available, from independent living to inpatient, subacute, rehab, assisted living facilities, group homes, and long-term care. A case study is provided of a couple’s declining health trajectory and worsening functional status, identifying resources that pay for various levels of care. Given that care plans must be tailored to the patient’s needs and circumstance, this review provides the foundation to build the structure of a transition or discharge plan. The use of complementary and alternative medicine in long-term care facilities is briefly covered.

A Comparison of Emergency Preparedness Policies by Long-Term Care Setting Type in Ohio: Assisted Living Settings Lag Behind Nursing Homes in Key Areas

2020 ◽  
pp. 073346482090201
Author(s):  
Katherine A. Kennedy ◽  
Cassandra L. Hua ◽  
Ian Nelson
Keyword(s):  
Assisted Living ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Long Term Care ◽  
Nursing Facilities ◽  
Community Based ◽  
Term Care ◽  
Skilled Nursing ◽  
Care Facilities

Skilled nursing facilities (SNFs) have received regulatory attention in relation to their emergency preparedness. Yet, assisted living settings (ALs) have not experienced such interest due to their classification as a state-regulated, home- and community-based service. However, the growth in the number of ALs and increased resident acuity levels suggest that existing disaster preparedness policies, and therefore, plans, lag behind those of SNFs. We examined differences in emergency preparedness policies between Ohio’s SNFs and ALs. Data were drawn from the 2015 wave of the Ohio Biennial Survey of Long-Term Care Facilities. Across setting types, most aspects of preparedness were similar, such as written plans, specifications for evacuation, emergency drills, communication procedures, and preparations for expected hazards. Despite these similarities, we found SNFs were more prepared than large ALs in some key areas, most notably being more likely to have a backup generator and 7 days of pharmacy stocks and generator fuel.

Improving Quality of Life in Long-Term Care

2009 ◽  
Vol 14 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Margaret P. Calkins ◽  
Jennifer Brush
Keyword(s):  
Quality Of Life ◽  
Nursing Homes ◽  
Assisted Living ◽  
Staff Training ◽  
Long Term Care ◽  
Assisted Living Facilities ◽  
Term Care ◽  
Management Structure

Abstract The entire field of long-term care is under tremendous pressure to change. Traditional environmental approaches based on staff-centric or medical models are no longer considered appropriate in long-term care settings. The new emphasis is on person-centered or self-directed care. This is reflected in settings where people can live comfortably and feel at home, as opposed to feeling like they are in a hospital. Increasingly, nursing homes are working to be more like assisted living facilities, which emphasize privacy, dignity, and choice. These changes affect all aspects of care from structure of governance to staff training to management structure and facility design. This article will cover the issues and the possible solutions to ensuring that long-term care living is more like a home than a hospital.

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