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This article presents results from a retrospective study of psychological assessments
of elderly persons with chronic mental illness residing in nursing homes. All residents
(N = 570) received this assessment as part of federally mandated screening for mentally
ill persons residing in long-term care. The process, the Preadmission Screening and
Resident Review, was mandated by the Omnibus Budget Reconciliation Act (OBRA 87).
These assessments were the first stage in a process to determine if the nursing home
was the most appropriate placement for each resident. If nursing home care was deemed
appropriate, then a psychological treatment program was to be established within the
nursing home setting. The sample ranged in age from 50 to 104 (mean of 70). The majority
had a diagnosis of schizophrenia and a history of psychiatric hospitalization occurring
early in their life. The assessments did not include any quantificable data on activities
of daily living, cognitive functioning, or level of psychiatric impairment. Therefore,
the researchers coded the narrative data so that it could be interpreted. The majority
functioned within the none-to-mild range of cognitive impairment, and very few were
completely dependent in the need for physical care. The most recorded symptom was
social withdrawal. Neuroleptic medications were administered to 64% of elderly persons
with chronic mental illness. Importantly, there was no relationship between demographic
or clinical information and treatment recommendations. Implications of these findings
for psychiatric nurses are discussed.
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Article info
Footnotes
Supported by a grant from the Pollack Research Fund of the Buehler Center on Aging, McGaw Medical Center of Northwestern University, and by the National Institute on Aging's Interdisciplinary Research Training Program on Aging, University of Iowa Center on Aging.
Identification
Copyright
© 1998 W.B. Saunders Company. Published by Elsevier Inc.
