[...]... producing the Manual of Nursing Home Practice for Psychiatrists Christopher C Colenda, M.D., M.P.H Chair, Council on Aging American Psychiatric Association Professor and Chair Department of Psychiatry Michigan State University he Manual of Nursing Home Practice for Psychiatrists is a product of the American Psychiatric Association Council on Aging and the Committee on Long-Term Care and Treatment of the Elderly... We, as psychiatrists with so much to offer older people, must lead the way The common public and media belief is that boredom, lack of dignity, a slide into anonymity, 3 4 Manual of Nursing Home Practice for Psychiatrists over-regimentation, neglect of personal needs, and helplessness will follow admission to the nursing home Some individuals have committed suicide in response to fear of nursing home. .. Manual of Nursing Home Practice for Psychiatrists is a timely reference for general psychiatrists, primary care physicians, and others interested in nursing home practice It is designed to assist general psychiatrists in understanding the clinical, regulatory, financial, and legal questions associated with nursing home practice By giving general psychiatrists and other interested professionals this... with the name of the person holding such authority Patient Interview The patient interview in the nursing home is like a home visit insofar as it introduces a number of variables not present in the hospital or office setting The environment in which the interview is conducted may be quite unpredictable and often suboptimal, requiring accommodation to be Manual of Nursing Home Practice for Psychiatrists. .. move) Manual of Nursing Home Practice for Psychiatrists Written Request for a Consultation The primary care physician’s request must be made in writing Documentation must use the facility’s order forms and could include an account of the patient’s psychiatric symptoms At the very least, this information should be listed in the “referral reason” section of the consultation form Justification of medical... delivery of quality mental health services in nursing facilities will be a top priority for any future legislation dealing with long-term care A key recommendation to the IOM Committee was the development of mental health quality indicators for nursing home residents that make explicit the need for nursing home residents to have access to more affordable, high-quality psychiatric care The Manual of Nursing. .. therefore is not understood or responded to by the nursing home staff Another question that must always be addressed is whether the patient’s behavior is a way of communicating pain or other physical discomfort Manual of Nursing Home Practice for Psychiatrists Interviewing Collateral Sources Nursing Home Staff To augment the patient’s records and information obtained from the patient interview, the... benzodiazepines and antipsychotics in the case of dementia diagnoses at least once every 6 months, unless documentation gives an adequate rationale for continuing the medication Failure to do so puts the nursing home at risk of being cited for noncompliance The psychiatrist is usually called into the nurs- Manual of Nursing Home Practice for Psychiatrists ing home initially to deal with a particular crisis,... types of behavioral interventions that are used for various behavioral disturbances The physician can reinforce the use of these techniques by practicing them in the presence of those who are with the patient more of the time Generally many of the nursing home staff members will be more experienced in the use of these interventions The psychiatrist can play an influential role by encour- Manual of Nursing. .. intercourse Of the residents surveyed, 53% of men and 25% of women had regular sex partners In a nursing home setting, views on sexuality may become increasingly limited (Mulligan and Modigh 1991) In a survey of nursing home residents’ views of sexuality, Kaas (1978) found that 61% of residents did not feel sexually attractive Wasow and Loeb (1979) found that residents of a Wisconsin nursing home believed . Association Professor and Chair Department of Psychiatry Michigan State University x Manual of Nursing Home Practice for Psychiatrists he Manual of Nursing Home Practice. other members of the multi- disciplinary staff • Being proficient in the use of the correct diag - 4 Manual of Nursing Home Practice for Psychiatrists nostic