Mental illness/behavioral health challenges are highly common among nursing home residents.  Over the past two decades, the number of individuals with mental illness–particularly depression—has increased significantly, and admissions for mental illness now exceed those for dementia. According to national statistics, nearly half of nursing home residents suffer from depression. At a March 27 Labor Management Project (LMP) and Continuing Care Leadership Coalition (CCLC) seminar addressing this issue, experts outlined various methods, including drum circles and pet therapy, for engaging uncommunicative or frustrated residents who may act out if they are unable to express themselves in other ways. “Drumming can be very energizing and cathartic, or very calming for residents,” said Paul Padial, the LMP consultant who led the drum circle. The owner of Tess, a therapy dog, explained that even very withdrawn residents often respond with a smile when touching the dog.

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The seminar was part of the LMP’s ongoing work to help our nursing home and other health care stakeholders address the challenges associated with the increase in mental illness and behavioral problems. Research suggests that nursing home workers are often ill-equipped to handle challenging conduct exhibited by residents who are dealing with these issues.  Nursing homes are also under increasing pressure from the Centers for Medicaid and Medicare (CMS) to improve behavioral health care, enhance the mental and psychosocial wellbeing of residents, and decrease the inappropriate use of antipsychotic medication for managing challenging behaviors.

The LMP is pursuing this work through two initiatives:

1. With the CCLC, the LMP launched a year-long Behavioral Health Learning Collaborative (BHLC) in February 2018 for staff at nine nursing homes and a managed long-term care plan. The aim of the BHLC is to provide nursing home leaders and front-line staff with information, best practices, and skills to improve behavioral health care for residents. So far, the BHLC has hosted two day-long seminars with about 40 nursing home staff from the participating nursing homes, including the one held this March. Participants have learned about CMS regulations, and non-pharmacological ways to manage depression, behavioral health, and “problem behaviors.” Pet therapy and the Music and Memory music therapy program have been among the interventions featured. Participants have also learned about the benefits of labor-management collaboration and process improvement (PI).

Four additional BLHC seminars are planned in 2018.  The LMP will also work with all participating organizations on establishing a labor-management behavioral health committee and guiding that committee through a behavioral health PI project.

2. The LMP is expanding its Mental Health First Aid (MHFA) offerings by certifying more of our consultants in the delivery of this eight-hour National Council for Behavioral Health course. To date, the LMP has trained nearly 175 health care staff in identifying, understanding, and responding to signs of mental illnesses and substance use disorders. Participants have responded favorably to the training. ”It was very educational, increased my awareness, and made me feel comfortable about assisting someone in crisis,” stated one participant. “I feel more confident in my work environment,” said another.

Learn more

Read the PowerPoint presentations from the March 27 seminar

Helping Nursing Home Staff Assist Residents with Mental Illness

LMP Advises Nursing Homes on how to Improve Mental Health Services

Improving Healthcare by Destigmatizing Mental Illness and Substance Abuse

Download a pdf of this article.

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