INVISIBLE RESIDENTS - THE CHRONICALLY MENTALLY-ILL ELDERLY IN NURSING-HOMES

This article presents results from a retrospective study of psychologi cal assessments of elderly persons with chronic mental illness residin g in nursing homes, All residents (N = 570) received this assessment a s part of federally mandated screening for mentally ill persons residi ng in longterm care. The process, the Preadmission Screening and Resid ent Review, was mandated by the Omnibus Budget Reconciliation Act (OBR A 87), These assessments were the first stage in a process to determin e if the nursing home was the most appropriate placement for each resi dent. If nursing home care was deemed appropriate, then a psychologica l treatment program was to be established within the nursing home sett ing. The sample ranged in age from 50 to 104 (mean of 70), The majorit y had a diagnosis of schizophrenia and a history of psychiatric hospit alization occurring early in their life. The assessments did not inclu de any quantifiable data on activities of daily living, cognitive func tioning, or level of psychiatric impairment. Therefore, the researcher s coded the narrative data so that it could be interpreted. The majori ty functioned within the none-to-mild range of cognitive impairment, a nd very few were completely dependent in the need for physical care, T he most recorded symptom was social withdrawal. Neuroleptic medication s were administered to 64% of elderly persons with chronic mental illn ess. Importantly, there was no relationship between demographic or cli nical information and treatment recommendations. Implications of these findings for psychiatric nurses are discussed. Copyright (C) 1998 by W.B. Saunders Company.