Magazine article Clinical Psychiatry News

Initial Psych Screenings Key at Nursing Homes

Magazine article Clinical Psychiatry News

Initial Psych Screenings Key at Nursing Homes

Article excerpt

SAN JUAN, P.R. -- Consulting psychiatrists can help improve the lives of nursing home residents by establishing psychiatric diagnoses, coordinating medications, and educating staff, Dr. Olivera Bogunovic said at the annual meeting of the American Association for Geriatric Psychiatry.

An estimated 91%-94% of nursing home residents have some form of psychiatric disorder, said Dr. Bogunovic, professor of psychiatry at the State University of New York at Buffalo. Despite that high prevalence, though, only 2.3% of nursing home residents receive psychiatric consultations.

Consulting psychiatrists, therefore, play an important role in caring for nursing home residents--who are usually managed by internal medicine physicians. Most important, psychiatrists establish a diagnosis, said Dr. Bogunovic, who has also worked as a psychiatric consultant in nursing homes for several years.

Psychiatrists also can assess the interaction between patients with psychiatric disorders and nursing home staff. By educating staff about a patient's condition, psychiatrists can improve general patient care.

In addition, nursing home patients are often taking several medications. "The role of the psychiatrist is to optimize medications and simplify drug routines," Dr. Bogunovic said. Make sure to discuss the rationale for medications with staff and provide for medications about possible drug-drug interactions.

Consulting psychiatrists should also arrange for brief psychiatric hospitalization when necessary. Psychiatrists are often called upon to make competency assessments.

Consulting psychiatrists also have an important role to play in helping nursing homes conform to requirements of the Omnibus Budget Reconciliation Act (OBRA). These regulations require that individuals admitted for the first time to a nursing home be prescreened for major psychiatric disorders. …

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