Caring for Residents With Mental Illness in Kentucky Nursing Homes

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We generally think of nursing home residents as elderly people, but people enter Kentucky nursing homes for various reasons. Some are physically disabled; some are aging and no longer able to care for themselves; some are mentally ill; and some have a combination of these factors.

When nursing home residents have mental illnesses, how are staff members trained to care for their unique needs? Approaches are tailored to the type of mental illness. Following are the forms of mental illness most often found in nursing homes, as presented on www.nursinghome.org, along with the staff’s way of providing care for these residents.

Schizophrenia

Individuals with schizophrenic disorders display these symptoms:

  • hallucinations;
  • delusions;
  • inability to take care of ADLs (activities of daily living);
  • bizarre behavior;
  • socially inappropriate behavior;
  • confused conversation;
  • low motivation;
  • poor hygiene; and
  • suspicious nature.

Components of treatment for residents with schizophrenic disorders include the following:

  • patience;
  • consistency;
  • caring yet firm approach;
  • medication;
  • not joking about or joining in the resident’s delusions; and
  • maintaining firm limits regarding boundaries.

Major Depression

Residents who are depressed display these symptoms:

  • sadness;
  • mental and physical slowness;
  • guilt;
  • low self-esteem;
  • inability to concentrate;
  • preoccupation with health;
  • talk about death;
  • tearfulness;
  • inability to enjoy life;
  • quick changes in mood;
  • sleep disturbances;
  • digestive problems;
  • extreme isolation;
  • internal focus that does not allow the person to see life realistically; and
  • weight loss.

Depression is generally treated with counseling, psychotherapy, or medication.

Bipolar Disorder

Once called “manic depression,” bipolar disorder involves a switch back and forth between states of depression and mania, usually once or twice a year. While symptoms of the depressive phase are similar to those of major depression, the manic phase includes the following:

  • extreme euphoria;
  • extreme irritability;
  • the tendency to talk a lot and more frequently;
  • a racing mind;
  • sleeplessness;
  • grandiose delusions;
  • pressured speech; and
  • engaging in enjoyable yet risky behaviors, such as extravagant spending or sexual promiscuity.

The depressive phase of bipolar disorder is treated with supportive interaction to reconnect the resident to staff and other residents. The manic phase is addressed by setting limits to keep the resident safe.

Anxiety Disorders

There are a number of anxiety disorders, including

  • generalized anxiety disorder;
  • panic disorder;
  • phobias;
  • obsessive–compulsive disorder (OCD); and
  • post-traumatic stress disorder (PTSD).

The common symptom of anxiety disorders is excessive, unrealistic fear.

Staff members deal with residents who have anxiety disorders by doing the following:

  • providing constant reassurance of safety and security;
  • assisting the resident with relaxation techniques;
  • not making residents do what they are afraid of unless they want to do it;
  • regularly reminding the individuals that their fears do not match the situation; and
  • medication (sometimes).

Personality Disorders

Personality disorders tend to be permanent traits, including excessive anxiety, dependence, paranoia, or antisocial behaviors. Caregivers deal with residents who have personality disorders by doing the following:

  • not getting angry or taking things personally;
  • setting firm limits while still fulfilling real needs;
  • avoiding being manipulated;
  • avoiding being turned against other staff members or residents; and
  • setting limits on inappropriate demands.

Has Your Loved One Been Injured In A Nursing Home?

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