NURSING HOME CONSULTATIONS
Posted by recep on June 25th, 2009NURSING HOME CONSULTATIONS
While most literature on geriatric consultation-liaison psychiatry focuses on consultations in general hospitals, such consultations can occur in all medical service settings.
Psychiatric disorders are quite prevalent (estimates range from 75% to 95%) in nursing home patients, in whom behavior disorders associated with dementia and depression are particularly common. The Omnibus Reconciliation Act of 1987 (OBRA 87) mandates psychiatric assessment of nursing home patients, but its impact on consultation psychiatry services has not been well studied. Most primary care physicians are not trained in the assessment and management of psychiatric and behavioral problems associated with depression and dementia, although some physicians are. Furthermore, the time required for thorough evaluation and treatment is rarely available to primary care physicians. Thus, despite the OBRA 87 mandates and the high prevalence of psychiatric disorders, only a minority of elderly long-term care residents who need psychiatric assessment and treatment actually receive it.
