AMDA Tackles Mental Health Education

Many nursing homes have no access to psychiatric consults. Primary care physicians and interdisciplinary team members who care for elderly residents in these settings are asking for education in areas of diagnosis, assessment, treatment, and monitoring of patients with psychiatric conditions.

In response, AMDA has developed a new course focusing on mental health issues in long-term care. “Navigating Geriatric Psychiatry in Long Term Care: Evidence-Based Strategies for the Interdisciplinary Team” will focus on delirium, dementia, and depression.

Currently, 4 million Americans suffer from dementia. Most of them eventually will be admitted to nursing homes. Patients with dementia comprise approximately 50% of the residents in nursing homes in the United States. Behavioral symptoms of dementia are much more common in nursing homes than in the community, and create concerns for injuries to self, other patients, and caregivers, according to a recently published book Psychiatry in Long-Term Care.

Delirium (acute confusion) represents a significant source of morbidity and mortality for patients in nursing homes. Studies indicate that the incidence of acute confusion in residents of nursing homes ranges from 14% to 40%. Because of the prevalence, possible adverse consequences, and potentially reversible condition of delirium in nursing homes, it is critical that health care professionals working in long-term care settings are competent in the recognition, diagnosis, and management of delirium.

Studies have suggested that the prevalence of probable and or definite major depressive disorder among testable subjects was 14.4%. Prevalence of minor depression was 17%, and of clinically significant depressive symptoms, 44%. Only 37%–45% of cases diagnosed by psychiatrists were recognized as depressed by nurses, nurses' aides, and social workers.

Uncomplicated mood disorders can be evaluated by general psychiatrists, primary care physicians, psychologists, nurses, and social workers experienced in differential diagnosis of psychiatric disorders in the elderly. Research has established that depression can contribute to deteriorating health and death among older persons through direct effects on food and fluid intake, resulting in weight loss, malnutrition, dehydration, and impaired resistance to infection.

The new course is scheduled to take place on Saturday, Nov. 21, 2009, in Providence, R.I. The event offers participants the opportunity to meet, network, and share best practices with experts and colleagues in the long-term care environment. Course content is designed to enhance knowledge, competency, and patient outcomes through effective management and individualized therapies for delirium, dementia, and depression.

Medical directors are encouraged to attend with their directors of nursing as well as other members of the nursing staff. Attending physicians, physician assistants, pharmacists, administrators, and social workers are encouraged to attend for the group exchange and to gain practical information for optimal results in long-term care.

Presentations are expected to spark lively discussions and provide strategies for effective monitoring of recognition, assessment, and treatment protocols, and how to integrate regulatory guidelines into care plans to ensure regulatory compliance. Attendees will leave with valuable take-home messages and tools for immediate implementation in their practice setting including AMDA clinical practice guidelines for delirium, dementia, and depression and the Protocols for Practitioner Notification.

Continuing education credits for physicians, nurses, and nursing home administrators will be provided. Also available are prescribed credits for family physicians and credits toward the American Geriatrics Society's Geriatrics Recognition Award. For more program details and registration information, go online to www.amda.com/education/institute.