Psychiatry in the Nursing Home  book cover
2nd Edition

Psychiatry in the Nursing Home

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ISBN 9780789012197
Published May 29, 2001 by Routledge
276 Pages

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Book Description

Get the vital clinical information you need with this comprehensive handbook!

In the decade since the first edition of this book, dramatic changes have taken place in the field of geriatric psychiatry. Psychiatry in the Nursing Home, Second Edition, presents timely information on the newest trends in law, culture, and medications, while still offering essential advice on the fundamental concerns of caring for elderly patients with mental illnesses.

The new edition of this essential handbook presents up-to-date information on psychiatric issues involving nursing home patients. Featuring helpful case histories and diagnostic criteria, Psychiatry in the Nursing Home, Second Edition, helps you effectively treat such difficult problems as noisy patients, sexual acting out, and incontinence. In addition, it offers help with such administrative concerns as financial issues, absent or warring families, and staffing problems.

Psychiatry in the Nursing Home, Second Edition, presents incisive discussions of the changes in the field since the publication of the first edition, including:

  • the effects of the new Prospective Payment System
  • the use of newly released psychotropic medications
  • the altered nomenclature of the DSM-IV
  • the rise in assisted-living facilities
  • the rapid development of the specialty of geriatric psychiatry
With its comprehensive scope and practical advice, Psychiatry in the Nursing Home, Second Edition, is a must-have for nursing-home administrators and staff. Policymakers, mental health professionals, and geriatricians will be fascinated by the book’s wider considerations of the problems of housing and caring for the mentally ill and its provocative suggestions for future policy.

Table of Contents


  • Introduction
  • Part I. The Places
  • Chapter 1. The History of Nursing Homes
  • Omnibus Reconciliation Act of 1987
  • Chapter 2. Paper, Paper, Paper
  • Care Plans
  • Acronyms
  • Chapter 3. The New Asylums?
  • The Homeless and the Jailed
  • Deinstitutionalization and Transinstitutionalization
  • Chapter 4. What Is a Nursing Home?
  • Skilled Nursing Facilities and Intermediate Care Facilities
  • Board and Care Facilities
  • Section 8 Housing
  • Home Care Agencies
  • Assisted Living
  • Mixed Level Retirement Communities
  • Chapter 5. Who Pays for What?
  • Medicaid and Medicare
  • The “Spend-Down”
  • Long-Term Care Insurance
  • Resource Utilization Groups
  • Balanced Budget Amendment and Prospective Payment System
  • Health Maintenance Organizations
  • The Balloon
  • Chapter 6. Anger at the Nursing Home
  • Complaints
  • Nursing Home Exposés
  • Litigation Against Nursing Homes
  • Measuring Quality of Care
  • Part II. The People
  • Chapter 7. The Families
  • The Absent Family
  • Disputes Between Family Members
  • The Difficult Family
  • Chapter 8. The Staff
  • Owners and Administrators
  • Nurse Assistants
  • The Nurses
  • The Doctors
  • Other Mental Health Professionals
  • Chapter 9. The Patients
  • Age
  • Sex
  • Socioeconomic Status
  • Psychiatric and Medical Conditions
  • Measuring Need for Care
  • The Informal Network of Care
  • The Road to the Nursing Home
  • Part III. The Problems
  • Chapter 10. Psychotropic Drugs
  • Surveys
  • Backlash
  • The Impact of OBRA'87
  • Antipsychotics
  • Drugs for Mania
  • Anti-Anxiety and Hypnotic Drugs
  • Recommendations
  • Chapter 11. Memory Loss and Confusion
  • The Terminology of Dementia
  • How Many of the Elderly are Demented?
  • Measuring Memory Loss and Confusion
  • Treatment of Dementia
  • Head Injury
  • Mental Retardation
  • Chapter 12. Delusions and Hallucinations
  • Delusions in Depression and Mania
  • Schizophrenia in the Nursing Home
  • Late Paraphrenia
  • Phantom Boarders
  • Release Hallucinations
  • Management of Delusions and Hallucinations
  • Chapter 13. Sadness and Depression
  • Depression in Old Age
  • Depression in the Nursing Home
  • Depression and Dementia
  • Incidence of Depression in Nursing Homes
  • Rating Scales
  • Treatment of Depression in the Nursing Home
  • Antidepressant Medications
  • The “New” Antidepressants
  • Suicide
  • Chapter 14. Anxiety and Sleeplessness
  • Hysteria and Hypochondriasis
  • Panic Attacks and Agoraphobia
  • Agitation versus Anxiety
  • Psychotherapy
  • Sleep Disorders
  • Anti-Anxiety Medications and Sleeping Pills
  • Chapter 15. Wandering, Falls, Restraints, and Loss of Mobility
  • Wandering
  • Falls
  • Physical Restraints
  • Loss of Mobility
  • Chapter 16. Violence
  • Risk Factors
  • Classification
  • Management
  • Medications
  • Chapter 17. Nonviolent Antisocial Behaviors
  • Agitation
  • Demanding and Difficult Patients
  • Noisemaking
  • Drooling and Smearing
  • Hoarding and Rituals
  • Incontinence of Urine and Feces
  • Sex
  • Chapter 18. The Medical Interface
  • Medicalization of Care
  • Pain
  • Bedsores
  • AIDS
  • Nutrition
  • Chapter 19. Neurological Disorders
  • Communication Impairment
  • Stroke
  • Head Injury
  • Seizures
  • Parkinson's Disease and Parkinsonism
  • Chapter 20. Death and Dying
  • Patient Self-Determination Act
  • Dementia and DNR
  • Hospice Care
  • Hospitalization of Nursing Home Patients
  • Part IV. The Future
  • Chapter 21. What Is Wrong?
  • Research
  • The View from Abroad
  • Chapter 22. A Modest Proposal
  • Is Home Care the Answer?
  • Calling a Spade a Spade
  • Medicaid Should Be for the Poor
  • The Cheapest Gift is Money
  • Envoi
  • References
  • Index
  • Reference Notes Included
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