Psychiatry in the Nursing Home

by D. Peter Birkett

Overview

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.

Product Details

ISBN-13:	9780789012197
Publisher:	Taylor & Francis
Publication date:	05/29/2001
Edition description:	2ND
Pages:	276
Product dimensions:	5.44(w) x 8.50(h) x (d)

Table of Contents

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

Editorial Reviews

Deep understanding of the subject—great wisdom and practicality. Global and comprehensive, yet simple. . . . Should be introductory reading for doctors and nurses, psychiatrists and geriatrics.

William Reichel

Reviewer: Daniel Loiterstein, MD (Rush University Medical Center)
Description: Geriatric psychiatry has evolved into a complex subspecialty. Practitioners must have knowledge and expertise that traverses not only psychiatry, but also public policy, law, and culture. This book undertakes the daunting task of explaining the care of the elderly in nursing homes.
Purpose: The objective is to provide both a comprehensive overview of nursing homes and a clinical handbook with practical use. These broad objectives are clearly met. The impact and nuances of a new law may be discussed in one chapter, while specifics of psychopharmacologic treatment are covered in the next.
Audience: Just as the backgrounds of people working with nursing home patients are broad, so is the audience for the book. Although physicians may find the material on psychotropic medication basic, they may find other sections very informative. The same may be said for administrators, social workers, or nurses. Dr. Birkett has been in the field of geriatric psychiatry since its beginning. Not only is he a credible academic, but he also remains an active clinician.
Features: The book is cleverly divided into four main sections: the places, the people, the problems, and the future. Not only does Dr. Birkett quote pertinent facts and studies, he also draws on his years of experience to provide useful and relevant anecdotal material. Perhaps the most interesting portion of the book is the final sections. The author provides his own proposals for fixing problems described in the previous chapters. The main shortcoming is also a stated objective. For many professionals in psychiatry the clinical material may be a review.
Assessment: This book is a valuable review of geriatric psychiatry in the nursing home. With the aging of the population, the relevance of the topic expands continually. The second edition provides a needed update about a dynamic topic.

Doody's Review Service