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Senior Depression: Mental Health Services in Long-Term Care Facilities

By Lori Deschene

For seniors who live independently, mental health is largely dependent on their capacity for self awareness and their willingness to seek appropriate care. For those living in nursing homes or other long-term care facilities, the situation is a little more tenuous. As the numbers show, depressive and behavioral disorders are prevalent in these settings. In addition to the usual stresses associated with aging, such as loss of loved ones, physical deterioration, and fears related to death, seniors in long-term care facilities often struggle with increased isolation and debilitating physical ailments, which can exacerbate latent mental issues. Since residents of senior facilities are often in poor health and have decreased cognitive functioning, it’s not always easy to evaluate and treat these individuals.

How Medicare Helps Seniors with Depression

The Nursing Home Reform Act of 1987 stipulated screenings for mental illness and the reduced use of physical and chemical restraints. As part of the Omnibus Budget Reconciliation Act (OBRA), this law mandated some pivotal changes in nursing home care, emphasizing quality of life. In 1990, Congress responded by revising the Medicare laws, specifying beneficiaries will receive mental health care, if needed. Unfortunately, Medicare does not cover blanket screening procedures. This renders it virtually impossible to uncover hidden symptoms that residents sometimes hide to avoid stress and shame. In 2002, however, Medicare recognized the value of psychological services coinciding with the management of medical conditions. I translate this as such: if you’re already physically very ill, your mental health is important. If depression or mental illness is detected, and a doctor refers the resident to a psychiatrist, Medicare will cover 50 percent of the approved amount. This is a hefty co-payment, especially in relation to the 80 percent Medicare covers for doctor’s office visits. I think it’s safe to say navigating through the Medicare system can be a little confusing.

Treating Depression in Long-term Care Facilities

Several organizations have emerged to bridge the gap between mental health and long term care. VeriCare, for example, partners with skilled nursing and other residential facilities to create programs tailored to their residents’ needs. This company, founded shortly after the Nursing Home Reform Act, improves compliance with OBRA standards and provides behavioral and mental health services unavailable in most long-term care settings. In searching for a long-term care facility, a process Gilbert Guide simplifies, it may be wise to inquire as to what mental health systems they have in place. With over 50 percent of nursing home residents exhibiting signs of depression and under 5 percent of those individuals receiving treatment, it’s crucial to plan ahead. I certainly wouldn’t choose a home for my grandmother if her physical health might be jeopardized. I’m even more hesitant to choose a place that doesn’t recognize her mental well being as equally important.

Be well, be aware, be happy—

Lori Deschene