Mental-Health Issues in Long-Term Care Facilities

While long-term care facilities range in scope from mental institutions and homes for the mentally handicapped to nursing homes and assisted-living facilities, the largest segment consists of the elderly and terminally ill. Dealing with mental-health issues is particularly important in such settings. Most residents are facing life-changing issues and trying to cope with the mental and emotional challenges that accompany them.

Depression

• Depression is one of the most common mental-health problems in long-term care facilities, as the Gilbert Guide reveals. Learning to face and deal with the post-retirement stage of life brings new challenges to older people. The resident may feel lonely, fear death, or experience helplessness, frustration, hopelessness or even anger.

  Symptoms of depression include feeling "down," not enjoying things previously liked, difficulty falling asleep or sleeping all the time, loss or increase in appetite, crying or acting out emotionally, anger, irritability, suicidal behavior or expressions, restlessness or slowed movement and a "who cares" attitude. Support groups, individual therapy and medicines can all help alleviate depression in the elderly. Also, making them feel included and sparking their interest in something can help. The most important factor is often human interaction, especially with loved ones.

Delirium

• While not technically a mental illness, Wayne State University of Gerontology explains, delirium affects the mind, so is often categorized as a mental-health issue in long-term care. Delirium can be caused by medication, a reaction to leaving familiar people and places, a brain injury such as stroke or medical conditions such as diabetes.

  The alertness level and behavior of a resident suffering from delirium will be erratic. He may act agitated without warning, then fall into a stupor, or may know exactly where he is at the beginning of a conversation, but forget by the end. Mild hallucinations can occur.

  When the condition causing the delirium is treated, the delirium often disappears, according to Wayne State. However, some cases remain. Therapy can help the individual cope, adapt and at times overcome the condition.

Dementia

• Dementia can appear similar to delirium; sleep patterns may be disturbed, memory can be impaired and even mild hallucinations can occur. The resident may forget where she is, what time or date it is or who someone else is.

  Unlike delirium, dementia is a slow process. By the time a name has been put to the problem, others can look back and see "something wasn't right" for a long time. According to Wayne State, the dementia may be caused by Alzheimer's, brain injury such as mild strokes or even long-term damage from alcohol.

  It is very important for elderly people displaying dementia to be evaluated by a medical doctor. Some causes can be cured; others can be treated with medicines to slow the progress and to eliminate behavioral problems that may accompany the dementia.

Other Mental Illnesses

• As Continuing Ed Courses reveals, other mental-health illnesses such as bipolar disorder, schizophrenia, generalized anxiety and obsessive compulsive disorder exist in the long-term care population. The illnesses are likely preexisting, but institutionalized living can create new and greater pressures affecting mental health. Continued medical and psychological care for these individuals is vital.

Behavioral Problems

• Behavioral problems can occur with any mental-health issue or simply result from coping mechanisms devised by the resident to deal with or express his emotions. According to Dr. Malaz Boustani in Psych Central, such behaviors can range from constant humming or repeating questions and phrases to wandering, pacing and hoarding or repetitive movements such as hand-wringing. Aggressive behavior can also occur, including hitting, spitting and throwing things. Behavioral therapy and some medications can help behavioral problems.